Choice is a fundamentally human quality. Not just epic or major decisions either. Beyond free will and religious notions of choice, there is a quality contained within the simple, everyday decision process that defines our lives as human beings; which sandwich to order, the best route to take home, what station to listen to. These little determinations result in the greater patchwork of our daily lives and histories.
The ethical dilemma concerning prenatal testing sidesteps the pro-life, pro-choice question and begets one equally complex and challenging
But decisions are more than the sum of our choices. Children from a very young age begin to realize notions of consequence for their actions and decisions. The bible too notes that free will alone separates us from a divine plan, but that our freedom to do good or evil will result in punishment or reward. The same free choices that give us liberty can harbor immense results in this life and, according to some, the one thereafter.
These days we have more decision making power than ever before. Our notions of consequence are infinitely more informed than those of our ancestors. Most recently the incredible advances in genetic testing have extended this power. Genetic and prenatal tests can now determine likelihood that a child will be born with a birth defect, chromosome abnormalities, genetic diseases and other conditions, such as spina bifida, cleft palate, Tay Sachs disease, sickle cell anemia, thalassemia, cystic fibrosis, and fragile x syndrome.
Pregnant parents who undergo prenatal testing are then at a major decision making crossroads, if doctors or genetic testers inform them that a child is predisposed to such conditions. Should they view this as a challenge or burden, a responsibility they have acquired for better or worse, or should they abort the fetus entirely?
Obviously this quandary gives rise to the ethical debates similar of Roe vs. Wade and pro-choice vs. pro-life, but let’s evade those issues entirely and for the moment focus elsewhere.
The ethical dilemma concerning prenatal testing sidesteps the pro-life, pro-choice question and begets one equally complex and challenging. Fundamentally, the abortion debate questions one’s right to choose whether or not to have a child, but prenatal testing grants would be parents another choice: What kind of child to have.
When a woman opts to abort a fetus, we generally perceive that choice as being a symptom of the fact that she does not desire a child at the time. But parents who opt to abort because they have been told their child might be born with a defect are making judgments beyond their immediate offspring. Such parents might be said to have judged that certain human lives more valuable than others and that the sick or handicapped are less deserving of life.
These considerations ring eerily reminiscent of the eugenicists who believed that human hereditary traits could be altered by controlling (sometimes forcibly) reproduction within the population. Terrifyingly, eugenics was first successfully practiced within the United States on 30,000 prisoners who were deemed unfit to reproduce. Hitler and the Nazi party, influenced by eugenics, overtly shared the belief that certain human lives are more valuable than others. In 1934, the party enacted the “sterilization law” under which between 300,000 and 400,000 people deemed “feebleminded” were sterilized through vasectomy or litigation of ovarian tubes in women. The victims of this heinous policy were not blanket racial or ethnic groups, but the infirm, handicapped and mentally disabled. While advocates of prenatal testing are only gauging their immediate offspring’s right to life, the practice is philosophically evocative of eugenicists nonetheless.
Consider also the testing methods and scientific accuracy of prenatal testing in general. The prenatally administered Quad test is hardly 100% accurate; in fact it has a 5% false positive rate. Many mothers informed that their fetus is at high risk for Down syndrome or other genetic illnesses suffer undue stress and anxiety from false results. Stress is thought to be a high contributing factor in miscarriages and should certainly be avoided during pregnancy.
Steven Spielberg’s 2002 sci-fi film “Minority Report” deals with questions of premonition that are food for thought when considering prenatal testing’s accuracy. In the film a pair of “precogs” are responsible for predicting “precrime”, criminal acts that have yet to take place. A specialized police force then arrests individuals based upon their, unrealized, prophecy. The films central themes of freewill vs. determinism are philosophical fodder in assessing prenatal testing. Does a doctor’s scientific premonition is some way alter the course of events? We already know that prenatal testing isn’t entirely accurate, so is being aware of a possible fetal defect a terrible form of determinism?
Ultimately, no one right of mind would ever claim that being concerned for the welfare of an unborn child is somehow wrong. But claiming that certain lives are preferable to others is frightening nevertheless. Still, we should perhaps celebrate the evolution of decisions beyond: that each of us will have to be judged on his or her own merits accordingly.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care an appropriate healthcare provider.