Down Syndrome Testing
September 15, 2008 7:31 PM Subscribe

All pregnancies are now recommended to be screened for Down Syndrome. 90% of those tested positive have opted for an abortion, while some in support groups discourage this to avoid becoming a vanishing minority with less funding. Now that campaign promises are being made to those with special needs, while vowing to outlaw abortion, a parent or voter might want to know more details. The costs used in this analysis were $146 for first-trimester screening, $66 for the second-trimester Triple Screen, and $86 for a second-trimester Quad Screen. A consultation with a genetic counselor is estimated at $68, and if a diagnostic procedure is also done, the total cost is $1,308. Terminations of pregnancy done in the first and second trimester are $648 and $1,146, respectively. The societal cost of raising and caring for an individual with Down syndrome is $762,748. Previously on Metafilter.
posted by Brian B. (272 comments total) 14 users marked this as a favorite

Terminations of pregnancy done in the first and second trimester are $648 and $1,146, respectively. The societal cost of raising and caring for an individual with Down syndrome is $762,748.

Brr. I find this kind of analysis very disturbing.
posted by prefpara at 7:36 PM on September 15, 2008 [14 favorites]

Medical care is never decided on issues of dollars and cents. If it was you'd see trucks full of Soylent Green parked six deep in the hospital basement instead of thirty tons of disposable medical waste.
posted by docpops at 7:38 PM on September 15, 2008

So let me get this, parents of kids with downs syndrome want others to have to go through that just so their kids aren't alone with this? That is so fucking crazy and selfish and DUMB. I have Cystic Fibrosis and I am ALL FOR pre-birth screenings so fewer people have to live through this crap (families and the kids who have it.) That is so selfish of them-I am in awe. I mean, if you choose to have a kid with downs even though you could choose not to, that's your problem. But don't try to pressure others to do the same becuase you made a selfish decision.

I just had my second baby on Friday and we had every screening for everything possible. I wouldn't have carried a baby to term with anything genetically wrong that can be figured out ahead of time. I think the more testing the better so people can choose.
posted by aacheson at 7:39 PM on September 15, 2008 [49 favorites]

Medical care is never decided on issues of dollars and cents.

Clarification: Medical care is always decided on issues of dollars and cents, just more dollars and cents if you're white.
posted by docpops at 7:40 PM on September 15, 2008 [6 favorites]

Also, I'm in favor of screening all parents of more than two children for insanity or at the very least latent stupidity.
posted by docpops at 7:41 PM on September 15, 2008 [5 favorites]

And I'd like someone to screen me for lice.

Now.
posted by docpops at 7:41 PM on September 15, 2008 [3 favorites]

What Would Corky Do?
posted by brain_drain at 7:43 PM on September 15, 2008 [3 favorites]

I have to wonder -- what is the cost to the family that must care for the child with Down Syndrome on a non-financial level? Are couples more or less likely to stay together? How do any other existing children react? I mean, isn't it hard to give the other children the attention they deserve?

(I am never having children for genetic and can't-stop-taking-my-medication reasons)
posted by giraffe at 7:43 PM on September 15, 2008 [2 favorites]

Anyway, it's unlikely Down's syndrome will ever go away, ny more than any other reasonably common genetic anomaly. Too many people simply have zero access to prenatal care for it to ever happen. ACOG is covering their ass instead of taking a more brave stand of telling it's members to do more pro bono work. Not that I blame them. The thing is, those same undesirables you won't see in the office will show up in the ED crowning, then sue you for a bad outcome.
posted by docpops at 7:44 PM on September 15, 2008

Haven't read the article, but I would just like to say that the screening is very, very often wrong. We were told by the head of perinatology at (insert name of large hospital that everyone would recognize) that our son had a 95% chance of having down's. NINETY FIVE PERCENT!!! That was after the ultrasound that measures the nuchal space. No blood work had come back, just the ultrasound that the tech did WRONG and therefore got the wrong measurements. Now this guy was the HEAD of the department and most would assume knows his shit. Personally, I would never abort for any reason, but how many people in the country would take his word as good info and abort a baby that doesn't have down's? Too many people see Doctors as infallible and make decisions based on what one Dr says. It was VERY troubling to me how quick he was to give us that devastating a diagnosis with only the first part of the nuchal screen complete. I hope people realize that these tests are never 100% and be completely sure of your diagnosis before you make such decisions. After going home and doing extensive research, I made them repeat the test and told the prick that he was seriously jumping the gun. We went back and forth several times but he ended up admitting that he shouldn't have quoted us those numbers at that time. It was a nightmare that I pray was only a one time occurance.

And my son is healthy. No child is perfect and if he had had Down's, he still would have been our child to love and cherish but we didn't have to face that.
posted by pearlybob at 7:50 PM on September 15, 2008 [11 favorites]

Now that campaign promises are being made to those with special needs, while vowing to outlaw abortion, a parent or voter might want to know more details.

Yes, parents and voters who make life decisions based primarily on monetary cost will surely appreciate those details.
posted by pardonyou? at 7:51 PM on September 15, 2008

I find these kind of topics fascinating because despite best efforts they tend to stray most unwillingly into rights-of-the-unborn territory. "I would never abort a child just because they have Down's! That's terribly cruel! He/she is a wonderful gift!" Uh, you're not talking about a he/she. There's no cruelty. It's not even a person. "..."

If you're squarely into fetus =/ person territory, you should have no problem with starting over to give everyone involved the best start possible. No?

No offence intended at all. I've just heard this particular argument play out again and again and it always ends up in this particular corner. otoh, this $ line is new to me, but wholly unnecessary. The NYT article (reporting the move to have all pregnancies tested) is not the one with the cost analysis. This fpp appears to be constructed to as to jerk some knees. And anyway, won't your eventual kid appreciate a healthy start? Won't you?
posted by Durn Bronzefist at 7:56 PM on September 15, 2008 [2 favorites]

$1.8 million if they happen to like venti caramel macchiatos.
posted by jimmythefish at 8:00 PM on September 15, 2008 [17 favorites]

It's very cruel to make a child who can never fully participate in the world he's born into.
posted by grobstein at 8:01 PM on September 15, 2008 [8 favorites]

down syndrome, not down's syndrome.
posted by andywolf at 8:02 PM on September 15, 2008 [2 favorites]

Corrected. Thanks, andywolf.
posted by Durn Bronzefist at 8:03 PM on September 15, 2008

It's very cruel to make a child who can never fully participate in the world he's born into.

It's very cruel to make simplistic assumptions about what constitutes "full participation" in the world.
posted by pardonyou? at 8:04 PM on September 15, 2008 [28 favorites]

I had a friend who was reading this book. The author had abortion, after learning her child was going to have down syndrome, and then decided to study the test and its impact. It's supposed to be a very fascinating.
posted by chunking express at 8:05 PM on September 15, 2008 [3 favorites]

It's very cruel to make a child who can never fully participate in the world he's born into.

Is it? The Down Syndrome people I've known (including one of my cousins) seem to be very happy, for the most part.

Sure, they're not as intelligent as I am, but they're happier than I am. Whose to say I have the better part of that deal?

They can hold jobs; they can marry; they can love. They don't live the same life you do, but that doesn't mean their lives are cruel or worthless.
posted by Class Goat at 8:05 PM on September 15, 2008 [25 favorites]

while some in support groups discourage this to avoid becoming a vanishing minority with less funding

Coming up in our next segment, pro-mosquito activists decry the eradication of malaria...
posted by Cool Papa Bell at 8:05 PM on September 15, 2008 [2 favorites]

It's very cruel to make a child who can never fully participate in the world he's born into.

Yeah, because so many people make the most of their lives. What's 'fully participating'? I don't think it's the strain on the individual as much as the strain on people around them that drives this decision.
posted by jimmythefish at 8:06 PM on September 15, 2008 [1 favorite]

Your attempt to quantify life in monetary terms is immoral and offensive. Furthermore the monetary comparison that you chose to present is clearly nothing more than trolling.

Flagged.
posted by oddman at 8:09 PM on September 15, 2008 [3 favorites]

They can hold jobs; they can marry; they can love.

The cognitive skills of those with Down Syndrome can vary widely. There are just as many high-functioning folks as there are low.
posted by Cool Papa Bell at 8:10 PM on September 15, 2008

Convinced that more couples would choose to continue their pregnancies if they better appreciated what it meant to raise a child with Down syndrome, a growing group of parents is seeking to insert their own positive perspectives into a decision often dominated by daunting medical statistics and doctors who feel obligated to describe the difficulties of life with a disabled child.

They are pressing obstetricians to send them couples who have been given a prenatal diagnosis and inviting prospective parents into their homes to meet their children.

What gives them the right? It's none of their business. They're strangers.

The decision belongs to the parents and their physician, NOT an outsider with a political agenda to push.
posted by jason's_planet at 8:12 PM on September 15, 2008 [5 favorites]

some in support groups discourage this to avoid becoming a vanishing minority with less funding

This reminds me of those in the deaf community who oppose cochlear ear implants (for many reasons).
posted by prefpara at 8:15 PM on September 15, 2008 [6 favorites]

The decision belongs to the parents and their physician...

The decision belongs to the parents alone. It isn't any of the physician's business, either.

And if, for whatever reason, the parents are sure that they will not abort the child, then there is no point in getting tested because the information gained is of no use.
posted by Class Goat at 8:17 PM on September 15, 2008 [2 favorites]

Your attempt to quantify life in monetary terms is immoral and offensive. Furthermore the monetary comparison that you chose to present is clearly nothing more than trolling.

I was just glad to get the information for free. You're welcome.
posted by Brian B. at 8:17 PM on September 15, 2008

This kind of reasoning is fine as long as you include the line about sterilizing the babies. Then we can see it for what it truly is.
posted by pmbuko at 8:18 PM on September 15, 2008

What's with the Palin tag?

I guess there is no issue that is seven degrees away from Sarah Palin. She's the Kevin Bacon of wedge issues.

Like Coca-Cola! Coke is associated with the color red, which is also the color of blood, Moose's blood is red and they bleed when shot, shot by hunters from helicopters in Alaska, and the Govenor of Alaska? Sarah Palin!
posted by hellojed at 8:18 PM on September 15, 2008 [7 favorites]

Medical care is never decided on issues of dollars and cents.

Really?

On what planet is that?
posted by rough ashlar at 8:21 PM on September 15, 2008 [9 favorites]

oddman writes: Your attempt to quantify life in monetary terms is immoral and offensive.

Economists do it all the time when performing cost-benefit analyses. It's necessary because, while plugging infinity into the equations (i.e. life is 'priceless') makes us feel much better about ourselves, the implication is that any infinitesimal improvement that could be made to safety, no matter what the cost, is "worth" it. The problem is that's not feasible. We have scarce resources. We have to peg lives at a dollar amount (really, it's the amount in dollars, based on things like additional salary necessary to work dangerous jobs, at which people value their lives) just so we can make realistic decisions about road improvements, stoplights, warning signs, and the like.

Obviously, the decision to abort a fetus with Down syndrome is not ethically equivalent to deciding whether or not to put a stoplight at an intersection, and that is why the dollar-to-dollar comparison offends us so much, because a decision at so visceral level goes beyond financial considerations to something much more primal and basic.
posted by anifinder at 8:22 PM on September 15, 2008 [22 favorites]

The societal cost of raising and caring for an individual with Down syndrome is $762,748.
Brr. I find this kind of analysis very disturbing.
posted by prefpara

Why? Because you have the money to cover that? Or because you have no problem with subjecting others to such an expense?
posted by rough ashlar at 8:23 PM on September 15, 2008 [6 favorites]

This post is offensive. I've flagged it, but I'd also like you - Brian B. - to hear me say it.

In a capitalist society, all human beings can be reduced to their various costs. You cost money too - the schools you went to, the roads you drive on, the pollution you create that someone, someday will have to clean up. But we dont' have to see human life in those terms, and I don't. People aren't price tags. Not people with Down's, who, like everyone else, contribute in all kinds of complex ways to their families and communities, and not anybody.
posted by serazin at 8:28 PM on September 15, 2008 [7 favorites]

"Brrr," indeed.

That said, I can't imagine being pregnant and being forced to carry it to term. It's something out of a horror movie to me, even though it happens to women every day.

Even worse would be forced to give birth to a child I know would have difficulty finding a good home, since I wouldn't be able to care for it myself.

I don't see the question of children with disabling or fatal conditions being addressed all that often during pro- anti-choice discussions. If 90% of positive tests for downs lead to abortion, I wonder why? Obviously, the people who get the tests are somewhat self-selecting, but that seems to point to large approval (at least of their OWN choice) of abortion in that type of circumstance.
posted by Kutsuwamushi at 8:29 PM on September 15, 2008 [1 favorite]

From the NYT article: "A dwindling Down syndrome population, which now stands at about 350,000, could mean less institutional support and reduced funds for medical research."

From the Anchorage Daily News: "Palin confirms baby has Down syndrome."

From Polar Bears International: "No adequate census exists on which to base a worldwide population estimate, but biologists use a working figure of 20,000 to 25,000 bears with about sixty percent of those living in Canada."

From the Anchorage Daily News: "Palin argued there is not enough evidence to support a listing [of polar bears as an threatened species]."

I SEE NO PROBLEM HERE.
posted by turgid dahlia at 8:30 PM on September 15, 2008 [17 favorites]

Many people with handicaps will need someone to care for them for life. As a parent, that's a pretty big issue. It's much harder to find child care for a child with special needs. You'll be fighting hard for your child's education. It's also expensive medically. People with Down syndrome often have heart defects requiring serious medical intervention. It's not an easy choice to make.

As an aside, I understand that it's now Down Syndrome, but why is that a big deal? It's Tourett's Syndrome, Sjögren's Syndrome, Reye's Syndrome and Asperger/Asperger's syndrome.
posted by theora55 at 8:32 PM on September 15, 2008 [3 favorites]

Brr. I find this kind of analysis very disturbing.

I remember when Newt Gingrich and the Reaganite hordes tried to eliminate food stamps, and nobody but liberals bothered to crunch the numbers to show how little it was. Funny that his district in Georgia drew 80% of its income from federal defense contracts, many of them in the pipeline at the time. As for this issue, it's odd that conservatives suddenly care so much about health spending when it helps preserve their religious condemnation.
posted by Brian B. at 8:32 PM on September 15, 2008 [4 favorites]

Oh lordie, here we go again in the comments with the people who need to tell me that aborting a fetus with Down's syndrome is the best result for all involved, including the then-dead fetus with Down's. Make whatever decisions you'd like wrt your own uterus, but don't condescend to tell me that you know what's best for mine. Because you do not.
posted by onlyconnect at 8:33 PM on September 15, 2008 [6 favorites]

And if, for whatever reason, the parents are sure that they will not abort the child, then there is no point in getting tested because the information gained is of no use.

I don't know about that. If I was going to have a baby with an unusual medical condition, you bet I'd want to know about it, so that I could spend the months until the baby's birth learning about the condition and preparing myself for it, mentally and materially.
posted by showbiz_liz at 8:33 PM on September 15, 2008 [2 favorites]

I think that people who discover that their fetus tests positive for Down Syndrome are better off for that information, whatever they decide.

If they choose to bring the pregnancy to term and parent, they will have several months' head start on lining up resources.

Trying to discourage the medical establishment from offering that information to pregnant women and their partners strikes me as an extraordinarily selfish and wrong-headed thing for anyone to do.
posted by Sidhedevil at 8:34 PM on September 15, 2008 [11 favorites]

On the last episode of Metatalk...

Medical care is regularly decided on issues of dollars and cents. A basis I've generally seen used to evaluate treatments or policies is which use of money/resources will be most efficient in alleviating suffering and death.

I think in this argument it can be important to keep in mind that Down Syndrome goes beyond cognitive development issues - there are a number of straight-up serious physical health problems, and then the Alzheimer's kicks in...
posted by TheOnlyCoolTim at 8:35 PM on September 15, 2008 [1 favorite]

I hope people realize that these tests are never 100% and be completely sure of your diagnosis before you make such decisions.

A) Nothing is 100%

B) Genetic testing is as close to 100% as is possible in the real world

C) Putting things in scare caps doesn't serve to help your argument
posted by Mental Wimp at 8:36 PM on September 15, 2008 [1 favorite]

Oh lordie, here we go again in the comments with the people who need to tell me that aborting a fetus with Down's syndrome is the best result for all involved, including the then-dead fetus with Down's. Make whatever decisions you'd like wrt your own uterus, but don't condescend to tell me that you know what's best for mine. Because you do not.

Strawman, oh Lord, strawman. Strawman my strawman, oh, strawman, that I may strawman my strawman and those strawmanless strawmen. In strawman's name, a-strawman.
posted by Mental Wimp at 8:38 PM on September 15, 2008 [21 favorites]

Too many people see Doctors as infallible and make decisions based on what one Dr says....I hope people realize that these tests are never 100% and be completely sure of your diagnosis before you make such decisions

This is true of all medical procedures, pretty much. And I'm sorry you received an incorrect diagnostic result and diagnosis, but I'm not really that clear on what it has to do with the FPP? Presumably, expanded Down Syndrome testing will be as accurate as all other medical testing--which means that some technicians and doctors will sometimes get things wrong.
posted by Sidhedevil at 8:40 PM on September 15, 2008

And if, for whatever reason, the parents are sure that they will not abort the child, then there is no point in getting tested because the information gained is of no use.

