The systematic screening for people with Down's Syndrome is unlawful...
There has been a revolution in attitudes towards disability in recent years. Yet Richard Dawkins’ recent recommendation to abort a foetus with a disability points to a contradictory zeitgeist.
'Abort it and try again. It would be immoral to bring it into the world if you have the choice.’ This was a piece of advice atheist writer Richard Dawkins recently dished out via Twitter to any mother who finds out she is expecting a child with Down’s syndrome.
Famous people often complain that their views have been taken out of context, but Twitter deprives them of this excuse. When the Oxford professor clicked that little ‘tweet’ button, he made a conscious decision to tell his 1.3 million followers that parents who discover severe disability early enough – that is, during pregnancy – should rid themselves of the burden. They shouldn’t just be allowed to abort that disabled foetus; they’re morally obligated to.
Dawkins’ tweets provoked an outcry from parents of and advocates for the severely disabled. One mother of a child with Down’s syndrome declared: ‘I would fight till my last breath for the life of my son.’ Her sense of indignation was echoed by Carol Boy, chief executive of the Down’s Syndrome Association: ‘People with Down’s syndrome can and do live full and rewarding lives. They also make a valuable contribution to our society.’
Admittedly, Dawkins’ ability to offend isn’t exactly noteworthy. No, the real significance of the row lies in something Dawkins said, again via Twitter, in his defence: ‘Apparently I’m a horrid monster for recommending WHAT ACTUALLY HAPPENS to the great majority of Down’s syndrome fetuses. They are aborted.’
The thing is, Dawkins is not wrong here. The majority of foetuses with Down’s syndrome are indeed aborted. In the UK, 750 babies are born with the condition each year, according to the NHS, while nearly 1,000 are aborted. But if this is ‘what actually happens’, it’s hard to resist drawing the conclusion that in the outcry against Dawkins this summer we saw an extraordinary moment when society expressed moral outrage about itself; when we were provoked by one of our own common practices.
"THIS SUMMER WE SAW AN EXTRAORDINARY MOMENT WHEN SOCIETY EXPRESSED MORAL OUTRAGE ABOUT ITSELF "
A PROFOUND CONTRADICTION
This irony takes us to the heart of a larger contradiction: on the one hand, there has been a revolution in attitudes regarding disability. Say what you will about the late-modern West. Lament the inequality of wealth. Bemoan the pervasive secularism. But if you have a profound mental or physical disability, into which other period of history would you prefer to be born?
Even in the last 20 years we’ve seen remarkable progress in the UK. In 1994, disability charity Scope undertook the largest survey ever conducted of disabled adults in the UK. They found that many disabled people felt they were ‘living in a world apart’; on the receiving end of deep prejudice. Fifty-nine per cent had been stared at because of their disability and 38% reported name-calling. By contrast, Scope found that both figures had approximately halved in 2014. On the other hand, over the same 20-year period, the development of prenatal diagnosis, coinciding with the legalisation of abortion, has increasingly afforded opportunities to abort disabled foetuses; opportunities that have been taken.
Dutch ethicist Hans Reinders refers to this contradiction as the ‘disability paradox’. In his seminal book, The Future of the Disabled in Liberal Society (University of Notre Dame Press), he reflects:
‘Curiously enough we find ourselves confronted by two different worlds with respect to disability. One is the world of normalization, depicting disabled people not unlike ourselves, people who have been wronged by their unnecessary exile from ordinary life and who, therefore, deserve our support. The other world is the world of prevention, which depicts living with disability as a fate that can be worse than death and offers a rationale for justifying the practices of selective abortion.’
To put it more starkly, we have on our hands a serious case of mixed messaging. The first message to the disabled and their families is: ‘Since you’re here, we’re going to care for you as best we can.’ The second is: ‘But everyone would be better off if you were not here at all.’
IN A HEARTBEAT
My wife Holly and I went to see our doctor two weeks after we found out we were expecting a baby. I was nervous that Holly had somehow been making it all up. Our doctor positioned the Doppler scanner. We waited and waited. My kingdom for a heartbeat! And then, at long last, the faint whirling of a helicopter. A beat! A heartbeat! A life! This was confirmed when our doctor’s face creased into a grin.
‘Does that mean it’s real?!’ I cried.’ ‘Yes,’ she replied. ‘A hundred and two beats a minute. Baby sounds good.’ (Why do doctors always lop off the definite article on ‘baby’?) Suddenly, though, the conversation took an about-turn:
Dr: ‘Have you thought about whether you want tests done?’
Me: ‘What kind of tests?’
Dr: ‘You know…tests for things like spina bifida?’
Me: ‘Why would we want to do that?’
Dr: ‘So you could, you know, decide…’
Me: ‘Decide what?’
Dr: ‘Decide whether you wanted to carry on with the pregnancy.’
Me: ‘As opposed to…?’
Dr: ‘Well, I suppose, terminating it.’
Me: ‘You mean, we could terminate the pregnancy because the baby might be disabled?’
Me: ‘Don’t you think that’s prejudicial towards disabled people?’ My wife Holly: ‘I’m sorry. My husband’s an academic.’
"HAS PRENATAL TESTING FOR DISABILITY LED TO THE RE-EMERGENCE OF EUGENICS?"
THE INVERSION OF MORALITY
Perhaps the outcry at Dawkins’ tweets has more to do with his assertion that, given the choice, it is ‘immoral’ to bring a disabled child into the world. In terms of ethics, Dawkins has made a decisive move: from saying you’re morally permitted to do something to declaring you’re morally obligated to do it. Is that what the parents of Down’s syndrome children find so offensive?
