Saturday, August 23, 2014

The new eugenics

Due to amniocentesis (which is unobjectionable in itself), I expect there will be increasing pressure to euthanize the developmentally disabled. Indeed, bioethics is moving beyond abortion, which it takes for granted, to infanticide ("after-birth abortion"). 

I expect the pressure will be due to increasing hostility towards the developmentally disabled. Parents will be publicly shamed for having developmentally disabled kids. Social disapproval will be extended to them and their kids, functioning as a deterrent to other prospective parents who flout social convention by daring to have developmentally disabled kids. 

In other words, you might have parents who, left to their own devices, would bring a developmentally disabled child to term, but there will be an external disincentive in the form of peer pressure. If the power elite succeeds in secularizing law and culture, this will become a very dangerous world for the weakest, most defenseless members of society. Indeed, we're already well-advanced in that direction. 


  1. Amniocentesis carries with it a small but definable risk of death/damage to the unborn child. Therefore if it is undertaken in a situation such that there is no potential for benefit to the child then it is blatantly unethical. Simple blood tests that purport to screen for disabilities & ultrasounds are also making life hazardous for the developmentally disabled. In a nation that kills it's own children at a rate of ~1 million a year one expects nothing better.

  2. I'm dubious of this hidden premise"

    • If X has an extremely low likelihood of killing person Y, then if doing X is not beneficial to Y, it is obligatory that you not do X.

    Seems to me there's *dozens* of cases where the antecedent is true and the consequent false. What's the argument for this premise?

  3. Mr F:
    I probably left out a mental step or two. Amnio is most commonly carried out in 2 specific circ's: 1) To ascertain the lung maturity of the baby to see if it would be safe to deliver the child early due to some specific risk to allowing the pregnancy to continue (e.g., preeclampsia, amnionitis), and 2) To confirm the presence or absence of a developmental disability. In the second case there is no discernible benefit to the baby, even if there is no malign intention on the part of the parent(s) or physician. In fact, of course, case 2 is almost always carried out so that an abortion can be done if the disability is confirmed.
    I make no claims to being a philosopher or logician. How low of a likelihood of death to an innocent who is unable to consent to the procedure is low enough to make an action ethically permissible? The risk of fetal death from amnio is ~ 1 in 200.

  4. Perhaps someone like Doc can correct me if I'm mistaken, but my understanding is (assuming the mother doesn't miss the time frame in which the screening tests can be undertaken) the nuchal translucency test as well as the triple test are more commonly performed to screen but not diagnose Down syndrome. Only if screening tests are positive do we move onto diagnostic tests like amniocentesis and chorionic villus sampling. At least that's what we've learned in med school, but this may differ in real world practice.

  5. I think you're right; I don't actively practice OB anymore, so I'm not sure what is typical these days, but I suspect that they are done as screening. If (+) typically an US is done (if it hasn't been done all ready). If inconclusive then amnio is typically recommended. Amnio w/o prior screening is typically offered to those considered to be at 'hi risk' for Down's etc. All of this is why I and most others who take care of kids see very few Down's children these days. Most have been victims of search and destroy missions before they're born.

  6. Thanks, Doc. That's quite informative!

    By the way, I don't suppose you might know if there are some parents who have had one of the screening tests, and received a positive for Downy syndrome, and so end up aborting their supposed Down syndrome child without a diagnostic test? I imagine it's possible a screening test could yield a false positive for Down syndrome, and so the parent(s) ends up aborting a perfectly normal child. But maybe (hopefully) this doesn't actually happen.

    Also, I don't know the sensitivity or specificity of the diagnostic tests, but I wonder how reliable they are?

  7. Afraid I don't know the specificity and sensitivity of the screening tests, and a quick search in my online Med library failed to disclose the info. If I had to guess I'd put them both in the 80% range. Amniocentesis would be in the hi 90% range. I doubt if anyone has good data on what actually goes on in a typical OB's or FP's office when the screening results are discussed, how much info is given, etc; the 'official' recommendation would be that an amnio be done to confirm or refute a (+) finding on screening. How many women just go get an abortion? Who knows.

  8. Thanks, Doc! That's already quite useful info. I appreciate it. :-)

  9. Although a bit unnerving to consider, as you say, "what actually goes on in a typical OB's or FP's office when the screening results are discussed." And I presume it's difficult to enforce these sorts of "discussions" to make sure they abide by the official recommendations, guidelines, etc.

  10. I suspect you may find the reality even worse than you suppose: the 'official' guidelines actually would call for every FP and OB, regardless of their own acknowledgment of, or denial concerning, the evil that is abortion, to offer it as if it were a legitimate option to every mother of a developmentally disabled unborn baby. Also to routinely order the 'screening' tests and, when indicated, amnios, usually w/o even outlining to the mom the implications of an abnormal result. I suspect many is the mother who is at least vaguely 'pro-life' who has had an abnormal screening result 'sprung' on her, been swept along to an amnio, then the agonizing choice with which she never should have been faced.

  11. Thanks again, Doc. :-)

    By the way, if you have the time, I'd be interested in hearing your time thoughts about abortion and ectopic pregnancy (I wrote my own thoughts about this here, or abortion and cancer during pregnancy (I'd like to post about this hopefully in the near future)?

  12. r-with-h:
    I read your take on ect/preg and abortion; I looked for a way to comment there but there was none, so I'll comment here; hope the triablogue folk don't mind.
    I basically agree with your take. If (a very big if) it were even remotely practical to salvage any significant % of unborn babies who are ectopically located, I'd be all for the attempt. It would be a matter of wisdom to balance the % risk to the mother's life vs the % chance of saving the baby's life. One would be tempted to conclude that the mother would be duty-bound to accept a fairly high risk for a chance of saving the baby's life, but one must be aware that she may have competing duties: other children perhaps. I think it may be one of God's mercies that the actual choice between saving mom and saving baby is so rare as to be almost nonexistent. In actual practice it's almost always the choice you alluded to: lose both or just save mom. Given our current medical abilities and knowledge I see no moral bar to medical or surgical treatment of an ectopic.
    If you are interested in more interaction concerning med ethics issues feel free to email me at