I'd like to speak to this. I was tested. If our son had Down Syndrome I would not have terminated the pregnancy (although I might have if some of the more horrific abnormalities that are possible had been present) -- but it was important to me to know. In advance. Not find out the day my perfect and dreamed of child was born, but far enough in advance to plan and learn and grieve if I needed to. Far enough in advance so that everyone would know and no one would recoil in surprise and then try to put on their "oh what a lovely baby" mask. Far enough in advance to be able to understand what I was getting into before I was standing in the middle of the field.

Its commonplace now to learn the gender of your child in advance "so you can plan." I see this testing as no different. Its a way to be prepared. To plan.
posted by anastasiav at 8:41 PM on September 15, 2008 [10 favorites]

Mental Wimp - you're wrong about your stats. Look up the numbers for the triple screen before you say what you're saying.
posted by serazin at 8:41 PM on September 15, 2008

The rational and intelligent dispensation of medical care is not decided on dollars and cents.

If it were we would have a Medicare plan for anyone under sixteen and we would quit pissing away money on unproven interventions in ninety year-old ICU patients.

I can't fucking believe we're debating this. A reasonably functional Down syndrome individual is more productive than our current president. Assembling bags of washers or sorting clothes or any other number of jobs has brought more intrinsic value to society than any number of chronic welfare recipients and multi-parous teen mothers in my practice.

This whole post smells like ass and needs a Hemingway right in the head.
posted by docpops at 8:44 PM on September 15, 2008 [7 favorites]

What annoys me about such utilitarianism is how poorly it's typically thought through. For starters, it's kind of pointless to look at the cost of something and ignore the value. If we did that when buying houses, we'd all live in cardboard boxes because they're really cheap. It doesn't take much for a person to bring more than $762,748 of value into the world. But it also doesn't take much for a person to take a few million in value out of the world. In general, I expect the estimated utilitarian difference in ROI between any two potential people is negligable relative to the overall values, not easily correlated to any specific genetic disposition, and less than the value of the time that might be wasted figuring it out.
posted by scottreynen at 8:49 PM on September 15, 2008 [4 favorites]

I was not saying that the option should not be available, nor was I expressing religious condemnation.

I find the reduction of a human life (even a potential human life) to a dollar amount to be very unsettling, however useful that exercise may be to an economic analysis of some kind.

And I am reminded of the enormously difficult questions we face in determining when to withdraw increasingly expensive medical care from gravely ill patients. Britain is struggling with this question, among others; I recall reading an article about the trouble they were having allocating care and balancing financial considerations with the mostly universal concern for human dignity.

Anyway.
posted by prefpara at 8:51 PM on September 15, 2008 [1 favorite]

Mental Wimp - you're wrong about your stats. Look up the numbers for the triple screen before you say what you're saying.

The triple screen (which does have a significant false positive rate but is not a genetic test) is, to the best of my knowledge, generally confirmed with amniocentesis for a genetic test.
posted by TheOnlyCoolTim at 8:52 PM on September 15, 2008

needs a Hemingway

Brilliant. Appropriated.
posted by adamdschneider at 8:56 PM on September 15, 2008

I know that all you concern trolls worrying about costing out caring for trisomy 21 children realize that we could save many children of all abilities if we spent more of our tax dollars on prenatal care for the disadvantaged. For those of you horrified at the thought of placing a price tag on life, check out the numbers regarding the costs. For those of you who resent your tax dollars going to medical care for the poor and indigent, I don't want to hear you bemoaning the callous valuing of human health in dollars, because you are the modern Pharisees. For all of you normal people, here are the estimated costs of prenatal care:

Costs for prenatal care

In an average pregnancy, doctors typically recommend that expectant mothers visit their obstetrician-gynecologist once a month for the first 6 months, twice a month for the seventh and eighth month, and then once a week for the last month of pregnancy.2 On average, you'll visit your ob-gyn approximately 14 times for prenatal care.

According to a 2003 report by the Agency for Healthcare Research and Quality (AHRQ), a part of the U.S. Department of Health and Human Services, the average amount charged to patients for prenatal and postnatal care was $133 per visit.3

Therefore, 14 appointments at a cost of $133 each adds up to $1,862. Tests such as laboratory blood work or ultrasound may add to these costs.

The benefits in health are enormous, but here's the kicker for you reluctant to spend taxes on the poor:

Studies estimate that every dollar spent on prenatal care yields between $1.70 and $3.38 in savings by reducing neonatal complications.

So this mode of taxing and spending is an investment. I know that's hard for some of you brainless "no more taxes" fok to wrap your head around, since your ideology says the government can never spend your taxes in a wise way unless it's used to kill people in other countries or turrists, but there you go. If you're curious, look into dollars spent on early childhood education or college assistance or just about any education. Yep, all investments that pay back big, at least 16% return per year (for example). I wish we could change the discussion about taxes from "cut taxes now" to "which expenditures are actually investments that return real dollars to the tax payer." The discussion currently is done at the 2nd-grade level of argument.
posted by Mental Wimp at 8:58 PM on September 15, 2008 [16 favorites]

This is the sort of thing that makes me think that socialized healthcare in the U.S. is going to be lots of fun. And by fun, I mean a brutal ideological siege war.

On one hand, we'll have the pro-life crowd, who will see this sort of testing (and the subsequent abortions) as nothing more than eugenics, perhaps even genocide, and fight against it tooth and nail.

On the other hand, we'll have the inexorable pressures of economics: the infinite demand for finite resources.

It's all well and good to take a stand against screening and termination when the question is framed purely as an issue of money: $1,308 versus $762,748. But I doubt that it will seem quite so black-and-white when the decision is framed in terms of what else could be done with the difference.

We may all be able to agree that a fetus with Down's is worth $761,440 of inanimate bills; but is it -- are they -- worth five heart transplants? Fourteen kidney transplants? Thirty cleft palate surgeries? Because that's the argument that will be made. How many people in the prime of life do you want to kill for that fetus? (The TV spots write themselves...don't think for a moment they won't go there.)

Our current system hides the opportunity costs of such decisions, thus allowing us to avoid the really tough ones by simply letting the invisible hand do the dirty work. But I don't think such a system is really sustainable, and we're already starting to see it break down. However, any alternative will require, as a consequence of eliminating all those wasteful layers of middlemen, the inevitability of deciding rather exactly how much various lives are worth.
posted by Kadin2048 at 9:01 PM on September 15, 2008 [11 favorites]

You can't put a price on Moe Howard haircuts.
posted by wfrgms at 9:02 PM on September 15, 2008 [2 favorites]

Most chromosomal defects result in spontaneous abortion. This is simply finishing the work that God didn't. Bam!

I love issues like this. Even when there is absolutely nothing disingenuous about what you say, people will still accuse you of trolling, so why hold back?

It's very cruel to make simplistic assumptions about what constitutes "full participation" in the world.

If I had Down Syndrome, I would certainly want my parents to abort me. I believe all those with Down Syndrome would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it. Therefore, aborting fetuses with Down Syndrome is a moral imperative.

So far, I've never seen an emotional argument that defeats that simple logic.
posted by 0xdeadc0de at 9:04 PM on September 15, 2008

I can't fucking believe we're debating this. A reasonably functional Down syndrome individual is more productive than our current president. Assembling bags of washers or sorting clothes or any other number of jobs has brought more intrinsic value to society than any number of chronic welfare recipients and multi-parous teen mothers in my practice.

Yeah, the problem is that "reasonably functional Down syndrome individuals" don't burst fully-formed from their mother's chests and immediately set to work sorting the colours at the Play Dough factory - there's still that brief interim period of, oh, just short of two decades where the Down syndrome infant/child/teenager must be cared for by one or both parents or a guardian or an institution (or any combination of those things), and regardless of what the child eventually develops into, or how "mild" or "severe" the condition is, well, some people just aren't interested in dealing with that, and I fully support their right to be as informed as possible and base their ultimate decisions on that information.
posted by turgid dahlia at 9:06 PM on September 15, 2008 [6 favorites]

any alternative will require, as a consequence of eliminating all those wasteful layers of middlemen, the inevitability of deciding rather exactly how much various lives are worth.

I agree. And I don't think the government should decide. Frankly, I don't know that anyone can decide. And I certainly don't want anyone deciding for me. It's so much easier to let "the market" decide, so that the dollar values are placed on human life "at random." Oh, oops, I mean by a complex interplay of societal practices and prejudices coupled with some luck and a lot of obscure buck-passing. Wait, that doesn't seem better... Can't we just have a system where NO ONE decides because we've cured everything in everyone? That must be what I mean by a "market solution." Now I feel good again.
posted by prefpara at 9:08 PM on September 15, 2008 [1 favorite]

0xdeadc0de - have you ever met someone with Down Syndrome? Didn't think so.
posted by serazin at 9:09 PM on September 15, 2008

So far, I've never seen an emotional argument that defeats that simple logic.

"But I love you, Daddy."

How do you feel about your logic now, Mr. Spock?
posted by Cool Papa Bell at 9:10 PM on September 15, 2008 [6 favorites]

Yeah, the problem is that "reasonably functional Down syndrome individuals" don't burst fully-formed from their mother's chests and immediately set to work sorting the colours at the Play Dough factory - there's still that brief interim period of, oh, just short of two decades where the Down syndrome infant/child/teenager must be cared for by one or both parents or a guardian or an institution (or any combination of those things).

This is actually true of all human beings. Or were you born ready to "fully contribute" to society?
posted by serazin at 9:11 PM on September 15, 2008 [8 favorites]

Trying to discourage the medical establishment from offering that information to pregnant women and their partners strikes me as an extraordinarily selfish and wrong-headed thing for anyone to do.

Or, extraordinarily patronizing, if you like; I prefer my doctors to give me the information I want and need, with as little agenda as possible, on the assumption that I'm an adult who can make her own decisions.

We didn't screen, but we didn't have many risks under the old guidelines.

I find the "screen everybody" approach interesting--especially since a) the infrastructure doesn't appear to be there yet, and b) insurance companies get to be billed for one more test hooray.

ACOG is a trade union for OBs, not a public health agency; nothing wrong with that, but since they lately went on a witch hunt against midwives and homebirth, I tend to wonder about their motives these days re doctor fees vs. patient needs. Even though maybe 2% of American births are non-OB-attended, they seem to be very...intent on increasing the need for OBs lately and protecting their turf from the use of nurse-midwives or certified professional midwives. Presumably you'd need an OB to order this "mandatory" test.
posted by emjaybee at 9:12 PM on September 15, 2008 [1 favorite]

This is actually true of all human beings. Or were you born ready to "fully contribute" to society?

We're not talking about me, or my parents. We're talking about individuals with Downs syndrome and the decisions of their parents (or potential parents, more accurately).

This isn't about "eugenics" - it's human fucking nature.
posted by turgid dahlia at 9:13 PM on September 15, 2008 [2 favorites]

Down Syndrome Through the Ages
posted by homunculus at 9:15 PM on September 15, 2008 [2 favorites]

And before it happens, don't attempt to frame me as somebody who thinks fetuses with a high probability of Down syndrome should be aborted left right and centre, or that individuals with Down syndrome should be postnatally aborted, or that I hate people with Down syndrome and think they should all be suffocated because they're a huge hassle to me personally and are worthless and silly. I don't think any of those things. But I do think that, in the context of this discussion, as in the context of all discussions about abortion for any reason, the actual rights of the woman win out over the perceived rights of the blastocyst/embyro/fetus, and if a woman is tested and there's a significant potential for the baby to be born with Down syndrome, and she basis her decision to abort on that information alone, then you don't get to tell her not to. And nor do I. And nor does anyone.
posted by turgid dahlia at 9:18 PM on September 15, 2008 [11 favorites]

"bases her decision", rather.
posted by turgid dahlia at 9:19 PM on September 15, 2008

nothing more than eugenics

Pedantic note: this can't really be called eugenics by anyone. Trisomy 21 is not a hereditary disorder, it's a mutation caused by maternal age.
posted by malphigian at 9:23 PM on September 15, 2008 [1 favorite]

This is the sort of thing that makes me think that socialized healthcare in the U.S. is going to be lots of fun. And by fun, I mean a brutal ideological siege war.

Taken out of context, this is the funniest thing I've read in a long time. Seriously, it cracked me up, specifically that last sentence. Thanks Kadin2048. You've radically expanded my universe of that which could conceivably be called "fun". (Yes, I know it's meant ironically.)
posted by Crabby Appleton at 9:23 PM on September 15, 2008

If I had ~~Down Syndrome~~ IQ <>Down Syndrome IQ <>Down Syndrome IQ <>

I'm reasonably certain that my change of genetic dice-roll doesn't change your logical statement. Qualitatively same assumptions and all that.

I'm assuming you're using moral imperative in the subjective sense (as in you're not claiming it's correct for anyone but yourself), or else I can tell you where your logic is flawed. If so, my critique is invalid for the obvious reason, but it still could be true for someone else. So I'm going to go with your argument being a bit too simplistic.

As for my choices: unsure what I would want in my case, damn sure it's not my place to force it on other people. The benefit of socialized medicine in my mind is that it prevents catastrophe from hitting a single person for no fault of their own. I'm willing to spend the additional 762,748/30,000,000 = 2.5 cents per Down Syndrome child.

2.5 cents per child, in Canada. Dollars and cents are the right way to measure things, but it's dollars and cents per person.
posted by Lemurrhea at 9:24 PM on September 15, 2008

Mental Wimp - you're wrong about your stats. Look up the numbers for the triple screen before you say what you're saying.

Hey, serazin, look over here:

American Journal of Medical Genetics
Volume 5 Issue 4, Pages 345 - 356

Chromosome findings in 2,500 second trimester amniocenteses
Barbara F. Crandall, MD 1 *, Thomas B. Lebherz 2, Lidia Rubinstein 2, Robert D. Robertson 2, William F. Sample 3, Dennis Sarti 3, Judy Howard 4, John M. Opitz

Abstract
We have analyzed the chromosome abnormalities found in 2,500 amniocenteses for prenatal diagnosis; 1,887 (75%) were performed because the maternal age was 34 years or more. Chromosome abnormalities were detected in 1.80% of those referred for advanced maternal age, 1.2% between ages 34 and 39 years and 4.6% 40 years and over. Of these, four occurred in women who would have been 34 years at delivery (2.9%). Trisomy 21 accounted for 50% of the chromosome abnormalities; sex chromosome abnormalities, for 25%; the remaining 25% was divided equally between trisomy 18 and partial trisomies and mosaics. Unexpected translocations were found in 0.4%, of which two-thirds were balanced and identified in one parent. The accuracy was 99.6%.

Next time, try not to be an ass.
posted by Mental Wimp at 9:25 PM on September 15, 2008

Personally, I would never abort for any reason

You lost me there.
posted by humannaire at 9:26 PM on September 15, 2008

Whoops. Screwed up a tag somewhere. Let's try again:

If I had ~~Down Syndrome~~ IQ less than 100, I would certainly want my parents to abort me. I believe all those with ~~Down Syndrome~~ IQ less than 100 would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it. Therefore, aborting fetuses with ~~Down Syndrome~~ IQ less than 100 is a moral imperative.
posted by Lemurrhea at 9:27 PM on September 15, 2008

I don't find it at all difficult to understand why many women choose to terminate their pregnancies once they discovery a major genetic defect in the fetus, such as Down Syndrome, and I agree with my fellow mefites that this is a right that should be protected.

I do find it hard to understand why so many people on here who claim to be pro-choice don't see the irony in stating outright that genetically imperfect babies "should" be aborted, and can't understand why some women would choose to bring such babies to term, imperfections and all.
posted by The Gooch at 9:27 PM on September 15, 2008 [5 favorites]

Personally, I would never abort for any reason

You lost me there.

She means an elective abortion on herself, methinks. Of course, unless she has standing medical orders, she might undergo one if her situation were dire enough.
posted by Mental Wimp at 9:29 PM on September 15, 2008

Mental Wimp -

You're right about amnio - I'm right about the triple screen. But sure - you can win this round if it makes you feel better to call me an ass.
posted by serazin at 9:29 PM on September 15, 2008

"But I love you, Daddy."

How do you feel about your logic now, Mr. Spock?

I'm thinking, "thank God we aborted, we have far more attention and resources to devote to our perfect, healthy child."
posted by 0xdeadc0de at 9:32 PM on September 15, 2008

The societal cost of raising my cat is over $25,000 in Tender Vittles, kitty toys, lint brushes and furniture replacement. And yet a .22 bullet is about 11 cents.

Which just goes to show you...well, nothing really. Excuse me while I go scratch Fluffy behind her ears. She likes that.
posted by LarryC at 9:35 PM on September 15, 2008 [4 favorites]

We did the screening. It was a waste. Unless it was clear that the baby would have had no chance of survival we would never have aborted. Luckily everything worked out fine, well except that the test itself led to some complications that put my wife into bed rest for about three months. If there is one thing I like about Sarah Palin it is her decision to keep and raise her special needs child. This post is some sort of cheap Palin smear attempt, but it fails as this is one area in which she truly comes out looking pretty good. You know you can be pro-choice and still think that abortion is not a good thing. You might not understand that until you have a child on the way. Of course there are some people who seem to be able to abort their kids with about as much feeling as changing the channel on the television. They are of course total scum, but luckily they are rare. For most people it is one of the hardest things they have to do. So, yeah, test away, but make sure you know what you are getting yourself in for. Will you have the stomach to end the life inside of you just because it is less than perfect? Have you ever spent any time with some Down syndrome kids? You know they seem to enjoy life just as much if not more than other people. Killing them in the womb is a favor to the parents who won't have to do the work, not a favor to the kid.
posted by caddis at 9:35 PM on September 15, 2008 [5 favorites]

I do find it hard to understand why so many people on here who claim to be pro-choice don't see the irony in stating outright that genetically imperfect babies "should" be aborted,

I do find it strawmanning to strawman why so many pro-strawmen who strawman strawmen, but don't strawman the strawman in strawmanning outright that strawmen "should" be strawmanned. Good lord, this is coming in handy!
posted by Mental Wimp at 9:38 PM on September 15, 2008 [5 favorites]

Think I'd rather be friends with someone with down syndrome than some of the people posting here.
posted by Fuzzy Skinner at 9:39 PM on September 15, 2008 [4 favorites]

You're right about amnio - I'm right about the triple screen. But sure - you can win this round if it makes you feel better to call me an ass.

