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.
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