This post is inspired by "The Last
Children of Down Syndrome", by Sarah Zhang, in the December 2020
issue of "The Atlantic". The starting point of the article
is how few children with Down syndrome are being born in Denmark, a
country which offers to all women free genetic testing. Abortion is
not just legal, but socially accepted and even expected in cases
where Down syndrome is detected. The article raises many issues, but
my main reaction is that it is examining a subject that is "tame"
in many respects, and more interesting questions arise if we let the
wild beasts loose and discuss those issues.
Zhang tells us that when people do have
a Down Syndrome child, they typically love him or her and feel glad
they did not abort him or her. By extension, those who are
considering an abortion also realize they would likely feel the same
way if they let the pregnancy continue. Going beyond the premise of
the article, this is surely the case for the far more common
situation where a woman aborts because she does not want any child at
that time. Some women regret that choice, but a great many do not.
For those women, a fetus is not a child with the rights of a child,
but just a potential child.
As an aside, I join most people in
feeling that a woman has an inalienable right to bring to term any
pregnancy she has, regardless of what she knows about it.
One of the key elements is information.
In the old days, pregnant women knew only that they were going to
bear a child (or perhaps two) and knew nothing about them. With
prenatal screening, there is some information, and an ability to
choose. When is there too much information?
I read an intriguing short story not
long ago about a society where they could determine the exact genetic
sequence that a woman or man would contribute to a baby if they were
to have intercourse right then. This doesn't require much fiction for
women, where the identity of the egg and its genetic make-up are in
fact determined, and the only scientific problem is how to detect it.
It is less plausible for men, but you could imagine technology that
would somehow identify the one sperm that would do the fertilizing.
The story continues to include an app on each person's phone that
would automatically be loaded with that genetic sequence, and an app
that can combine them so it knows the genome of the baby that would
result if the two of them had sex. Technology had also advanced to
the point where they could "age-progress" this genetic
sequence forward and get a good indication of what the child would
look like, its IQ, its likes and dislikes, and its mannerisms. You
could look at a little video of the child you could make with this
person you're with. Faced with shrinking populations, governments
might subsidize the program!
I expect this is a world that would
drive people crazy with anxiety and grief. There is no physical
embryo whose rights a person might want to protect, but there is an
"informational baby". If you're sitting next to someone at
a concert, or waiting in some line, or in your aerobics class, the
two of you looking at your phones can see a potential baby. But if
you don't have intercourse with that person, such a baby will never
exist. If a woman turns to the man on the other side of her, the
profile of a different baby will appear. The failure to have
intercourse with each of these other people is killing a baby whose
properties you can identify. TMI today stands "too much
information" and is used today in a lighthearted way, but in
this imaginary but possible world it would apply with full force.
One aspect that is absent from most
debates about abortion is what the economists would dryly call
"opportunity cost". If you live in a world where
pregnancies are planned, terminating one baby likely results in the
creation of another one. On its more ominous side, carrying the one
baby to term precludes life of another baby, even if we in fact don't
know anything about its properties.
As for knowing you will love any baby
you get, consider this case. A woman who would never have an abortion
gets pregnant by a brutal rape. Chances are that the resulting baby
will be as delightful and charming as any other baby. Beholding her
delightful 3-year-old, can the woman say she is glad she was raped,
since otherwise she wouldn't have the baby? She might say that, but
surely no one wants to work backwards and offer it as an excuse for
rape. Imagine a rapist in our science fiction world showing his
victim the baby that would be born if he follows through with his
rape, and telling the woman that unless he rapes her she is denying
that baby a chance at life. We are in the territory of moral
nightmare.
As a result of all those
considerations, I feel like a woman should choose whether or not to
continue a pregnancy, armed with whatever information she has,
without any moral qualms. Sarah Zhang is shocked by a parent of a
Down syndrome baby saying, "we would have asked for abortion if
we knew". She shouldn't be shocked. A mother after a bitter
divorce can say, "I wish I hadn't married him" without
betraying her children by that marriage. Telling your child, "I
wish you had never been born!" is typically a very bad thing,
said in the heat of anger about one's current feelings. But if in a
calm and loving moment, as a result of questioning and honest
conversation, you admit to your child that they were the result of an
unplanned pregnancy that upset you a great deal, that is just telling
the truth.
An issue that the article touches on is
that of removing heritable genes from the gene pool. Down syndrome is
not caused by the allele of a particular gene, and in fact those with
Down syndrome very rarely have children themselves in any case. If
the genes for Tay-Sachs or cystic fibrosis plummet in the population,
few people will mourn. There are other genes that we will identify
that tend to make a person dumber, less attractive, less athletic,
less outgoing... and we will argue about those. But, to get whimsical
for a moment, suppose there were a detectable gene that strongly
predisposes a person to become a Republican. That would invite a
field day of comment and argument.
A far more consequential form of
screening is the abortion of girl fetuses, notably in India. Here the
undesirable trait to be eliminated is in fact a necessary trait of
one of the two parents. How do Indian women feel about having their
girl babies aborted? Perhaps the same culture that allows such a
practice enforces silence on women about such issues. Perhaps there
are such articles that I do not know about. Or perhaps the women
share the same set of beliefs. I have heard of Jewish mothers who are
elated to find they have given birth to a son, since the life of a
woman is so hard in Judaism (as they see it).
My conclusion that people should choose
whether to abort fetuses given what they know does not address this
case in India. My view does not allow for moral outrage at the
termination of any particular girl fetus. If a family from any
culture has three girls and chooses to abort female fetuses until
they get a son, my principles don't object to that, and similarly a
family of three boys can abort male fetuses until they get a
daughter.
To the extent I deplore society-wide
selective girl abortion (and I do) it has to be on other grounds. A
topic for another day.