If it soothes your ego to say so, but I clearly said genetic testing and nothing about the triple screen.
posted by Mental Wimp at 9:39 PM on September 15, 2008

I'd like to state here for informational purposes, that there are people who are on waiting lists to adopt babies born with Down syndrome. If someone has a baby with this condition and feels unable to cope with raising him or her, adoption is certainly an option.
posted by konolia at 9:36 PM on September 15

Like, on purpose? Is there a "Down Syndrome" section in the Fall 2008 calendar of adoption? Or is the demand so high for unwanted children that adoptive parents are now scraping the bottom of the barrel?
posted by GooseOnTheLoose at 9:44 PM on September 15, 2008

Aborting an assertedly less-than-perfect child is nothing more than the consumerism most Mefites daily deride. Some of the rash, almost flippant, amorality of Mefites leaves me wondering why I ever read this site anymore.

And where do we draw our line? Or is it all just societal, utilitarian value?

People with Down's DON'T ENJOY THEIR LIVES? Oh my God.
posted by resurrexit at 9:46 PM on September 15, 2008 [2 favorites]

I have cared for a lot of kids and adults with Down Syndrome. Some were high functioning in society and some were so effected by their condition they couldn't communicate their basic needs. I will tell you, it was challenging on the good days and hard, really hard, on the bad ones. I don't know if I could do it on my own every day. On one hand, I liked these kids - even held some of them pretty close to my heart. On the other hand, could I raise a child with this? I don't think I could. The financial burden coupled with the amount of time needed to give to my child would put me out of work and on welfare. And when I am gone, my adult child would be an orphan... an orphan who still needs a parent.
posted by Foam Pants at 9:47 PM on September 15, 2008 [12 favorites]

she basis her decision to abort on that information alone, then you don't get to tell her not to. And nor do I. And nor does anyone.

At what point when the money of society used to pay for said non-aborted child gives society a vote? $1 $5 $500,000 ? Never?
posted by rough ashlar at 9:50 PM on September 15, 2008

Mental Wimp: I do find it hard to understand why so many people on here who claim to be pro-choice don't see the irony in stating outright that genetically imperfect babies "should" be aborted,

I do find it strawmanning to strawman why so many pro-strawmen who strawman strawmen, but don't strawman the strawman in strawmanning outright that strawmen "should" be strawmanned. Good lord, this is coming in handy!

I don't think "strawman" means what you think it means. From this thread alone:

"I mean, if you choose to have a kid with downs even though you could choose not to, that's your problem. But don't try to pressure others to do the same becuase you made a selfish decision. " - aacheson

"If you're squarely into fetus =/ person territory, you should have no problem with starting over to give everyone involved the best start possible. No?" - Durn Bronzefist

"It's very cruel to make a child who can never fully participate in the world he's born into." - grobstein

"If I had Down Syndrome, I would certainly want my parents to abort me. I believe all those with Down Syndrome would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it. Therefore, aborting fetuses with Down Syndrome is a moral imperative." - 0xdeadc0de
posted by The Gooch at 9:53 PM on September 15, 2008 [2 favorites]

There's been a MetaTalk post made about this thread.
posted by Kattullus at 9:53 PM on September 15, 2008

It's the sound of sacred cows to the slaughter, and tonight I shall dine on steak! It's called pro-choice. If you believe you are strong enough to care for a impaired child, good for you! I say this will all honesty, I have some relatives with Down Syndrome and they can become great people. But if you don't believe you can handle it, why couldn't you be given the choice of people who couldn't handle a child at all?

Oh, and don't pretend that someone with Down Syndrome isn't more work to raise. The increase is variable just like the level of impairment, but it is there.
posted by The Power Nap at 10:02 PM on September 15, 2008

The comments in this post are missing the most important point!! If 90% of Downs Syndrome fetuses are aborted, this means that righteous Catholic and Evangelical Christian women are practically immune from having a fetus with Downs!!!
posted by Crotalus at 10:04 PM on September 15, 2008 [4 favorites]

Your problem, Gooch, (and the place where you stray into strawman territory) is when you assume that being "pro-choice" means one believes the choice whether to abort is completely morally neutral. It does not necessarily mean that. I happen to be pro-choice, but when you impute to me the further notion that I never think abortion can be right or wrong (which you do by suggesting it's contradictory to say someone "should" abort), you're strawmanning me. Despite being pro-choice, I think that it can sometimes be right to abort, and sometimes wrong (I just think the government is insufficiently competent to make a blanket decision about it).

Similarly, I'm pro-choice about telling mean gossip -- I don't think the government should ban mean gossip. However, I can still say one should refrain from telling mean gossip. So please do not recruit my post to make your incoherent point.
posted by grobstein at 10:10 PM on September 15, 2008 [1 favorite]

At what point when the money of society used to pay for said non-aborted child gives society a vote? $1 $5 $500,000 ? Never?

How much does 20 years to Life cost in a maximum security prison? And how much does 5 years on death row cost?
posted by tkchrist at 10:10 PM on September 15, 2008

Your attempt to quantify life in monetary terms is immoral and offensive.

No, it's quite moral, actually.
posted by Mr. President Dr. Steve Elvis America at 10:13 PM on September 15, 2008

Oh, and don't pretend that someone with Down Syndrome isn't more work to raise.

OMG, raising children is work, and special needs children are just too tiring. Kill it first!
posted by caddis at 10:23 PM on September 15, 2008

OMG, raising children is work, and special needs children are just too tiring. Kill it first!

I think the reason strawmen are being so frequently used on this side of the argument is that the arguers are unable to cope with the idea that 90% of women pregnant with trisomy 21 fetuses elect to abort the pregnancy. They are left with a sinking feeling that they are so far in the minority that their emotions overwhelm their cognitive functioning. Once that is no longer in play, all they can do is imagine their opponents to be heartless, demanding baby killers rather than their fellow human beings with feelings similar to theirs, but without the stiff-necked absolutist moral stance they have elected.
posted by Mental Wimp at 10:32 PM on September 15, 2008 [15 favorites]

OMG, raising children is work, and special needs children are just too tiring. Kill it first!

I know a couple whose "special needs" (severe birth defects) kid had left them in abject crushing poverty.

She had to quit her job to care for their daughter. Soon they lost their house due the medical expenses. They had to liquidate their life savings and retirement. And by age five their daughter finally died a slow horrific death.

Two years ago they divorced, after one them had a complete nervous breakdown attempting suicide, thus leaving other two older children tragically shattered to be raised by an ill equipped grandparent. These two children will of course have no hope to attend college barring scholarships. Which is unlikely.

Reality ain't no after school special.
posted by tkchrist at 10:33 PM on September 15, 2008 [27 favorites]

Is there a "Down Syndrome" section in the Fall 2008 calendar of adoption? Or is the demand so high for unwanted children that adoptive parents are now scraping the bottom of the barrel?

These are people who "walk the walk". A Down Syndrome baby for them isn't a last resort, it's something they actively want.

Why? For many of them it's because they oppose abortion, even in this case, and at the same time understand that there are women who cannot, or do not want to, raise their own Down Syndrome child.

These people, who want to adopt, are saying, "Even if you yourself cannot or do not want to raise that baby, don't abort it. Carry it to term, and we will take it and give it a loving home."

These are people who believe that every child is precious, and they prove it by being willing to adopt the children that no one else want.

By the way, it isn't just Down Syndrome. There are people like this who adopt kids who are severely handicapped in other ways, too. Things like spina biphida.

I'm not one of them, and I couldn't do it. But I respect them for the strength of their belief, and their willingness to take responsibility for the consequences of their beliefs.

But, then, I was never very good at fashionable cynicism and snide dismissal.
posted by Class Goat at 10:34 PM on September 15, 2008 [3 favorites]

My aunt had Down Syndrome. She died of old age around 40. When she was born the prevailing opinion in the medical community was that it was best to separate children with Down's from their parents so that the disabled individuals could grow up independent. That was the idea, anyway. My aunt was separated from my grandparents for 2 whole years from the age of 6 to 8. To me that seems unbelievably cruel to my aunt and grandparents but the pressure on my grandparents from doctors to do so was very strong. My aunt lived in an assisted living community for the rest of her life outside of Reykjavík. I never saw her very often, maybe once every three months when I was living in Iceland and she was healthy and very rarely after she started deteriorating. I only really knew her in the twilight of her life, when she didn't have the same amount of energy she had before. But she was always very happy. In every memory of her I have she's happy.
posted by Kattullus at 10:37 PM on September 15, 2008 [2 favorites]

I think the reason strawmen are being so frequently used on this side of the argument is that the arguers are unable to cope with the idea that 90% of women pregnant with trisomy 21 fetuses elect to abort the pregnancy. They are left with a sinking feeling that they are so far in the minority that their emotions overwhelm their cognitive functioning. Once that is no longer in play, all they can do is imagine their opponents to be heartless, demanding baby killers rather than their fellow human beings with feelings similar to theirs, but without the stiff-necked absolutist moral stance they have elected.

Mental Wimp, I don't think many people here believe that everyone who is pregnant with a baby with Down Syndrome should maintain her pregnancy. I certainly don't think that since I'm pro-choice, pro-abortion on demand.

On the other hand, I don't think that having an abortion is somehow "the right thing to do" if your fetus has Down Syndrome. People with Down Syndrome are people - not social burdens.

Women should have the right to choose. Period. People with Down Syndrome are human beings with value and merit. Period. The two aren't mutually exclusive.
posted by serazin at 10:38 PM on September 15, 2008 [5 favorites]

On the other hand, I don't think that having an abortion is somehow "the right thing to do" if your fetus has Down Syndrome. People with Down Syndrome are people - not social burdens.

If you are, indeed, pro-choice and pro-abortion on demand, then your argument here makes no sense. If indeed a woman has the right to choose, then she should equally be able to choose to abort a fetus with Down Syndrome - as she does to abort a fetus simply because she does not want to give birth to it.

Women should have the right to choose. Period. People with Down Syndrome are human beings with value and merit. Period. The two aren't mutually exclusive.

Except "a fetus" and "people with Down Syndrome" are not the same thing. The articles aren't suggesting euthanising people with Down Syndrome. The articles are about in utero screening for Downs. The choice is then up to the woman who is pregnant whether to abort the fetus or not.

Methinks you are not as pro-choice as you claim.
posted by crossoverman at 10:47 PM on September 15, 2008 [1 favorite]

tkchrist writes "She had to quit her job to care for their daughter. Soon they lost their house due the medical expenses. They had to liquidate their life savings and retirement. And by age five their daughter finally died a slow horrific death. "

This is precisely why anti-abortion Republicans and Evangelicals so staunchly support a nationalized health care plan that leaves no needy person behind.

Oh, wait.
posted by orthogonality at 10:47 PM on September 15, 2008 [10 favorites]

Women should have the right to abort fetuses who have Down Syndrome. Period. Women should also have the right to NOT abort fetuses who have Down Syndrome. Period. And aborting is not somehow "better" because of the supposed social cost of Down Syndrome.

Does that make my point more clear?
posted by serazin at 10:53 PM on September 15, 2008 [9 favorites]

But, then, I was never very good at fashionable cynicism and snide dismissal.

Sorry, didn't mean to be so fashionable.

People with Down Syndrome are people - not social burdens.

Actually, it is this that should be highlighted as "not mutually exclusive."
posted by GooseOnTheLoose at 10:56 PM on September 15, 2008 [1 favorite]

I do find it hard to understand why so many people on here who claim to be pro-choice don't see the irony in stating outright that genetically imperfect babies "should" be aborted, and can't understand why some women would choose to bring such babies to term, imperfections and all.

You quote me elsewhere, Gooch, so I'll assume I'm one of the targets of this comment, but I said no such thing. While I am certainly pro-choice, I don't think there's a moral imperative to abort "imperfect" fetuses. Rather, I find it odd that anyone who would in other situations refer to a fetus as "a bundle of cells" or the like -- distinctly not-human, not viable, and with no rights whatsoever -- would be bothered by tossing that bundle of cells for another. It's not an imperative. It's completely pragmatic. I've seen the same temptation when people argue about sex selection in China, yet... that position doesn't mesh with their perspective on the (lack of) rights of a fetus. It has no right to exist or develop. Nor do the genes have a right to be expressed. It's up to the parents. (note, I am not disagreeing with the proposition that you can be pro-choice but decide that a particular choice is "wrong" yet worthy of protection -- only that your concept of the fetus should be consistent)

A less charitable interpretation might be that by considering "less perfect" proto-humans, you've elevated them to a vulnerable group you're suddenly willing to protect. Which is a perspective worth questioning, imho. A fetus is a few scrapings on a chalk board. A few lines on an etch a sketch. Erase and start over.

On preview, what crossover noted. Suddenly fetuses with Downs are "people" and "babies".
posted by Durn Bronzefist at 10:56 PM on September 15, 2008

Mommy, what's a gogortion?
posted by Saxon Kane at 10:57 PM on September 15, 2008

Can't possibly read all the comments to this point while still getting a reasonable amount of sleep tonight, but I started the article and got to

Now the risk is considered to be quite low, and in any event, Dr. Goldberg said, for some couples “losing a normal pregnancy secondary to the procedure is not as problematic as the birth of a Down syndrome child, so they’re willing to take that risk.” and got a shiver up and down my spine. We're entering the 7th month of my wife's first pregnancy, at age 38 (39 in November). We had significant problems getting pregnant and this successful pregnancy is the result of IVF. Thus, I don't know if that sentence grates on me the wrong way because of our fertility history and the fact that we think we appreciate our situation more than a lot of people or what... but I wanted to say this regarding amnio:

The oft-stated statistical risk of miscarriage resulting from amniocentesis is 1%. This is a national average, and anyone considering the procedure would be wise to find out what the stats are for the hospital and the specific doctor set to perform it. Ultimately, obviously, the question the mother/couple needs to ask is, "Will I terminate the pregnancy if the fetus has Down?" I am stunned by the 90% stat, but that's for another comment.

Because we did IVF, we knew we were pregnant within days, so doing the nuchal translucency in the 11th or so week was not a problem. We did, and were very positively impressed by the professionalism and integrity of the medical personnel involved (major HMO). After the ultrasound technician performed the initial screening, she showed stills from the scan to an OB AND brought in the doc to do the scan live in front of us (we also did the blood work ahead of time, so didn't run into the uncertainty pearlybob did).

So much to comment on... not enough time...
posted by yiftach at 11:00 PM on September 15, 2008

Does that make my point more clear?

Better, yes, but notice how much better the argument is when you stop after the word "Period."
posted by Mental Wimp at 11:01 PM on September 15, 2008

If you are, indeed, pro-choice and pro-abortion on demand, then your argument here makes no sense. If indeed a woman has the right to choose, then she should equally be able to choose to abort a fetus with Down Syndrome - as she does to abort a fetus simply because she does not want to give birth to it.

You assume that abortion is morally neutral. A lot of pro-choice people believe that abortion is bad, but that in some instances it is not as bad as the alternative. Also, they believe that even if it is bad, people are going to do it so it is better that in the act only one life, rather than two, are lost. Face it, abortion is kind of immoral. You kill another human being. I say this and I am pro-choice. If you can not see the moral dilemma with abortion you are either ignorant or immoral. This is not a right like free speech. When you exercise this right someone else pays a mortal price.
posted by caddis at 11:01 PM on September 15, 2008 [1 favorite]

Face it, abortion is kind of immoral. You kill another human being. I say this and I am pro-choice.

I'm gonna go out on a limb here and say that a sizeable proportion of pro-choice people do not agree with all three of your statements here. Perhaps none of them.
posted by Durn Bronzefist at 11:04 PM on September 15, 2008 [18 favorites]

"The accuracy was 99.6%"

When it comes to population wide testing, 99.6% is not as good as you would think. I remember doing "false positive" calculations in my population genetics classes. I googled some of these numbers so they might not be 100% accurate (hah!)

Incidence of Down Syndrome (DS): 1 in 800 to 1 in 1000. Let's go with 1 in 1000.
Total births in the US: 4.25 million
Total births with DS in US: ~4250

Healthy and test indicates no DS (No's with No's):
(4.25 million - 4250) x 99.6%= 4.23 million

Healthy and test indicates DS (No's with Yes's):
(4.25 million - 4250) x 0.4%= 17,000

DS and test indicates DS (Yes's with Yes's)
4250 x 99.6% = 4,233

DS and test indicates no DS (Yes's with No's)
4250 x 0.4% = 17

Total true yes's: 4,233
Total false yes's: 17,000

Total yes results: 21,233

Therefore, if your test comes back positive, you have an 80.1% (4,333/17,000) that your child does not have Down Syndrome. If your test came back negative, you have 17/4.23 million or 0.04% chance of your child actually having Down Syndrome.