Again, it’s vital to stand back and try to see the big picture so we can be, in the words of the chronicler, people who ‘understood the times’ (1 Chronicles 12:32).
What we’re seeing is an intriguing, though tragic, example of an inversion of morality. It goes a bit like this:
1. People should not do something
2. It’s permitted to do that thing
3. People should do the exact thing that was previously prohibited
Though abortion has always been practised, ‘conventional morality’ viewed it as wrong in the past (option 1 above). But from the 1960s onwards, as social mores and the legal situation changed, we moved from (1) to (2). Terminating an unwanted pregnancy – including pregnancies that were unwanted following the detection of disability – came to be seen as a difficult but acceptable personal choice (2).
Now, though, the routinisation of genetic screening has led to a situation in which many couples report feeling pressure, even from the medical profession, to do exactly what used to be forbidden: having an abortion. The raised eyebrow of an ultrasonographer, the continued questioning of an obstetrician about whether you ‘really know what it will be like to raise a child with Down’s?’ you can see why parents can be left with a strong sense that it would be irresponsible to proceed with the pregnancy.
THE RE-EMERGENCE OF EUGENICS
Understanding the times requires us to relate this inversion of morality to the key question that dogs the whole debate. Bluntly, has prenatal testing for disability led to the re-emergence of eugenics?
The word ‘eugenics’ immediately conjures up the horrific spectre of the state-sponsored elimination of the ‘unfit’ in Nazi Germany. What has been forgotten is that eugenics in the 20th century was not confined to Nazism. Eugenics – both ‘positive’ and ‘negative’ – was at the forefront of progressive thinking and policy in liberal countries. It was seen as an innocuous but essential aspect of public health.
An astonishing 63,000 people were sterilised by the state in Sweden between 1935 and 1975. The majority were women. While many US states had initiated sterilisation programmes in the 1920s, senior Virginian doctor Joseph DeJarnette complained in 1934 that: ‘The Germans are beating us at our own game.’
The crucial difference between now and then is that in the past eugenics was carried out coercively. Today, couples freely choose not to bring disabled children into the world.
That’s the argument. Yet, if there really has been an inversion of morality in our society, it is questionable how ‘free’ that decision really is. Coercion is a subtle beast, and it is arguably more effective the less obvious it is. Why might a sense of moral obligation percolating down through society – the obligation not to continue with a pregnancy where Down’s syndrome is diagnosed – prove more effective in the long term than a law?
THE WELCOME OF THE KINGDOM
The Bible obviously doesn’t mention the specific issue of prenatal screening for disability, nor even the practice that was contemporary: abortion. Does that mean Christians should look elsewhere for guidance on whether to undertake genetic testing? If they do so and the tests prove positive, how do they make the gut-wrenching decision that follows?
‘Our texts say not a word about what it means to be a good person or to serve God’s will in these extraordinary situations,’ concludes critic Ruth Schwartz Cowan in her book Heredity and Hope: The Case for Genetic Screening (Harvard University Press).
I disagree. Any theological response to severe disability must begin with the ministry of Jesus. His fame spread on account of his healing miracles. The Son of Man cured the chronically ill men and women who crossed his path: ‘A man with leprosy came and knelt before him’ (Matthew 8:2).
A paralysed man was brought to Jesus by friends who were so desperate to help him that they vandalised someone’s roof (Luke 5:19; I’ve always wondered whether they paid for the damages). And think of the woman who had been crippled for 18 years (Luke 13:10-17).
Yet, as New Testament scholar NT Wright has persuasively shown, Jesus ‘never performed mighty works simply to impress’. In Jesus and the Victory of God (Fortress Press), Wright urges us to see these healings in their original context: ‘For a first-century Jew, most if not all of the works of healing could be seen as the restoration to membership in Israel of those who, through sickness or whatever, had been excluded as ritually unclean.’
EXCLUSION OR EMBRACE?
For Jesus, this wasn’t just about physical healing, awesome though that was. The extraordinary healings demonstrated what Wright calls ‘the open welcome which went with the inauguration of the Kingdom’. And Jesus then enjoined this welcome on his followers.
The Church was, and is, supposed to continue the ‘open-table fellowship’ that defined Jesus’ ministry: engagement, acceptance, hospitality towards and friendship with those ostracised by society; not least those living with disability.
Abortion may historically always have been a possibility, albeit to varying degrees of safety. But abortion specifically on the grounds of disability is a new possibility only admitted by technological advances. Exclusion or embrace? We face the choice earlier and far more starkly than our ancestors. Welcome begins in the womb.
Stanley Hauerwas, an American theologian who has thought deeply about disability, wrote an essay on abortion that joins up biblical convictions to arrive at this conclusion: ‘The church is a family into which children are brought and received. It is only within that context that it makes sense for the church to say, “We are always ready to receive children. We are always ready to receive children”.’
Hauerwas addresses not just parents in the Church, but the Church community as a whole. How can we, as the larger Church family, support individual families to receive children who have been diagnosed with severe disability? How can we, as local communities of Christians, become the kind of people who practise the welcome of the kingdom?
Sterilisation: Preventing the severely disabled or otherwise ‘unfit’ from procreating. In 1927, Supreme Court Justice Oliver Wendell Holmes argued: ‘It is better for all the world if…society can prevent those who are manifestly unfit from continuing their kind…Three generations of imbeciles is enough’
Euthanasia: The putting to death of children diagnosed with severe disabilities upon birth
Actively encouraging reproduction by people of good stock
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