By Dave Andrusko
The headline for Appiah’s post is “Does Prenatal Testing for Down Syndrome Amount to Eugenics?”
The subhead softens the decision to abort a baby who has Down Syndrome: “The magazine’s Ethicist columnist on the moral concerns associated with certain medical exams.”
The way the column works is that people write in with their dilemmas and Appiah offers his insight.
A husband writes that and his wife are planning on having children sometime but worry about “challenges,” one of those “challenges” being a child with Down Syndrome. He knows there are tests that “might tell us if he or she comes with any health challenges and allow us to terminate the pregnancy if we decide that we do not want the added responsibility (and medical bills).”
What’s his question?
We’re worried this course of action might constitute practicing eugenics. Is this decision morally wrong? —
To be clear, as a rule, Appiah shuns making overt judgments, moral or otherwise. So…
They are not “practicing eugenics.” Why? The history of eugenics began in the 19th century with Francis Galton, a cousin of Darwin’s, “who was drawn to the idea that humanity, like livestock, should be improved through selective breeding.”
But “Real harm happened when the state [The Nazis] used its powers of coercion in pursuit of this aim.”
“Real harm?” That’s putting it in the mildest possible terms.
So this couple shouldn’t be worried that they would be “practicing eugenics,” should they abort, because [a]the power of the state is not forcing them to have an abortion and [b]
You’re not hoping to affect our common genetic stock (people with Down syndrome rarely have children, though the rate of Down syndrome in their children is quite high when they do). What you are considering, then, isn’t a eugenic choice.
But bioethicist Wesley J. Smith keenly understands where Appiah’s reasoning falls short:
This is too narrow a view of what constitutes eugenics. Eugenics is more than trying to control the health or other attributes of a general population. Rather, it reflects an all-too-commonly promoted mindset that some people are better or have greater value than others, and that an acceptable answer is to make sure disfavored persons are never conceived — as in the old eugenics of the early 20th century — or never make it out of the womb as occurs today (or even, serving as a justification for infanticide as justified by utilitarians like Peter Singer).
Appiah uses the fact that 2 out 3 babies diagnosed with Down Syndrome babies are aborted to opine “Your sentiments would seem to ally you with the majority, going by the choices people make.”
But to be fair, while we may (and do) disagree over Appiah’s conclusions, he does make some very good observations at the end. For example
At the same time, I worry a bit that your reason for not wanting a child with Down syndrome reflects a misunderstanding of what that child’s life will be like. While people with Down syndrome had severely curtailed lives in the past — their life expectancy in the early 20th century was estimated to be about 9 years — they are now living much longer. Recent estimates suggest that a child with Down syndrome will now have a life expectancy of around 60 years.
He concludes with very encouraging (and very accurate) advice:
When you’re thinking about what may lie ahead for your offspring, it helps, I think, to maintain the proper perspective about what it is to live well, which is what Aristotle meant by ethics. Human life is not a competition in which everyone places somewhere in a ranking from one to eight billion. That’s because each person has different capacities, aims, relationships, projects and identities. These are all relevant to deciding what a good life is for them. Once children with Down syndrome are born, the task of families, medical professionals and teachers is to identify what these children need to develop their capabilities, which will be different for each one. The task, in other words, is to give them a chance at living their best lives. The same thing goes for all children, of course, whatever their endowments.
Indeed, “whatever their endowment.”