The moral of this story is, these tests are far more accurate to determining if you DON'T have a disease than if you do. Also, applying genetic tests to large populations where the incident rate is less than the false positive rate (in this case, 0.001 is less than 0.004) you better be darn sure that your test is *extremely* accurate.

When the result of a positive test result is something as well, final, as an abortion you better be giving the person the best information you can. And this 99.6% accuracy isn't as good as it sounds.

Luckily, that's what genetic counselors are for.

Due diligence.
posted by wilky at 11:09 PM on September 15, 2008 [12 favorites]

Face it, abortion is kind of immoral. You kill another human being. I say this and I am pro-choice.

Abortion is no more or less immoral than killing animals for food or shelter or in defense. You're destroying a non-sentient living being. I've no moral qualm with that.
posted by TypographicalError at 11:29 PM on September 15, 2008 [8 favorites]

Face it, abortion is kind of immoral. You kill another human being. I say this and I am pro-choice.

Sometimes I wonder if there isn't anything more immoral than morals themselves. We are such a self-important species. I say this and I'm pro extinction.
posted by twistedonion at 11:36 PM on September 15, 2008 [2 favorites]

Hey wilky, lets crack your maths right open with the fact that most (all?) parents faced with this choice will, often with the advocacy of their doctor, get a second opinion/test.

Now how many false positives are tehre?
posted by wilful at 12:05 AM on September 16, 2008 [1 favorite]

Despite the rather high temperature of this thread, I found it enlightening and learned quite a bit about DS and the related issues. Thanks!
posted by Harald74 at 12:07 AM on September 16, 2008

I know a couple whose "special needs" (severe birth defects) kid had left them in abject crushing poverty...

I know a couple whose "special needs" (severe birth defects) kid is loved and well cared for by her family and a system, that while by no means perfect, still strives for compassion, dignity, and every citizen's right to realize their potential, as relatively limited as it may be.
My girlfriend knows and works with many more.

Reality ain't no after school special.

It's not a pithy anecdote, either, obviously; it's somewhere between our respective comments, and way more complicated than either gives it credit for.
Regardless, hopefully there'll come a day when progressive countries stop treating their most vulnerable citizens like inhuman burdens.
posted by Alvy Ampersand at 12:12 AM on September 16, 2008

Also: *Cough* (Not in reference to the comment I responded to, mind you)
posted by Alvy Ampersand at 12:14 AM on September 16, 2008

This kind of handwringing about costs always reminds me of the following from Eisenhower's "Cross of Iron" speech:

Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.

This world in arms in not spending money alone.

It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children.

The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities.

It is two electric power plants, each serving a town of 60,000 population.

It is two fine, fully equipped hospitals.

It is some 50 miles of concrete highway.

We pay for a single fighter with a half million bushels of wheat.

We pay for a single destroyer with new homes that could have housed more than 8,000 people.

You want to save society's money? Stop the war.
posted by Flunkie at 12:19 AM on September 16, 2008 [21 favorites]

I'm concerned about disabled rights in this election. Currently disabled rights include the right to assembly, rights against unreasonable search and seizure, right to due process, and right to trial by jury.

This bullshit smokescreen by the Republicans about disabled rights means nothing, but gets everyone excited and at each others' throats about the semantics of defining life. Iraq, the current financial meltdown, the huge and spiraling deficit, deflation of our retirement savings, violation of voter rights, and implosion of our current healthcare system are all real problems that these stories are designed to distract us from. We could care for all children with Down's in this country with 1% of the funds being wasted on any of these other unaddressed problems.
posted by benzenedream at 12:28 AM on September 16, 2008 [1 favorite]

My cousin has Down('s) syndrome, and I would characterize him as highly functional. He seems fairly happy most of the time. His parents are affluent enough to afford good care for him. However, whenever I think of him I worry about him, not so much because of his health, but more because the syndrome is like a target for those who like to abuse others.

As for the price comparison, if you must go there it needs a lot more analysis. Starting with accounting for mistaken termination of Down syndrome false positives, and costs of long term post termination complications such as increased cancer rates.

For those of you who think human life is priceless, grow up. Health resources are not a purely zero sum model, but to some extent diversion of resources for any given purpose results in a bad outcome somewhere else. There are only so many kidneys, dialysis machines and MRIs to go around. Fund more and maybe you don't have the money for pre-natal screening, etc... A price has to be put on human life, express or implied. Far better it be done in the open, transparently, than secretly with multiple tiers on race/class boundaries. Refusing to quantify or decide these things is to my mind the worst sort of moral ~~paralysis~~ cowardice.
posted by BrotherCaine at 12:34 AM on September 16, 2008 [5 favorites]

Wow this is one ugly thread.
posted by cj_ at 12:42 AM on September 16, 2008 [1 favorite]

Medical care is never decided on issues of dollars and cents.

That's right. We should totally - totally - give equal weighting to the value of a lung transplant to a healthy 25 year old and a 75 year old 3 pack a day smoker. Because, as we know, doctors and nurses are a limitless talent pool who work for free.
posted by rodgerd at 1:21 AM on September 16, 2008 [3 favorites]

It's all well and good to take a stand against screening and termination when the question is framed purely as an issue of money: $1,308 versus $762,748. But I doubt that it will seem quite so black-and-white when the decision is framed in terms of what else could be done with the difference.

The incidence of Down Syndrome in the US last year was 1 per 733 live births, so the actual "difference" would be $1308 x 733 = $958,764 - $762,748 = $196,016.

Sometimes I wonder if there isn't anything more immoral than morals themselves. We are such a self-important species.

From my childhood observation of other species, I distinctly remember how some mothers handled defective or excessive children. In order to both conserve resources for their remaining offspring and to make use of the protein - they ate them.
posted by fairmettle at 1:32 AM on September 16, 2008

When my wife was an 'elderly prima gravida' (a description which rankled somewhat), she was pressed to agree to amniocentesis. Since we had decided that we wouldn't abort in any case, whatever the result, the test was pointless - and the risk of amnio causing an abortion (we were told about 1%) made the decision a no-brainer. But that logic did not wash at all with the hospital staff, who clearly considered test-and-abort-if-Downs the only socially responsible attitude. They seemed sure that if they could just get us to have the test anyway, we could be induced to change our minds afterwards if the result was bad; or maybe they just didn't think about it at all and were just doing what they do. (Test good. Test always good. Test good.)

Of course with less invasive tests there isn't the same horrifying risk of having aborted a healthy child for no good reason, but for people like us the tests would still be a waste of time and effort and an extra bit of unwanted stress. This ought to be taken into account by the medical profession, though I entirely respect both the desire of people like anastasiav to know as soon as possible, and the understandable decision of most people to abort in some cases.
posted by Phanx at 1:51 AM on September 16, 2008

The rational and intelligent dispensation of medical care is not decided on dollars and cents.

Good.

Next time I can't afford a medical procedure, I'm showing up for my free treatment along with all the other welfare recipients and teen mothers round at docpops practice. Provided I can dodge his shotty, ...

A price has to be put on human life, express or implied. Far better it be done in the open, transparently, than secretly with multiple tiers on race/class boundaries. Refusing to quantify or decide these things is to my mind the worst sort of moral paralysis cowardice.

This.
posted by PeterMcDermott at 2:02 AM on September 16, 2008 [3 favorites]

Wow this is one ugly thread.

I second this. Between the jokes about Corky and Moe Howard haircuts, the strawmen, and what looks like the distant rumbling of an approaching abortion shoutmatch avalanche, I think it best to talk about the possibility of a third season of Rozen Maiden instead. I mean, they did start the manga again. They pretty much have to do a third season, right?
posted by Marisa Stole the Precious Thing at 2:28 AM on September 16, 2008

When my Down Syndrome daughter, decides to look up information about her condition, and finds this site, I wonder what she'll think of you discussing her disability in terms of 'what it costs you.'

People with Down Syndrome are still people you callous fucks.
posted by BadSeamus at 3:36 AM on September 16, 2008 [5 favorites]

As with the last time this discussion happened, it's really missing the voice of Michael Berube and others like him--pro-choice people who happen to have a Down Syndrome kid.
posted by hydropsyche at 3:39 AM on September 16, 2008 [3 favorites]

The rational and intelligent dispensation of medical care is not decided on dollars and cents.

Still rubbish. Given a limited amount of resources to expend on medical care, the rational dispensation of care must be based on the underlying economics. In the UK we even have a national body - NICE - that decides on appropriate spending.
posted by biffa at 3:47 AM on September 16, 2008

When my Down Syndrome daughter, decides to look up information about her condition, and finds this site, I wonder what she'll think of you discussing her disability in terms of 'what it costs you.'

I would hope that she thinks the same sorts of things as any other person with any medical condition being discussed on mefi (eg: those in need of expensive transplants). After all, she's just a person too, right?
posted by fairmettle at 4:12 AM on September 16, 2008

pearlybob: Sounds like your doctor didn't understand Bayesian statistics. The test may be 85% sensitive with a false positive rate of 5%, but a positive result does not mean a 95% chance that the fetus has Down Syndrome. Instead, it means that there is a 6.7% chance.
posted by jedicus at 8:08 PM on September 15

Good lord, I can't favorite this enough. The few doctors whom I personally know are smart as hell, but some of them are still shit at math and especially statistical analysis, which leads to them saying stuff like, welp, you tested positive, so there's a 99.9% chance you have terminal buttzilla or what have you.

Always, always ask your doctor the specifics behind any serious screening (false positive rates, etc), and then sit down and do the math yourself (or get a math weenie to help you).
posted by Optimus Chyme at 4:16 AM on September 16, 2008 [2 favorites]

Over 130 comments, and people are still confusing a fetus with a person.

Would any of you, even a single one, wish the condition of Down Syndrome on any living person? Those with Down Syndrome are people, and some of them are certainly good and loving people, but it is still a horrible condition that causes them massive difficulty through life, a shorter lifespan, and health problems throughout beyond the mental incapacity.

An abortion is a "do-over." You get the test, you see something is terribly wrong, and modern science grants you that do-over. You can say, "No, I do not wish Down Syndrome on my child!" and try again. You are not killing a person with Down Syndrome, you are aborting a mass of cells that would develop into one. The difference is as wide as the difference between arson and preventing a building from being put up in the first place.

Now, granted, I'm just a simple city atheist minding my own business, but aside from modern fundamentalist theory, don't many classical religious views hold that there isn't even a soul until about 4 months in, when the fetus "quickens"? That there is no life until that point? No one's advocating late-term abortion in this thread, but seriously, the issue is that we have the ability to essentially reduce the incidence of Down Syndrome by giving parents a "do-over", and some people argue against it because they get confused and see a tiny person rather than a fetus.
posted by explosion at 4:41 AM on September 16, 2008 [28 favorites]

An abortion is a "do-over." You get the test, you see something is terribly wrong, and modern science grants you that do-over. You can say, "No, I do not wish Down Syndrome on my child!" and try again. You are not killing a person with Down Syndrome, you are aborting a mass of cells that would develop into one. The difference is as wide as the difference between arson and preventing a building from being put up in the first place.

And fortunately, people still have the choice one way or the other. Which I think is what all but a one or two people here are saying.

This thread is doomed, doomed I tells ya. Now, who wants to talk anime?
posted by Marisa Stole the Precious Thing at 4:47 AM on September 16, 2008

Some info on Down's Syndrome:

There is a definite link with advanced maternal age for reasons yet unknown. However, most babies with Down's syndrome are born to women under the age of 35, as younger women have higher fertility rates.

Nothing done before or during pregnancy can cause Down's syndrome. It occurs in all races, social classes and in all countries throughout the world. It can happen to anyone.

posted by asok at 5:18 AM on September 16, 2008

To echo what pearlybob said early on in this post, those technicians at the hospital often get things wrong, and it's sad that the hospital administration fails to understand this.
posted by Vindaloo at 5:24 AM on September 16, 2008

Quantifying life has absolutely nothing to do with capitalism, at all. In any society with non-infinite resources (translation: all of them), that society will either develop a means to apportion those resources or that society will squander their resources and starve that winter. We do not have infinite minerals, energy, or hours in the day. We have bread, and even a little bit of cake, but we only have so much of each.

If we were all green blobs with nine tentacles placed with radial symmetry just a scant meter below a bush of sensory organs of unimaginable function, we'd be budgeting reproductive tokens and making deals to untranslatable for untranslatable with Noble-Gaseous-Humor-2E5AB3 (you know, the one who does that thing with his mineral-gizzard at parties that makes you spasm). With enough tokens, you and the rest of your gene-swapping-clan will be able to produce a fresh clutch of eggs which would hatch into little bitty green blobs with nine tentacles, except you have to eat the eggs, because it triggers the hibernation hormones that will allow you to survive the portion of the local year when there's only two suns in the burnt sienna sky. Life's gonna be tough everywhere.

It's capitalism, and it's in America, so we talk about dollars, but it could just as easy be IKPs (Instant Karma Points) in a post-modern breakaway Tibetan monastery. It's a trifle pointless to discuss Down's (and I have seen the lit go both ways on the spelling, so I'm sticking with what I know) on a societal level when we're wasting so much more money on, well, just about everything, but it isn't irrelevant when it comes to the family budget at all. Yeah, that a kid with Trisomy 21 may have heart surgeries and might take until age seven to potty-train has a cost to the family.

Emotional reactions suck for making long-term decisions. That's why we analyze these things. If it seems chilly to you, just wait 'til you see how chilly find a Maine winter to be when the gas, firewood, and electricity run out.
posted by adipocere at 5:27 AM on September 16, 2008 [3 favorites]

Down Syndrome has become the American usage, but the original and still UK usage is Down's Syndrome, from the same discovered by the English doctor John Langdon Down - hence Down's.

To me, Down always sounds "wrong" because it imagines there is an Up syndrome.
posted by A189Nut at 6:07 AM on September 16, 2008 [2 favorites]

People with Down Syndrome are still people

And the humans in Iraq/Afaganastan/Darfur/prisoners at Gitmo are still people.

(And to toss yet more rhetorical petro on the fire, if 'being human' is defined as a X and Y chromosomes, the extra 21st would put 'em outside of the chromosomal norm - thus not human)

you callous fucks.

Rhetorically, this thread will yield many examples of hypocrisy to be mined in the future. Man's inhumanty to man and the willingness for man to fight over resources rather than share are fine examples of 'callous fuckery'.
posted by rough ashlar at 6:14 AM on September 16, 2008

An abortion is a "do-over." You get the test, you see something is terribly wrong, and modern science grants you that do-over. You can say, "No, I do not wish Down Syndrome on my child!" and try again.

But you can also say, "I don't think being a person with Down Syndrome is the worst thing ever. I have the resources to raise such a child and I don't wish to end this pregnancy." It could be because the woman is older and it was already difficult to conceive the first time. It could be because she knows someone with this disorder and is familiar with it. Being pro-choice means it's none of my business which of those choices someone else makes, or what her reasoning was, as long as she makes her choice freely and fully informed.
posted by hydropsyche at 6:30 AM on September 16, 2008 [7 favorites]

How much does 20 years to Life cost in a maximum security prison? And how much does 5 years on death row cost?

As the end of cheap energy (aka peak oil) takes hold, it'll strangle many a sacred cow. Right now the system of capital is getting choked. But along the way down, the systems of societal support for 'the non-productive' will also be hit. So the down syndrome fetus/baby of today will be the 'in a better place next to Jesus' as food becomes an issue in the future due to expensive I-NPK/Oil and changing weather due to global warming.
posted by rough ashlar at 6:36 AM on September 16, 2008

It's very cruel to make a child who can never fully participate in the world he's born into.

What a bizarre self-absorbed sentiment. What is full participation? An Ivy League education? Getting your legs blown off in Iraq? What?
posted by Mister_A at 6:37 AM on September 16, 2008

Being pro-choice means it's none of my business which of those choices someone else makes,

And when the burden of that choice falls to you as a taxpayer - do you still have no say?
posted by rough ashlar at 6:37 AM on September 16, 2008

to the men who think that pro-choice women go wantonly aborting every cystoblast or fetus just because we can,

SHUT THE FUCK UP!

you don't have a womb? you can't carry a child to term? you want to smear your pious bullshit on women? FUCK YOU!

i am rabidly pro-choice and an avowed feminist. yet after the alpha-fetoprotein test came back in 1997 saying that my child had a high probability of having Down Syndrome and after the genetics specialist sat us down to discuss aborting not my fetus, but my 6-month pre-born BABY, i wanted to not just kill the asshole. i wanted him to feel ten times the pain I was feeling sitting there having to listed to him tell me that MY BABY, MY CHILD could be easily aborted.

and all this for a false positive test.

i chose to not go through the amniocentesis. you know why? i was afraid that it would actually lead to MY BABY being a "spontaneous abortion" statistic.

this from a rabid pro-choice feminist.

i was having MY BABY by any means necessary. i was having MY BABY against all odds.

my son is 11 years old now and he just called me from middle school to say he was coming out a bit late. that false positive was false indeed. he's fine. and had he not been fine at birth, he would still be MY BABY, MY CHOICE.

so FUCK YOU ASSHOLES who think that making the decision to have a child is just cut and dried if you are pro-choice.

and here :

The late term abortion I never had
http://www.culturekitchen.com/node/10627

all you men you think you have an idea you just don't. you know NOTHING of the excruciating pain a woman has to go through when deciding to have or terminate a pregnancy.

sincerely,
liza sabater
posted by liza at 6:38 AM on September 16, 2008 [8 favorites]

0xdeadc0de, I used to work with teenagers who had Down Syndrome -- I helped them learn their jobs, so they could earn money.

None of them expressed a desire not to have been born. The girls expressed a desire to attract boys, and the boys expressed a desire to watch/play sports. I know that's kind of cliched, but that's what I remember about them. Although there were differences, at heart they were pretty much like other teenagers I've known. Of course, I don't know many teenagers these days. Maybe they've changed.

I have met a person who expressed a desire "not to exist," but he didn't have Down syndrome.

My guess is that you don't know any people with Down syndrome (or other intellectual disabilities).
posted by Badmichelle at 6:42 AM on September 16, 2008 [1 favorite]

People with Down Syndrome are still people

Yes, but fetuses that are likely to develop Down's Syndrome are not people, they are lumps of protoplasm.

Jesus Tapdancing Christ, people are up in arms in this thread. There is nothing wrong at all, in the real world, in basing a decision as to whether or not to terminate a pregnancy in part on economic factors or on the possibility that the child will develop something like Down Syndrome. People really need to stop making more of this then it is. It's not a huge moral quandary, its not the resurgence of the Eugenics movement (and if it was, would that be so bad, necessarily?) and its not a denial of the "worth" of. Don't be daft. Its an acknowledgment of real world considerations, that it would be criminal negligence not to take into account on some level.
posted by Aversion Therapy at 6:45 AM on September 16, 2008 [1 favorite]

Would any of you, even a single one, wish the condition of Down Syndrome on any living person? Those with Down Syndrome are people, and some of them are certainly good and loving people, but it is still a horrible condition that causes them massive difficulty through life, a shorter lifespan, and health problems throughout beyond the mental incapacity.

Explosion,
Since you cast your argument emotively, I'll do the same.

I am very, very firmly pro-choice, yet I'll never forget a series of articles by a woman, Rosa Monckton, about her experience in the UK of wishing to continue with her (correctly) Down Syndrome diagnosed pregnancy.

Rosa M. was, is, the epitome of a highly articulate, highly educated, "powerfully" connected middle class woman. (Husband was a prominent journalist, Dominic Lawson - brother of Domestic Goddess Nigella). Her religious background made abortion an impossibility and she could not have been better informed about the likely severity of the syndrome (in the case of her child), shortened lifespan, heart problems etc.

At every stage of her pregnancy check-ups - as I recall - there was at least one medical professional on hand who assumed she was making her decision out of sentimental ignorance & sought to enlighten her.

Every single time, and no matter how tactfully it was phrased, the professional assumption was that she must either be thick - or in the hysterical grip of a mommy-as-martyr complex.

Maybe she was slightly hamming up her account, but still. Her articles managed to be amusingly exasperated, self-mocking, unsparingly detailed - and incredibly moving.

I've felt - ever since - that you probably need a will of iron and a remarkably thick skin to persist with your "choice" when it's not the one we pro-choicers seem to like.
posted by Jody Tresidder at 6:45 AM on September 16, 2008 [2 favorites]

If I had Down Syndrome, I would certainly want my parents to abort me. I believe all those with Down Syndrome would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it. Therefore, aborting fetuses with Down Syndrome is a moral imperative.

Someone mentioned you probably don't know anyone with Down Syndrome. It appears you also don't know much about logic.
posted by Pax at 6:54 AM on September 16, 2008 [3 favorites]

I personally don't have that desire to procreate at all, but kids, all kids, have all kinds of problems. How do you know your kid isn't going to grow up with untreatable depression? How do you know he's not going to end up on the couch at 30, freeloading, doing drugs, stealing your retirement funds or compulsively shopping? He could have cancer or heart problems or cerebral palsy. He could be paralyzed for life in a car accident. He could end up with some kind of brain trauma that impairs him. He might be schizophrenic.

If you're brave enough and emotionally stable enough to weather having kids at all, with all the unforeseen problems they are going to bring along with them (and they will bring them), then you're probably going to have a fine life, regardless of whether your kid has Down syndrome or not. If you can't handle problems in your life because you want to have control over your life, reassess whether or not having kids is for you.
posted by onepapertiger at 6:55 AM on September 16, 2008 [1 favorite]

Bravo Liza, I appreciate your comment. You were able to separate your politics from your personal decision and what was going to best for you and your family. It is so easy to sit in your easy chair, laptop in lap, with drink in hand and comment about "what I would do," or "What you SHOULD do". I really appreciate knowing what someone else who has been in the diagnosis chair did. The news that there may be something wrong with a pregnancy/baby (yes, I saw my fetus as a baby, even at eleven weeks when we had our testing) is like no other and every woman needs to A) be 10000% sure the diagnosis is correct and then B) make the right decision for her. That is all that needs to be said.
posted by pearlybob at 7:03 AM on September 16, 2008 [1 favorite]

I believe all those with Down Syndrome would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it.

Someone mentioned you probably don't know anyone with Down Syndrome. It appears you also don't know much about logic. [Pax]

Pax,

Yup, about time someone demolished the "logic" in that fatuous comment you quoted!

(But you should have bolded both words in "I believe...":) Actually reading it again, the entire comment needs to be in sarcastic bold...!)
posted by Jody Tresidder at 7:08 AM on September 16, 2008

With regard failing to distinguish between First Amendment rights and an abortion right, let us not forget Wendie's maxim: "The right to swing my fist ends where the other man's nose begins."

[D]on't many classical religious views hold that there isn't even a soul until about 4 months in, when the fetus "quickens"? That there is no life until that point?

From a scientific materialist point of view, what does ensoulment have to do with one's humanity?

Oh, and NO. While some theologians playing the armchair embryologist might have theorized along these lines based on Aristotelian theories of human development, I can't think of any religious group that ever adopted this as its teaching. (So far as I know only the LDS--to the surprise of many, not dogmatically pro-life [though neither are they a classical religion]--go down this road.) Religious groups who could be identified as pro-choice are forced to make the convenient fetus v. human moral distinction. Theology has nothing to do with it; their decision is nothing more than caving to a social demand.

Conversely, I believe the major religions have been amazingly open to the views of science that, from the moment of conception, a distinct human being is formed. Its humanity means that it is possessed of all the rights inherent in its very humanity, however much it might "look" like a blob of cells. That blob of cells only becomes one thing after that point.

//runs away
posted by resurrexit at 7:10 AM on September 16, 2008

Being pro-choice means it's none of my business which of those choices someone else makes,

And when the burden of that choice falls to you as a taxpayer - do you still have no say?

Of course I have no say. That's what being pro-choice means: the decision is up to the pregnant woman and no one else. I have no right to say what she does with her body. Period.

My tax money supports all kinds of children--poor, disabled, sick--and that's exactly what I pay taxes for. Are you suggesting the dismantling of WIC and Medicaid?
posted by hydropsyche at 7:23 AM on September 16, 2008 [5 favorites]

This thread is still here? Sad, disgusting, but sadly not surprising. I expect it's keeping the mods on their toes, though.

You know, you might as well try to debate the merits of breathing air or a blend of helium and argon.

Every week I do standard med checks on folks with Down's. Not a one is anything but a dream as far as temperament and decency. Quite a few are in to their fifties and likely will make it into their sixties with simple, basic care.

If you spent two hours shadowing me, your juvenile pseudo-Randian pontification would evaporate like a weak fart in a cyclone. About one person in five is leading anything remotely resembling a "fulfilled" life by the time they leave high school, assuming your metric is anything resembling an attempt to live up to even 50 per cent of their potential. Societally we're pretty much a bunch of intellectually and physically lazy children who would rather watch sports and eat chips instead of trying to lose five pounds. They figure it's their birth right to have society help defray the costs of their self-inflicted illnesses and moronic choices. Go look in the mirror. If you have nicotine stains on your teeth or a spare tire then you are a fucking drag on society. It's just that you are too self-absorbed to imagine it's true.
posted by docpops at 7:27 AM on September 16, 2008 [7 favorites]

He could be paralyzed for life in a car accident.

You can't tell before a person exists that they would be paralyzed for life in a car accident and prevent your child from being paralyzed. You can tell before a person exists that they would have Down Syndrome and prevent your child from having Down Syndrome, by aborting and having another try, hopefully with well-formed gametes this time. This does involve preventing the realization of a "potential person," but that's a silly concept, as you prevent the realization of "potential persons" whenever you're not doing all you can to pump out as many babies as physically possible.
posted by TheOnlyCoolTim at 7:28 AM on September 16, 2008 [1 favorite]

And when the burden of that choice falls to you as a taxpayer - do you still have no say?

Of course you have a say. You are probably paying several one-hundredths of one percent of your taxable income every single year to support these free-loading Down's kids. You can get out there and protest the misappropriation of your hard-earned tax dollars to support the several thousand kids with Down's syndrome born annually. You should bring a sign with you. That sign should have the word "moran" on it.
posted by Mister_A at 7:29 AM on September 16, 2008 [1 favorite]

liza makes a good point, also made earlier in the thread – about errors in testing. She adds another data point of confusion however to the whole fetus vs. MY BABY dynamic. You would not have aborted your baby. No one is suggesting anybody abort anyone’s baby.

Would we even be hearing these objections in the test tube scenario, where we’ve got a half dozen blastocysts going and perhaps observe that one or more appear abnormal and get rid of those samples? Those too could be your baby. However that’s not what they are right now. Samples of genetic matter. Baby simulations. If the simulation isn’t working out, run another. I’m sorry that you were apparently traumatized by your decision. I do not agree (by your use of “a woman”) that all women experience this, or that they do every time if they make that decision more than once. Your experience is your own. But I would suggest that the value you place on your child has little to do with the decision at a much earlier stage. We’re fast approaching “every sperm is sacred” territory here, and all its attendant craziness.

I think there are only one or two "moral imperative" people in this crowd. Everyone else seems to be on board with the fact that this is a parental choice. Period.
posted by Durn Bronzefist at 7:36 AM on September 16, 2008 [1 favorite]

Just a thought (though I'm sure someone's already had it--I haven't read the entire thread): what are the social benefits of having folks with Down syndrome around? Was it Orwell who said you can take the measure of a society by looking at their prisons and hospitals? There is something in us that wants to pick up those who have fallen down. It does us good. How much?
posted by MarshallPoe at 7:39 AM on September 16, 2008

TheOnlyCoolTim: My point is that you have no idea what's going to happen. Down syndrome isn't the worst thing in the world to happen to a kid, though it seems like it would be the worst thing to happen to a parent whose hopes and aspirations for the baby revolve around being "normal" or "exceptional." And you're not scot-free once your kid shows that his gametes are "well-formed."
posted by onepapertiger at 7:43 AM on September 16, 2008

This is an incredibly ugly thread, attached to a post made by someone whose ulterior motive in posting only one-side of the issue is sadly obvious. The "Palin" tag was subtle, Brian B. Way to be even-handed in the information you provide. *sigh*

My wife and I (both pro-choice,) lost a fetus through a late miscarriage and one through selective reduction -- a choice we were forced to make by circumstances. Try and save twins or be guaranteed to lose triplets. A third heartbeat you've watched for weeks on an ultrasound monitor is silenced, and then there are two. And the only thing you can do at that point is follow the doctors' orders (the OB and the perinatologist,) and hope and pray that everything will be ok. We dealt with false positives on several tests, screwed-up samples (my wife had 3 CVS tests and 2 amnios -- and every one scared the hell out of us, because every 12" needle into the belly carried an additional a risk of miscarriage.)

For what it's worth, I hope that everyone here who is bitterly complaining about those who knowingly bring disabled children into the world never has to go through such hell. I pray they never have to deal with false positives on tests.

I used to think the way many commenters in this thread do. But abstractions and reality are very different animals, and parenting is more than statistics. Being a parent means taking direct responsibility for a human life. Most of us don't take that responsibility lightly. Sometimes, the decisions we have to make as parents are agonizing and awful. And frankly, the potential cost one's child may impose on taxpayers is simply a distant abstraction.
posted by zarq at 7:45 AM on September 16, 2008 [5 favorites]

So, because there will be unforeseen problems we should do nothing about the easily foreseen ones? Don't bother to quit drinking, pregnant mothers! If you're brave and emotionally stable, you're going to do just fine caring for a child with fetal alcohol syndrome!
posted by TheOnlyCoolTim at 7:49 AM on September 16, 2008 [2 favorites]

TheOnlyCoolTim: Um, overstating your flimsy case much? Nice exclamation points.
posted by onepapertiger at 8:08 AM on September 16, 2008

onlyconnect: Oh lordie, here we go again in the comments with the people who need to tell me that aborting a fetus with Down's syndrome is the best result for all involved, including the then-dead fetus with Down's. Make whatever decisions you'd like wrt your own uterus, but don't condescend to tell me that you know what's best for mine. Because you do not.

Mental Wimp: Strawman, oh Lord, strawman. Strawman my strawman, oh, strawman, that I may strawman my strawman and those strawmanless strawmen. In strawman's name, a-strawman.

The Gooch: I do find it hard to understand why so many people on here who claim to be pro-choice don't see the irony in stating outright that genetically imperfect babies "should" be aborted

Mental Wimp: I do find it strawmanning to strawman why so many pro-strawmen who strawman strawmen, but don't strawman the strawman in strawmanning outright that strawmen "should" be strawmanned. Good lord, this is coming in handy!

The Gooch: I don't think "strawman" means what you think it means. From this thread alone:

"I mean, if you choose to have a kid with downs even though you could choose not to, that's your problem. But don't try to pressure others to do the same becuase you made a selfish decision. " - aacheson

"If you're squarely into fetus =/ person territory, you should have no problem with starting over to give everyone involved the best start possible. No?" - Durn Bronzefist

"It's very cruel to make a child who can never fully participate in the world he's born into." - grobstein

"If I had Down Syndrome, I would certainly want my parents to abort me. I believe all those with Down Syndrome would choose to have never existed over the diminished, dependent life they live, had they capacity to comprehend it. Therefore, aborting fetuses with Down Syndrome is a moral imperative." - 0xdeadc0de

I agree with The Gooch that "strawman" does not mean what Mental Wimp seems to think it means. I have no quarrel with people who choose to abort their fetus after they find out it has a genetic defect. In this position I can see myself choosing to do the same thing. But there are a host of voices in this thread saying straight up that it's wrong to make any choice other than abortion in this situation. It is not invoking a "strawman" -- i.e., misrepresenting my opponent's opinions for the purposes of more easily rebutting them -- to say in response to these voices that they are allowed to make their own choices, but my uterus is mine, and they have no business dictating to me what I should do with it. Abortion in this situation might be the right thing for you, but exactly where do you get off telling me what the right thing for me or anyone else is? Is that what pro choice means now?

grobstein: Your problem, Gooch, (and the place where you stray into strawman territory) is when you assume that being "pro-choice" means one believes the choice whether to abort is completely morally neutral. It does not necessarily mean that. I happen to be pro-choice, but when you impute to me the further notion that I never think abortion can be right or wrong (which you do by suggesting it's contradictory to say someone "should" abort), you're strawmanning me. Despite being pro-choice, I think that it can sometimes be right to abort, and sometimes wrong (I just think the government is insufficiently competent to make a blanket decision about it).

This is impressive because you are effectively saying that although the government is insufficiently competent to make an across-the-board, blanket decision about when women should have an abortion and when they should not, you -- only you -- have the proper notion about when it is right and when it is wrong, and therefore you are sufficiently competent to make this decision for all women. Because apparently you know as a fact that "It's very cruel to make a child who can never fully participate in the world he's born into." Again, I have no problem with you making this decision for yourself and your own fetus. But when you apply this judgment to all situations, you have just taken the "choice" out of "pro choice." How is this different from the conservative position of dictating to women that abortions are "wrong"? Because it is based on your own morality, which is righteous, and not theirs, which is evil?
posted by onlyconnect at 8:12 AM on September 16, 2008 [3 favorites]

Just FYI Tim's point, but I recall a finding in my undergrad years back that some overwhelming percentage (I think about 90%) of FAS mothers choose not to abort. I don't remember how/if religious beliefs factored in, mind. But I don't see how this is a wildly incomparable scenario.

That being said, I do believe that parents should be held responsible for harm done to a fetus, not because the fetus has rights, but because the baby (eventually) does. I'm not sure how I square that with the decision to carry to term an individual with a severely compromised genetic structure -- whether that in itself constitutes harm -- but that choice I am willing to protect. The choice to intentionally render harm in other ways not so much.

on preview: onlyconnect -- once again I am swept up in the Gooch's quotations, and I do not in any way endorse a "should" or "must" abort policy. My entire point is that people should not get up in arms about the decision of parents to abort or not because the fetus is not a person. Period.
posted by Durn Bronzefist at 8:16 AM on September 16, 2008

I do believe that parents should be held responsible for harm done to a fetus, not because the fetus has rights, but because the baby (eventually) does.

As an abstract concept, sure. But in the real world, situations aren't so easily quantified. Not all fetuses are injured through FAS. For example, it is nearly impossible to determine accurately whether say, a medication is going to cause harm to a fetus. My wife was prescribed two medications (Lovenox and indomethicin) by her perinatologist that some medical experts say might be dangerous to a growing fetus. Nearly all pharmaceuticals are labeled with warnings that pregnant women shouldn't take or use them. Yet, a very high percentage have never actually been tested on pregnant women, because pharmas don't want to take the risk of causing harm to an unborn child. So, why the label? They're covering their asses.

Where do good intentions fit into your scenario?
posted by zarq at 8:39 AM on September 16, 2008

Long thread is long, so I apologize for not reading every comment. I just wanted to say that this strikes fairly close to home. My wife and I had our second child a year ago, and we discussed it and opted not to have the screening, because we both wouldn't be willing to abort a child even if the screening came up positive for Down syndrome. So, why bother, you know?

We had the normal ultrasounds, and they found two "markers" for Down syndrome. A thickening in the heart and water on the kidney. They didn't give us any numbers, that I recall, they just said these were two possible markers but the probability was still fairly low.

At that point, we actually wished we had had the screening, just so we could know for sure and start preparing. Turns out there wasn't any question we woud be having the baby, regardless, so we might as well have known beforehand. Instead we spent three months sort of half-worrying, and reading about Down syndrome.

Well, my son was born last August, and he's perfectly healthy and cute as a goddamn button. He has a slight lack of function in one kidney, and the heart thing seems to have been nothing. He does not have Down's.

We're in the camp that are not pro-life, but see no reason to abort a child due solely to Down's syndrome. I know, and have known a few people with Down's, and I'm not willing to say they do not deserve to live. As a number of you have pointed out, they seem, on the whole, a hell of a lot happier than I usually am.

What are we going to do when this screening gets better? Will we start aborting people due to the likelihood of depression? OCD? Brown hair? It seems to me that Down's is the wide end of a long and ugly slope, and I'm not willing to be the one to jump aboard. I guess people will, overall, determine where that slope stops. Right now it appears that the general society as a whole has said "we do not think Down's syndrome should exist." I think that's unfortunate.
posted by rusty at 9:02 AM on September 16, 2008 [3 favorites]

If you have nicotine stains on your teeth or a spare tire then you are a fucking drag on society.

Before or after needing medical care?

One of the arguments of the 'no socialized medicine' crowd - Want the gov-u-mant telling you not to have a big mac?

My tax money supports all kinds of children--poor, disabled, sick--and that's exactly what I pay taxes for.

Because they are 'poor, disabled, sick' as compassion or as a simple calculation that helping the kids now means less expensive jail later?
posted by rough ashlar at 9:06 AM on September 16, 2008

My tax money supports all kinds of children--poor, disabled, sick--and that's exactly what I pay taxes for.

Because they are 'poor, disabled, sick' as compassion or as a simple calculation that helping the kids now means less expensive jail later?

Because I firmly believe that one role of government is taking care of children like these. It's one reason I buy into the social contract, pay taxes, and give up some of my rights in the process: so that poor, sick, and disabled kids are taken care of.

But if a cost/benefit analysis helps you, it is probably more cost-efficient to pay some money when they are kids to help avoid prison and/or institutionalization later.
posted by hydropsyche at 9:12 AM on September 16, 2008

Argh, late to the party, but better late than never.

Right now it appears that the general society as a whole has said "we do not think Down's syndrome should exist."

I think it's more along the lines of "Having a kid with down syndrome can be really hard, and most people don't want to have to deal with it. Let's give those people an out." Is that an invitation to go ahead and eliminate every "undesirable" trait? Maybe, and maybe that's not as bad a thing as people would like to make it out to be. Maybe people are more than the sum of these traits.

I don't think people with down syndrome are a drag on society, or somehow less than human than other people. Despite that, if I were a woman and I found out my baby was going to have down syndrome, I would want have an abortion. It's a selfish decision (as with almost any abortion), pure and simple. I am not afraid to admit it, because I don't feel that having an abortion is wrong.
posted by symbollocks at 9:24 AM on September 16, 2008 [2 favorites]

My goodness. Having now waded through most of this ~~clusterfuck~~ discussion, I would like to make it clear that my comment was not "No one should abort Down's babies," but simply "I am so uncomfortable with the implications of doing so that I decided not to." As I said at the beginning, I am pro-choice, even in cases where I disagree with the decision to abort, because it fundamentally isn't my decision.

I'm not a big fan of the social and medical-industry pressure to abort Down's babies. I am also not a big fan of the religious right's pressure not to abort any baby ever. I wish people with agendas would shut up and let people get on with making what is, for almost everyone, the most difficult choice they'll ever have to make.
posted by rusty at 9:30 AM on September 16, 2008 [2 favorites]

It's very cruel to make simplistic assumptions about what constitutes "full participation" in the world.

I really like this point. Who gets to decide what participation is? What constitutes a disease or disorder? Perhaps an autistic child cannot "fully participate" in our world, but perhaps they are really a genius that we can't understand. We don't really know. Above posts were right, their cognitive skills vary widely, WWCD.

But on the other side of the coin, our society is much more into the whole "save life, damn the cost." While I appreciate that perspective, places like Britain aren't like that. If given the choice of a highly experimental and expensive drug for cancer that would only give you a couple months to live or dying, they choose dying. They aren't as hung up on life as we are. The reason for this is pretty pragmatic, they have socialized health care, and if every person wanted to live for an extra three months at 700k a pop, the whole system would fail.

I think no one should be forced to abort if they don't want, but if there are parents that would put a baby up for adoption because of downs perhaps they should abort. Maybe the parents can't afford to raise the baby, or something. That downs baby will have a harder time getting adopted. Maybe it's okay. I don't think many pro-choice people are against teen mothers aborting because they couldn't be good parents at that juncture in their life. Is this situation much different? If you believe it's okay to abort a fetus, aborting a fetus because it likely has downs doesn't seem much different/worse.
posted by metricfan at 9:32 AM on September 16, 2008 [1 favorite]

I recall a finding in my undergrad years back that some overwhelming percentage (I think about 90%) of FAS mothers choose not to abort. I don't remember how/if religious beliefs factored in, mind.

If Canada's Aboriginal population ("The prevalence of FAS/FAE in high-risk populations, including First Nations and Inuit communities, may be as high as 1 in 5") is any indicator, I would guess that poverty, lack of education, and the availability of abortion has a greater influence.
posted by Alvy Ampersand at 9:35 AM on September 16, 2008

Durn Bronzefist: on preview: onlyconnect -- once again I am swept up in the Gooch's quotations, and I do not in any way endorse a "should" or "must" abort policy. My entire point is that people should not get up in arms about the decision of parents to abort or not because the fetus is not a person. Period.

Durn Bronzefist, earlier: While I am certainly pro-choice, I don't think there's a moral imperative to abort "imperfect" fetuses. Rather, I find it odd that anyone who would in other situations refer to a fetus as "a bundle of cells" or the like -- distinctly not-human, not viable, and with no rights whatsoever -- would be bothered by tossing that bundle of cells for another. It's not an imperative. It's completely pragmatic. . . . A fetus is a few scrapings on a chalk board. A few lines on an etch a sketch. Erase and start over.

I think I understand your position now. You are not telling me what to do, but you do seem to be telling me when human life begins and what feelings I should be having about aborting a 20-week-old fetus. (Amnio generally can't be performed until 16-18 weeks, and it takes 1-2 weeks to process the results, so any abortion occurring after amnio is generally well past the first trimester and into the second). You say, and apparently believe everyone should agree, that a fetus is "just a few scrapings on a chalk board," and not something human that my body has sheltered for half of the length of a normal pregnancy.

I agree with you that a fetus is not a person, but it's not completely nothing, either. It's moving around in there. It's touching its own face, or scratching its ear. It feels things. I think I as an adult pregnant woman would have more rights than the fetus, and the ultimate right to say whether it lives or dies, and whether I want it in my body anymore or not. But it is a living thing that is human with the potential to be a person, and that is not insignificant. So you are not telling me what to do, no, but you're in effect telling me that killing it and starting over if it's not perfect is the obvious choice, and you're implying that anyone who doesn't make this choice is a bit of an illogical nutter. That's fine, I guess, if you see the fetus in the apparently black-and-white way that you do. But not everyone does, and you don't seem to recognize that.
posted by onlyconnect at 9:42 AM on September 16, 2008 [1 favorite]

Every time I see that 90% statistic I am amazed. I am pretty open with friends about personal reproductive choices and yet I do not know anyone that admits to an abortion due to a a diagnosis of down's. Not that I doubt the number, I just find that interesting. When faced with a similar situation, a child born with a fatal genetic disorder I was glad that the technician had screwed up and not told me of the neural tube disoder on his screen so that I did not have to make the angonizing choice whether to abort after the already feeling the quickening in the fifth month. I know several people with downs, when I went to grammar school in the seventies I had developmentaly disabled classmates and didn't think it was unsual. They are just part of the spectum of human beings, ranging from people with severe communication disorders to the eloquent people on metafilter. I wonder if the reduction in the number of people with developmental disablities will make it more likely that women will abort because they do not have people they have built relationships with that are "different" and therefore scary.

Because they are 'poor, disabled, sick' as compassion or as a simple calculation that helping the kids now means less expensive jail later?

No, because all people are entitled to get the same support that able, wealthy, white male children historically recieved so they can contibute to society .
posted by saucysault at 9:47 AM on September 16, 2008

Anyone insisting that disabled lives aren't lives worth living and fetuses with disabilities should be aborted, please read this article by Harriet McBryde Johson. She was a severely disabled woman, attorney, activist, and truly wonderful writer. This article made a huge impact on the way I thought about quality of disabled people's lives. It's one of the few things I can specifically point to and say, "This. This opened my mind. This changed the way I thought about something." Googling to find the article, I was so sad to see that she died in June. She was only 50, and needed people around her all her life to help her with daily tasks, but she did so much more than most "fully able" people will ever do.

[And to those arguing that disabled people are a burden, would you be the same people who are in favor of the social safety net, universal health care, food stamps, and other benefits? If not, you're consistent. If you are the same people, then you shouldn't think the "burden" of disabled people is an argument against their existence, but an argument against our society for our narrow-minded and selfish failure to offer adequate supports to all our citizens.]
posted by Mavri at 9:48 AM on September 16, 2008 [2 favorites]

There are two questions here: 1. Does the State get to regulate gestation? What about genetically modified sperm or egg? As the price and potential of IVF falls, more and more people may elect to go IVF, thereby guaranteeing not only a genetically normal baby, but perhaps the smartest most beautiful baby they could possibly produce. What if there were a genetic test for homicidal psychopathology? What would the State's interest be then? Remember, the State is not compelled to financially support any particular group, so arguing the "cost to the State" is pointless.

2. Are there moral absolutes? Clearly there aren't. Saying that something is right or wrong is just expressing your preference. Is a discussion of moral preferences in itself immoral? Clearly, another preference.
posted by ewkpates at 9:49 AM on September 16, 2008

don't many classical religious views hold that there isn't even a soul until about 4 months in, when the fetus 'quickens'?

Or that the soul enters the baby's body at birth.
posted by kirkaracha at 9:51 AM on September 16, 2008

Medical care is never decided on issues of dollars and cents.

You need to see Sicko. Deciding medical decisions on issues of dollars and cents is exactly how the American health system works.
posted by kirkaracha at 10:04 AM on September 16, 2008

Boy, nothing brings out the worst of MetaFilter like an abortion thread. Pompous douchebaggery for all!!
posted by Shohn at 10:07 AM on September 16, 2008 [1 favorite]

(Amnio generally can't be performed until 16-18 weeks, and it takes 1-2 weeks to process the results, so any abortion occurring after amnio is generally well past the first trimester and into the second).

I agree with your points regarding Durn Bronzefist's positions.

I think it is worth pointing out that an amniocentesis is not the only test which can determine whether a fetus has Down Syndrome or other genetic issues. A Chorionic Villi Sampling test (or CVS) can be done at 10-13 weeks (approximately 4 weeks earlier than an amniocentesis -- my wife had hers done at the 12 week mark,) and a nuchal translucency test (typically performed at 11-13 weeks) is a non-invasive diagnostic that is used by most, if not all obstetricians and perinatologists to determine whether a possibility of Down exists, and if an invasive genetic test might be needed.

The CVS test takes a sample from the placenta, rather than the amniotic fluid, but is more dangerous to the pregnancy than an amniocentesis.

The nuchal transparency test (our doctors called it a nuchal cord scan) looks for amniotic fluid buildup behind the neck, as well as other measurements which might indicate a problem. The nuchal scan is usually accompanied by maternal blood tests that look for elevated levels of HCG and PPAP which are also associated with Down.

Full results of a CVS usually are available within 2 weeks. If you're testing for certain other disorders, (Fragile X, for example,) results may take up to 4 weeks, since the sample needs to grow to a threshold number of cells before it can be accurately assayed. Either way, results come in during the first month of the second trimester.
posted by zarq at 10:24 AM on September 16, 2008

Errrr.... that should be nuchal translucency, not nuchal transparency. My bad.

Also, (and this a perfect example of what sleep deprivation from twin babies will do to one's mind...) a nuchal cord scan checks to see if the umbilical cord is wrapped around a body part, such as a neck. It's not the same thing as a nuchal translucency scan. I shouldn't have said they were interchangeable. Apologies.

I need a nap. :P
posted by zarq at 10:30 AM on September 16, 2008

We're in the camp that are not pro-life, but see no reason to abort a child due solely to Down's syndrome.

You can't abort a child.
posted by TheOnlyCoolTim at 10:44 AM on September 16, 2008

"don't many classical religious views hold that there isn't even a soul until about 4 months in, when the fetus 'quickens'?

Or that the soul enters the baby's body at birth.

Reform and Conservative Judaism teach that a fetus is a potential (or 'partial') human life which does not become a full-fledged person until the head emerges from the womb. From what I understand, many (but not all,) Orthodox rabbis hold the same belief. These pro-choice groups make up the vast majority of Jews.

That 'partial' life isn't simply dismissed, either. Jews are not supposed to have abortions because a fetus is genetically imperfect. They are, however, supposed to protect the health and life of a mother (an actual life) over her fetus (a potential life).
posted by zarq at 10:52 AM on September 16, 2008

TheOnlyCoolTim: Yes, you can.
posted by rusty at 10:53 AM on September 16, 2008

You can't abort a child.

Yes, you can. The word 'child' can refer to an unborn fetus.

http://dictionary.reference.com/browse/child
posted by zarq at 10:58 AM on September 16, 2008

Interesting. I retract my statement.
posted by TheOnlyCoolTim at 10:59 AM on September 16, 2008

:pedantry-filter: You don't abort a child or a fetus. You abort (stop) a pregnancy.
posted by hydropsyche at 11:04 AM on September 16, 2008 [1 favorite]

TheOnlyCoolTim: FWIW, I read your comment and thought "Oh crap, I'm not actually sure if the definition of 'child' includes a fetus, it was just kinda how I think about babies I helped make inside my wife. I better look it up." [clickety clickety clickety clickety] "Ha! The definition does include fetuses...." (and, if you watch very carefully, perhaps slow the replay waaaaaaay down, you'll see that right here's where I go from reasonable person to Internet Douchebag in 0.13 seconds) "...I'll show that guy what an asshole he is!"

We're none of us safe from the hazards of this medium. :-)
posted by rusty at 11:11 AM on September 16, 2008

Woah, a truckload of ignorance evident in this thread. One point I haven't seen raised is that people with DS are not the only people supported by services for people with intellectual/learning/developmental disabilities (strike as appropriate for location), aren't even the majority, so the fear of services being reduced is quite unfounded. For many people in need of such support there is no known origin for their disability, and as the rate of autism and other forms of ID are increasing it is very unlikely that such support services will be reduced - at least in places where there is already a solid base of support.

As for me, I'm utterly pro-choice, in that I respect people who choose to terminate a pregnancy for whatever reason and I work with people with disabilities to have as fulfilling a life as possible. The only moral imperative I see is to ensure you care for those for whom you have responsibility, and those with whom you come into contact, to be the best people they can. If that means you feel you can't handle the 'perpetual grief' researchers have identified in many carers of people with disabilities then so be it, but anyone who chooses to have a child with disabilities should not be derided or have to suffer vitriol - ultimately, people with disabilities are, first and foremost, people, and should be afforded the same rights, responsibilities and respect enjoyed by those without.
posted by goo at 11:13 AM on September 16, 2008

Also, I'm in favor of screening all parents of more than two children for insanity or at the very least latent stupidity.

Physician, heal thyself.
posted by mattholomew at 11:21 AM on September 16, 2008

Face it, abortion is kind of immoral.

Oh, well, since you put it that way. I don't think abortion is immoral in the slightest. In the slightest. No, not everyone shares your morality.

If you can not see the moral dilemma with abortion you are either ignorant or immoral.

Or, they don't share your morality, which for the record, I find idiotic and silly.
posted by spaltavian at 11:47 AM on September 16, 2008 [1 favorite]

My friend's mother is an elementary school teacher and she says the last people on earth you ever want to cross as PTA moms with disabled children. She says the advocacy becomes a coping mechanism.
posted by MiltonRandKalman at 11:51 AM on September 16, 2008

you know NOTHING of the excruciating pain a woman has to go through when deciding to have or terminate a pregnancy

Actually, for many women who don't want children (me, for instance) THERE'S NO 'EXCRUCIATING PAIN' AT ALL.

I don't want children. I got pregnant. I got an abortion. No big deal.

I appreciate that you were upset by the false diagnosis you received on the genetic status of a much-wanted pregnancy. I understand that it would have been heartbreaking to you to terminate this much-wanted pregnancy. I'm glad you made the choice that worked for you, and glad to hear you have a happy, healthy son.

But abortion just isn't a big deal, or an upsetting decision, for everyone who chooses it.
posted by Sidhedevil at 11:58 AM on September 16, 2008 [3 favorites]

My friend's mother is an elementary school teacher and she says the last people on earth you ever want to cross as PTA moms with disabled children. She says the advocacy becomes a coping mechanism.

She has an amazing grasp of the obvious.
posted by mattholomew at 12:10 PM on September 16, 2008

Christ, what assholes.

Even the ones I agree with.

Ok, here's my view. Abortion is a private, personal choice, made by the one carrying the embryo/fetus and perhaps the one who helped create it. Anyone else who gives advice on the matter should be invited in. We've lost track of the fact that these people are asking for personal medical records so they can go harass people. Whatever your view of Down Syndrome or abortion, I hope you'll agree that this is wrong. Unless, I guess you're one of those subhumans who blocks access to health centers.

On the other hand, there should be no pressure from those in the medical profession for an abortion. That's just as sickening.

On preview, I also agree with spaltavian and Sidhedevil (My mother had an abortion before I was born. I've never seen any mental anguish about it or anything else. She was in a spot where having a child was a really bad idea. So she didn't.).

And while you're at it, re-read aacheson's comment at the top of the page. I'm surprised that those who are opposed to aborting because of Down have not responded to that one at all. Then again, maybe I'm not.
posted by Hactar at 12:10 PM on September 16, 2008

But abortion just isn't a big deal, or an upsetting decision, for everyone who chooses it.

you obviously don't get the point, do you. at 6 months i already had declared the fetus i was carrying my child. you obviously had no attachment whatsoever to your pregnancy. and that's the point. when a woman declares the abstract "the pregnancy" or "the fetus" her very concrete "child", the tables are turned and the decisions are much harder to make.

geezus, that's the point i make about women who have chosen to have abortions of the fetus they've already called their child. when you have to make a decision about putting an end to the life in you you've become attached to, that decision comes with an amount of psychical pain that cannot be described.

you didn't call that pregnancy your "child". to you ---as it was to me 20 years ago when i had an abortion-- it was a condition i wanted to take care right away before it got out of hand.

seriously, women like you who say "no biggy" are building as big a strawman as all those fetusists who would have loved to force you to carry "that pregnancy" to term.

/liza
posted by liza at 12:16 PM on September 16, 2008

Think I'd rather be friends with someone with down syndrome than some of the people posting here.

I wish I could favourite that comment ten times...
posted by johannahdeschanel at 12:16 PM on September 16, 2008

I know a couple whose "special needs" (severe birth defects) kid had left them in abject crushing poverty.

She had to quit her job to care for their daughter. Soon they lost their house due the medical expenses. They had to liquidate their life savings and retirement. And by age five their daughter finally died a slow horrific death.

Two years ago they divorced, after one them had a complete nervous breakdown attempting suicide, thus leaving other two older children tragically shattered to be raised by an ill equipped grandparent. These two children will of course have no hope to attend college barring scholarships. Which is unlikely.

American Reality ain't no after school special.

Fixed that for you.

Nowhere in the world should anybody, for any reason, lose their home because they tried to keep their family healthy.

It's called socialized medicine, folks. Get with the program.
posted by ymgve at 12:28 PM on September 16, 2008

you obviously don't get the point, do you. at 6 months i already had declared the fetus i was carrying my child. you obviously had no attachment whatsoever to your pregnancy

You didn't say that the "excruciating pain" was experienced only by women terminating a wanted pregnancy.

You implied that the "excruciating pain" was experienced by all women terminating pregnancies.

I get that point (as you see in the rest of my post). The problem is, you didn't make that point.
posted by Sidhedevil at 12:50 PM on September 16, 2008 [1 favorite]

to the men who think that pro-choice women go wantonly aborting every cystoblast or fetus just because we can,

SHUT THE FUCK UP!

all you men you think you have an idea you just don't. you know NOTHING of the excruciating pain a woman has to go through when deciding to have or terminate a pregnancy.

Wow. What a hostile post. Do you think it's just men who are pro-life? You might want to talk to Konolia or Sarah Palin (among millions of other women about that).

I'm a married man with kids and like most posters here, I find that the choice to have a Down syndrome child to be totally up to the parents themselves. Their baby. Their choice.

My wife has had five miscarriages. Five. It was a tremendously difficult time for both of us. It's not my body. But it would have been my baby as well. And, though I am still completely pro-choice, it has radically changed my views on abortion.

And we had our scares as well. But we both decided that if we had a fetus that was a Down syndrome fetus, we would have aborted. It would have been a tremendously difficult decision if it had come to that. but that's what we decided.

I'm not criticizing you for your choice. Your pregnancy. Your choice.

But I can NOT understand why getting on this post and screaming "Fuck You" at men because you didn't like your doctor helps anyone. Pro-choice means accepting everyone else's choice as well, be it pro-life, aborting a down syndrome fetus or whatever else that woman or couple decides.
posted by cjets at 12:56 PM on September 16, 2008 [1 favorite]

all you men you think you have an idea you just don't. you know NOTHING of the excruciating pain a woman has to go through when deciding to have or terminate a pregnancy.

No, some of us do. Some of us mourn just as deeply. Some more so. Some less. Sometimes, a father actually focuses more quickly on their baby as an actual person than a mother does. Every situation is different. I'm sincerely sorry for your loss, but your personal experience doesn't give you the right to diminish my experience or anyone else's, as a husband and father.
posted by zarq at 1:02 PM on September 16, 2008 [2 favorites]

Choice. Being pro-choice is about retaining the right to choose. I believe that no woman should be forced to carry a pregnancy against her will.

Anyone having a child with Down Syndrome, Cystic Fibrosis, Muscular Dystrophy, Sickle-cell Anemia and other genetic diseases for which there are tests should be able to choose to carry that pregnancy to term.

Those conditions are expensive to treat, and we all end up paying the bills, either in health insurance costs, higher hospital bills (due to unpaid care) or taxes (Medicare or Medicaid). How far away is the future in which insurance companies mandate genetic testing, and decline coverage for the pregnancy of a child with a trisomy, or an unlucky combination of genes?

I think we should let women and their families choose.
posted by theora55 at 1:21 PM on September 16, 2008 [1 favorite]

The societal cost of raising and caring for an individual with Down syndrome is $762,748.

By my estimation the societal cost of raising George W. Bush was about 3 Trillion dollars.
posted by mazola at 1:24 PM on September 16, 2008 [6 favorites]

Regardless, hopefully there'll come a day when progressive countries stop treating their most vulnerable citizens like inhuman burdens.

Yes. That would be awesome.

In the mean time here on present day planet Earth in America a huge portion of people end up in with destroyed lives in crushing poverty due to health care costs.

Especially those costs related to caring for a family member with a fatal diagnosis. And at the top of that are the costs associated with an infant child with fatal birth defects. And likely why 90% of those couples who test positive for carrying a Down Syndrome fetus have opted for an abortion.

Look we hear enough of the after school special stories of sick "kids loved and well cared for by their families." That's the fucking problem.

We DON'T hear enough about the horrible reality that most often occurs in places like the US where families are buried by their dependent sick loved ones. And. THAT'S WHY IT HAPPENS HERE.

Because we get this guilt machine propaganda about how you are such an awful person for aborting a pregnancy that will likely destroy your life. Sacrifice your families future, they say, or your a bad person.

The reality here in the US is NOT in between the "lovely-sunny-everything-is-roses" view and the pithy anecdote of crushing poverty. The reality is most often skimming the rim of bone crushing poverty.

If people could just be honest about it and supported to make their hard choices then maybe the heath care system could change. But they can't because the Save The Babies Brigade come rushing in calling anybody talking about reality an immoral Baby Killer.
posted by tkchrist at 1:41 PM on September 16, 2008 [1 favorite]

It's called socialized medicine, folks. Get with the program.

Yes, because as well as this discussion is going here on MeFi, it's going to go so much better when it happens on the floor of Congress.

While I'm not saying that, overall, socialized / single-payer healthcare won't be a good thing, you're deluding yourself if you don't realize that it's going to open the door to a hell of a fight.

People in favor of socialized healthcare seem to take on premise that such a system would allow people and their doctors to make medical decisions in private, and would allow for procedures like abortions and genetic tests. I don't think this is a safe assumption at all. There are people who are going to fight tooth and nail against anything resembling taxpayer funding for abortions or genetic tests (which might result in more abortions, in their minds). There are people who are going to object to their tax dollars being used to pay for 'lifestyle diseases' that they don't have. Or on injuries from high-risk sports they don't do. Or birth control they don't want. Or drug treatment they don't need. Or being spent disproportionately on minorities. Or spent at all on illegal immigrants.

Sure, one solution to all these objections is for everyone to realize that although they may object to 'their' tax dollars being spent on somebody else, somebody else probably objects to their dollars being spent on them, and to just relax and be inclusive. That's pretty logical; it makes sense. It'll never, ever happen that way.

What seems more likely, given the level of discourse here, and the frankly brutal undercurrents of hate and distrust that permeate our society, is a system that funds or refuses funding based on the public's whims and whoever has the best PR machine and the most resources to commit to the task of getting more resources from the public purse.

It's folly to think that the U.S. can ever have European-style socialized medicine; the societies aren't the same. What we'll get, eventually, is American-style socialized medicine, and that's a pretty sobering thought.
posted by Kadin2048 at 1:48 PM on September 16, 2008 [5 favorites]

But they can't because the Save The Babies Brigade come rushing in calling anybody talking about reality an immoral Baby Killer.

Apparently you are in the wrong thread. You seem to think you are in the thread where people have argued that the only moral choice to make when a woman finds out her fetus might have a genetic defect is to carry that baby to term. Nobody in this thread has said that. Rather, this is the thread that is trying to make people who would choose to have babies with genetic defects feel guilty about their decision because they have not considered the so-called crushing impact of this choice on society and apparently are just not sufficiently "pro choice" enough to always choose abortion in such situations.

You might want to ask the mods to move your comment to the other thread you seem to have in mind, wherever it is.
posted by onlyconnect at 1:54 PM on September 16, 2008 [4 favorites]

onlyconnect do you ever tire of your strawmen?
posted by tkchrist at 2:24 PM on September 16, 2008 [1 favorite]

after the genetics specialist sat us down to discuss aborting not my fetus, but my 6-month pre-born BABY, i wanted to not just kill the asshole. i wanted him to feel ten times the pain I was feeling sitting there having to listed to him tell me that MY BABY, MY CHILD could be easily aborted... this from a rabid pro-choice feminist.

No you aren't. You're just rabid. This person was there to enable you to make a choice. Just because you didn't like that choice and already viewed your fetus as a child, doesn't mean you should rob others of the same choice who do not view their fetus as such. In a society where abortion is so taboo, I am very grateful that specialists like this exist to spell out the options available to you and give a you a chance to weigh the (very real) probability of costs of your pregnancy to yourself and your child in the future, given the new important health information. The fact that 90% of women choose to abort show that most will take the option when it is available, so it is prudent for specialists working on your side to clearly communicate that availability.
posted by dgaicun at 2:34 PM on September 16, 2008 [1 favorite]

tkchrist, please explain to me exactly how I have employed a strawman. Maybe you even need to use words limited to one or two syllables. Because I don't see how I have distorted your argument. Plenty of people in this thread, including me, are saying that others should be "supported to make their hard choices" of choosing abortion if they find their fetus has a genetic defect. Nobody in this thread is saying that people who choose to abort in this situation should not be "supported to make their hard choices." So is the strawman mine, or yours?
posted by onlyconnect at 2:35 PM on September 16, 2008

And yeah, uh.... I WANT TO TORTURE AND KILL THE MURDEROUS ABORTION DOCTOR

... is, uh, really, really not rabid pro-choice feminism.
posted by dgaicun at 2:37 PM on September 16, 2008

This thread is really a fine demonstration of the failure of the medium to serve some topics. Even with it being pared down to on-topic posts, the cross talk and outrage seems to remove the chance of reasonable dialogue.
posted by Shutter at 2:53 PM on September 16, 2008 [2 favorites]

Because I don't see how I have distorted your argument.

Please. I want to guilt you into having abortions.

i think I'm in the right thread when I read:

OMG, raising children is work, and special needs children are just too tiring. Kill it first!

yeah. That's not guilt inducing or inflammatory. Nah.

So is the strawman mine, or yours?

Most definitely yours. But I see the confusion. It's hard to choose which one.

Now go have an abortion or this puppy dies.
posted by tkchrist at 2:55 PM on September 16, 2008 [1 favorite]

The fact that 90% of women choose to abort show that most will take the option when it is available, so it is prudent for specialists working on your side to clearly communicate that availability.

qft.
posted by tkchrist at 3:01 PM on September 16, 2008 [1 favorite]

yeah. That's not guilt inducing or inflammatory. Nah.

Well, that's interesting. Because the person who said that in this thread also said they are pro-choice. Which I take to mean (although apparently in this thread that is not a given) that whatever choice they might make for themselves, they support the right of other people to make different choices, even if they don't agree with them. Caddis may not think that abortion is the right choice, but s/he is not trying to force his/her own choice on someone else. And this is by far the most extreme "protective of the fetus" viewpoint that we have seen in this thread -- the view that such a choice would not be right for the individual posting, but that others should certainly have the right to choose it.

What do we have on the other side in this thread? People saying that children with Down syndrome are a drain on the public coffers, and on other people who come into contact with them, and generally lead lives that aren't in effect worth living. And a few people saying that it is a "moral imperative" to abort such babies for the good of the baby and of society. The post itself puts a price tag on the societal cost of raising a child with Down syndrome. I don't think these views are supportive of a person's decision to carry a baby with genetic defects to term, if that's what they choose to do. I think these views are saying, "you should feel guilty for your choice."

You're telling me that this post really has more to do with guilting people into carrying babies with genetic defects to term and not guilting people into doing what 90% of the population does and aborting fetuses with genetic defects? You're entitled to your own opinion, of course, but I strongly disagree.
posted by onlyconnect at 3:24 PM on September 16, 2008 [1 favorite]

-Being pro-choice means it's none of my business which of those choices someone else makes,

-And when the burden of that choice falls to you as a taxpayer - do you still have no say?

I have an idea: why don't you move up until the mountains and build yourself a cozy little Kaczinski cabin, so that not one penny of your tax dollars will ever have to help anyone else in this society? In this way, you can unfurrow your brow over what another human being might have to cost you, personally, and the rest of us can carry on, relieved that we are no longer a burden to you.
posted by Marisa Stole the Precious Thing at 3:28 PM on September 16, 2008 [2 favorites]

“Pro-choice means accepting everyone else's choice as well, be it pro-life, aborting a down syndrome fetus or whatever else that woman or couple decides.”

Excellent point. I’m completely ruthless when it comes to certain things. When we were planning a family my wife and I based our choices on cold statistics and best probable outcomes. I’m used to treating my body dispassionately like a machine and accepting the reality of abilities and limitations.
She had a harder time with it, but understood and accepted the logic of thinking about and developing contingencies when we were not overwhelmed by emotion and in the midst of a situation.

What it came down to, really, was me doing whatever she wanted. But with deep forethought and, importantly, a plan.

I object, as a matter of course, to abortion being ‘no big deal.’ Because, as has been alluded to - abortions are a contingency - NOT a plan. No one has sex without birth control -by design- to have an abortion (Sarah Silverman jokes aside).
It’s what occurs when something’s gone awry.
So from a purely pragmatic moral perspective - it’s not ‘no big deal.’
The question of it being ‘wrong’ or other moral considerations - is a whole other huge convoluted and disputed line of country that I’m not addressing here.

But - it’s one thing to apply the methodical forethought and contingent thinking and calculated planning to oneself and one’s family as a guide and protection for when your emotions might overwhelm you - it’s a whole other thing when someone comes in and pushes some set of concepts on you, no matter their perspective.
I don’t care whether you call a fetus a child or not. It’s irrelevent to that component of the argument. And as pro-life as I am, it’s the only component that matters.

Making a decision to terminate a pregnancy or not because you weigh the costs and quality of life for the child and your family, think you can handle it, don’t think you can handle it - solid.

Someone else coming in, doing the math or laying down the morals, saying no - or yes - and you’re starting down the road to eugenics and/or totalitarianism.
posted by Smedleyman at 3:39 PM on September 16, 2008 [3 favorites]

And tkchrist, I never said you personally were making arguments designed to make those that chose not to abort in cases of genetic defect feel guilty. I said this was an opinion that has been expressed several times in this thread. You still have not shown that I invoked a strawman, but you have invoked one yourself. Sorry to be a stickler about this, but I take your charge quite seriously.
posted by onlyconnect at 3:46 PM on September 16, 2008

What do we have on the other side in this thread? People saying that children with Down syndrome are a drain on the public coffers, and on other people who come into contact with them, and generally lead lives that aren't in effect worth living. And a few people saying that it is a "moral imperative" to abort such babies for the good of the baby and of society. The post itself puts a price tag on the societal cost of raising a child with Down syndrome. I don't think these views are supportive of a person's decision to carry a baby with genetic defects to term, if that's what they choose to do. I think these views are saying, "you should feel guilty for your choice."

Palin proposed an increase in special needs funding, to go with her platform of banning abortion. That's raises many questions, including the ethics of using her own child as a campaign issue, perhaps as a preemptive, and then buying off some voters to satisfy her personal religious demands (which includes forcing rape victims to have children). Obviously, if there ever is a future tyrannical requirement for a "reason" to have an abortion, then the idea of brain damage to a fetus has plenty of traction in that argument among rational people who weigh options, and who aren't religious robot slaves, making Palin's position look more like a bribe. So the post was over your head.
posted by Brian B. at 3:52 PM on September 16, 2008

Plus, as a nice sort of side dish to the abortion ban, Palin also cut funding for counseling and adoption services.
Kind of a dead giveaway there that the good of the baby isn’t a priority.
(Although I’ll refrain from Sobchaking)*

*( “Donny you’re out of your element”)
posted by Smedleyman at 4:12 PM on September 16, 2008

Why is this an issue?

I see only one remotely morally tenable position "retardation sucks, pregnancies should be screened." Abortion has zero moral cost under any sane/modern moral metric. A retarded person may live a happy life, but they are a moral cost under many different moral metrics. So bring a retarded baby to term is an immoral act, period. I ain't talking public coffers here, just raw morality.

I'm happy to consider any sane modern rationally defined moral metric, but I don't think you'll give one contrary to the above reasoning. I mean, can you tell me any pseudo-quantity that maximizing or minimizing can lead one to conclude either that abortion is bad or that retardation doesn't suck?
posted by jeffburdges at 5:00 PM on September 16, 2008

Right. See what I mean?
posted by onlyconnect at 5:08 PM on September 16, 2008

Adopting a child with Down Syndrome

Born With Down Syndrome, in Love With Life

Down Syndrome: Mother/Child Pictures
posted by konolia at 5:33 PM on September 16, 2008

I mean, can you tell me any pseudo-quantity that maximizing or minimizing can lead one to conclude either that abortion is bad or that retardation doesn't suck?

How about being pro-choice means another person's reasoning about whether or not to continue a pregnancy is none of your business? Or, you know, what onlyconnect has said like 20 times?
posted by hydropsyche at 5:36 PM on September 16, 2008 [4 favorites]

Probably way too late to respond (I couldn't from work) but anyway:

zarc: Where do good intentions fit into your scenario?

Squarely. I was only intending to cover wanton negligence, not well-intentioned measures that turn out badly. We all take our chances on the best information we have.

you are not telling me what to do, no, but you're in effect telling me that killing it and starting over if it's not perfect is the obvious choice, and you're implying that anyone who doesn't make this choice is a bit of an illogical nutter.

I see varying degrees of logic in this thread. There seems to be a powerful temptation for people who would classify a "normal" fetus as clearly not a person to refer to a Downs-indicated fetus as a "baby", "person", etc. Which is maybe a factor of perceived vulnerability, but what is more vulnerable than a fetus in the first place? If anything, despite its slant, I think this fpp is about taking stock of your view on life and personhood, and as dispassionately as possible think about the burdens this will impose -- much as you would, I hope, for any expected child. And then make a decision. Anyone who can read klang's tale in the MeTa attached to this thread and maintain any illusions about having this enter your life needs to think about it a bit more. But sure, if your end result is to march on, may you have as good a time of it as you can. It is your choice to make.

But I see this has somehow become a Palin-fest (Palindrome) so I will contentedly bow out.
posted by Durn Bronzefist at 5:41 PM on September 16, 2008

Squarely. I was only intending to cover wanton negligence, not well-intentioned measures that turn out badly. We all take our chances on the best information we have.

OK, fair enough. Thanks for clarifying.
posted by zarq at 7:15 PM on September 16, 2008

A fetus (before a certain point) is not a person. It has no soul (there being no such thing), it has no self-awareness, it has no personality, it does not love anybody, it does not have emotions. Many people love fetuses and think about them as if they already are little people, but that does not make it the truth.

It also does not give them the right to decide that they other people's fetuses so much that we all as a society have to pretend that they really are people. It does not give us the right to throw women in jail for having an abortion. It does not give us the right to lock up their doctors.
posted by callmejay at 7:21 PM on September 16, 2008

Some users believe I should have posted this MeTa thread within this thread. Since I chose not to address the aspects of this discussion related to morality, abortion, or costs, I do not believe it belongs here. I believe cross-linking is a fair concession.
posted by plinth at 7:36 PM on September 16, 2008

Choosing to bring a person into the world and force them to live with a debilitating terminal genetic disease like Down is, pretty straightforwardly, a sick perversion of 'family values.'

The most common manifestations of Down syndrome are the characteristic facial features, cognitive impairment, congenital heart disease (typically a ventricular septal defect), hearing deficits (maybe due to sensory-neural factors, or chronic serous otitis media, also known as Glue-ear), short stature, thyroid disorders, and Alzheimer's disease. Other less common serious illnesses include leukemia, immune deficiencies, and epilepsy.

I can't believe people are actually arguing in favor of doing that to another human being. Acorns are not oak trees, people.
posted by mullingitover at 8:13 PM on September 16, 2008 [2 favorites]

Making a decision to terminate a pregnancy or not because you weigh the costs and quality of life for the child and your family, think you can handle it, don’t think you can handle it - solid.

Someone else coming in, doing the math or laying down the morals, saying no - or yes - and you’re starting down the road to eugenics and/or totalitarianism.

QFT
posted by Marisa Stole the Precious Thing at 8:18 PM on September 16, 2008

jeffburdges: So bring a retarded baby to term is an immoral act, period

Thank you.

I was getting tired of people accusing onlyconnect and me of arguing against strawmen.
posted by The Gooch at 8:27 PM on September 16, 2008 [1 favorite]

I was getting tired of people accusing onlyconnect and me of arguing against strawmen.

Against a strawman?
posted by Brian B. at 9:01 PM on September 16, 2008

debilitating terminal genetic disease like Down

I think you're being over-the-top with "terminal" except in the sense that life is a terminal disease. There is a shortened life expectancy, from the Alzheimer's if nothing else, but it's still around 50 years.
posted by TheOnlyCoolTim at 9:02 PM on September 16, 2008

TheOnlyCoolTim writes "There is a shortened life expectancy, from the Alzheimer's if nothing else, but it's still around 50 years."

That's a pretty drastic shortening, and it only gets that good with modern medical care. I still wouldn't wish that life on my worst enemy.

I have to wonder, for those who are against a 'do-over' in the case of Down: at what point would you accept that abortion was the ethical option? How short, debilitating and illness-ridden of a life would you require of your potential child before you would give it mercy?
posted by mullingitover at 9:42 PM on September 16, 2008

Is it wrong of me to wonder how quickly some of the various positions in this debate would do a 180 degree turn if it turned out you could reliably screen for homosexuality?
posted by rodgerd at 10:34 PM on September 16, 2008 [1 favorite]

"I'm happy to consider any sane modern rationally defined moral metric"

I have the real feeling I "evacuated" 30,000 Jews already, by shooting them, at Riga. Is what I did "evacuation"? When they fell, were they "evacuated"? There are another 20,000, at least, waiting for similar "evacuation". - I just think it is helpful to know what words mean... with all respect.

Some things, moral, immoral, aren't worth the potential cost or risk of drift, and indeed, who decides? It can't be anyone other than the parents.
Not that there's anything wrong with screening, but define something as "a problem" and one starts looking for solutions.
posted by Smedleyman at 10:47 PM on September 16, 2008

I have to wonder, for those who are against a 'do-over' in the case of Down: at what point would you accept that abortion was the ethical option? How short, debilitating and illness-ridden of a life would you require of your potential child before you would give it mercy?

I have to wonder what kind of parallel universe I'm in when your use of "give it mercy" in this context means "kill it" rather than "allow it to live what is commonly recognized to be a reasonably fulfilling life."

Let's be perfectly clear that this notion of a "do over" that Durn Broadfist has propounded is basically a convenient fiction. You are not actually transferring the life that was previously in your Down syndrome fetal body into a different, perfect fetal body. You are terminating the life of one fetus and then deciding to try to have another, different fetus. I want to be clear that I am okay with this, and likely might choose to do it myself if faced with this prospect, but I don't pretend that it would be for the ultimate happiness of my then-dead child -- rather it would be for my own convenience and my own potential future happiness. I do not picture this whole thing to be the simple little mulligan maneouvre that one might make on a golf course. Abortion is not a "do over."
posted by onlyconnect at 8:13 AM on September 17, 2008 [5 favorites]

I have to wonder, for those who are against a 'do-over' in the case of Down: at what point would you accept that abortion was the ethical option? How short, debilitating and illness-ridden of a life would you require of your potential child before you would give it mercy?

This is a completely academic question, since Metafilter is an overwhelmingly pro-choice site. Saying "People with Down syndrome don't automatically lead terrible, worthless, horrible, illness-ridden lives" is not the same thing as saying, "Anyone who is pregnant with a Down syndrome fetus should be forced to bring it to term". Nobody has said the latter in this thread (or if someone has and I missed it, they are clearly the minority viewpoint here).

On the other hand, I could easily turn your question around and ask you what gives you the right to be judgmental about somebody else's highly personal pregnancy decisions and if someone feels up to the challenge of raising a special needs child who the hell are you to question their morality or tell them their kid would have been better off never born?
posted by The Gooch at 8:36 AM on September 17, 2008 [4 favorites]

On the other hand, I could easily turn your question around and ask you what gives you the right to be judgmental about somebody else's highly personal pregnancy decisions and if someone feels up to the challenge of raising a special needs child who the hell are you to question their morality or tell them their kid would have been better off never born?

A-fucking-men. Honestly, I've seen less sanctimonious moralizing from the religiously conservative side of my family. I thought we were supposed to be better than that...
posted by the other side at 9:05 AM on September 17, 2008 [1 favorite]

Choosing to bring a person into the world and force them to live with a debilitating terminal genetic disease like Down is, pretty straightforwardly, a sick perversion of 'family values.'

Good for you for looking up health issues common to Down syndrome. Now that you've done that, let's look at some of those things in more detail (I'm looking at the ones that aren't morphological) -
Heart defects are fairly common: 45% - Here is an article about VSD's, the most common defect which covers treatments. VSD's and ASD's are treatable with a high degree of success especially via minimally invasive surgery.
Hearing issues are screenable and treatable.
Thyroid issues are in 5% or less - you have a greater chance of heart disease (8%).
Leukemia is 1 in 150 - less than a percent - and if it's AML Leukemia, there is an 85% survival rate (quite higher than general population).
Cognitive impairment is varied - some severe, some mild.

When considering a fuller context, it doesn't look so bad. Oh, and chalk up on the plus side the incidence of breast cancer is far less than the general population.
posted by plinth at 9:41 AM on September 17, 2008

The Gooch writes "On the other hand, I could easily turn your question around and ask you what gives you the right to be judgmental about somebody else's highly personal pregnancy decisions and if someone feels up to the challenge of raising a special needs child who the hell are you to question their morality or tell them their kid would have been better off never born?"

I worked with people with developmental disabilities for six years. In some cases their family members were caring and attentive. However, for the most part their families abandoned them. Maybe I'm going out on a limb here, but I predict that having a developmental disability makes you more likely to be abused, neglected, or simply abandoned. Their quality of life, despite our heroic efforts, was profoundly lower than it would've been if they'd not been disabled. I would not wish that life on anyone.

onlyconnect writes "You are terminating the life of one fetus and then deciding to try to have another, different fetus."

Here's where we diverge, when you start confusing clusters of cells with people who have lives which can be taken away. I don't know how to argue with this kind of fallacious reasoning, so I won't. Go on believing that zygotes and fetuses are little people, I'm not going to try to rob you of this fantasy.
posted by mullingitover at 10:06 AM on September 17, 2008

I don't know how to argue with this kind of fallacious reasoning

Interestingly, I didn't say a single thing that you can point to as incorrect. I correctly stated that in such cases that Durn Broadfist referred to as a "do over" you are actually terminating the life of one fetus and deciding to try to have another one. Think of it as some amorphous cluster of cells if it makes you feel better, but as I and others have described above, the CVS or amnio testing that is the sort of conclusive result that you would want to perform in such a case before taking the step of abortion cannot be completed until you are in the second trimester of your pregnancy, long after the "amorphous cluster of cells" has formed a head and limbs and is generally recognizeable as a fetus and not an amorphous cluster of cells. (An amnio cannot be done until later in the pregnancy than CVS testing, but in both cases the results are not available until you are in the second term of your pregnancy.)

Nowhere have I defended the rights of zygotes. Nowhere did I call the fetus a person. I simply stated the truth -- that an abortion is not technically a "do over" -- it is the termination of the life of one fetus and an attempt to conceive another, wholly different fetus. Which one of us is living in a fantasy?
posted by onlyconnect at 10:52 AM on September 17, 2008

Maybe the confusion is occurring over my use of the phrase "terminating the life of one fetus"? Technically, though, that is correct. The fetus in the womb of a pregnant woman is alive. I imagine it to be similar to the life of a parasite living off the mom's body, but it has a heartbeat and is considered to be alive. If it were not alive, that would be a miscarriage.
posted by onlyconnect at 11:01 AM on September 17, 2008

it is the termination of the life of one fetus and an attempt to conceive another, wholly different fetus

But as fetuses aren't people I don't see how this matters. In the case of an abortion "do over" the eventual person will end up with a different genetic makeup, but they'd also almost certainly end up with a different genetic makeup if the parents had simply decided to conceive a month sooner or later.
posted by TheOnlyCoolTim at 11:03 AM on September 17, 2008 [1 favorite]

I'm certainly not arguing that every sperm is sacred or whatever. I'm just making the technical point that one fetus gets killed and you try to conceive another one. You're not magically transporting life from one damaged body to a perfect one; you're making two wholly separate attempts at creating children. Maybe it's a small point. This seems to me like a somewhat more serious undertaking than taking a mulligan in a golf game, but I understand that others may view it differently.
posted by onlyconnect at 12:04 PM on September 17, 2008

This reminds me of those in the deaf community who oppose cochlear ear implants

That's a different situation. There's a very strong argument that deafness can be considered a culture; a deaf child born into a deaf community has no difficulties whatsoever. It's only when a deaf child is born into a hearing community that there are problems. By contrast, a Down Syndrome child would be distinctly worse off if born into a community of Down Syndrome adults; in fact, a town inhabited solely by Down Syndrome adults would probably fail pretty quickly. That indicates that Down Syndrome is, in fact, a real disability. Deafness, by contrast, is more like a predisposition to a foreign language.
posted by frankchess at 12:07 PM on September 17, 2008

onlyconnect writes "Interestingly, I didn't say a single thing that you can point to as incorrect. I correctly stated that in such cases that Durn Broadfist referred to as a 'do over' you are actually terminating the life of one fetus and deciding to try to have another one."

onlyconnect writes "The fetus in the womb of a pregnant woman is alive."

Anthropomorphizing the fetus, no matter how often you do it, does not make it a living person.
posted by mullingitover at 1:09 PM on September 17, 2008

a deaf child born into a deaf community has no difficulties whatsoever. It's only when a deaf child is born into a hearing community that there are problems.

This assumes that being denied access to the larger, hearing, community is not a problem for the child. That's a choice the child should be free to make for himself, not one the parents should force on him by unnecessarily destroying his hearing.

which withholding hearing aids at an early age does by preventing brain development related to hearing
posted by grobstein at 1:19 PM on September 17, 2008

mullingitover writes "Anthropomorphizing the fetus, no matter how often you do it, does not make it a living person."

btw I realize that I am vulnerable to accusation of strawmanning based on this attempt at a disclaimer:

onlyconnect writes "Nowhere did I call the fetus a person."

However, this disclaimer is immediately discarded as you launch into

onlyconnect writes "it is the termination of the life of one fetus"

Since we agree that a fetus is not a person, but that if it develops unhindered it may become one, there is little ambiguity about the ethics of preventing it from developing into a person who will live a life predisposed to great suffering. When you choose to bring a person into the world knowing they will live a shortened life constrained by physical and mental disability, your rationalization of your desire to protect children has taken a turn for the perverse and selfish.
posted by mullingitover at 1:42 PM on September 17, 2008

wilky: Healthy and test indicates no DS (No's with No's):
(4.25 million - 4250) x 99.6%= 4.23 million

Healthy and test indicates DS (No's with Yes's):
(4.25 million - 4250) x 0.4%= 17,000

You have assumed that the accuracy referred to was specificity, which if it were the case would lead to the problem you identify here. You have remembered your statistics well, grasshopper. By the accuracy they refer to is all forms of inaccuracies. I just quoted the abstract, but the article itself makes it clear that it was referring to 9 errors, 1 of which was failing to identify a Down syndrome (trisomy 21) (less than perfect sensitivity, which should make those who want to continue the trisomy 21 pregnancies happy), and the remaining 8 were failure to sex type properly, due to karyotyping errors, maternal contamination, and paperwork errors (!). The specificity was 100% for trisomy 21 (and the other aneuploidy's tested), so, whew!
posted by Mental Wimp at 2:02 PM on September 17, 2008

Re: strawman. Wiki:

To "set up a straw man," one describes a position that superficially resembles an opponent's actual view, yet is easier to refute, then attributes that position to the opponent.

I believe that the statements superficially resemble the opinions they putatively paraphrase, but they are different. The strawmanned statements are merely declaring the reasons the writer have for why they would choose to abort. I have seen no one yet on this thread claim that they would force anyone else to abort. So I used the term strawman to describe this mischaracterization. But, using Wiki's definition, I am wrong. You see, for it to be a true straw man under that definition, onlyconnect and Gooch would have needed to actually rebut the statements, which they did not do. They merely pointed a shaming finger, which clearly is not a rebuttal. So, you're right, no straw man, just very poor argumentation.
posted by Mental Wimp at 2:15 PM on September 17, 2008 [1 favorite]

onlyconnect: A fetus is "alive", but it is a parasite until viability.
posted by Mental Wimp at 2:28 PM on September 17, 2008

I have seen no one yet on this thread claim that they would force anyone else to abort.

I took rough ashlar's statement: And when the burden of that choice falls to you as a taxpayer - do you still have no say? to mean that he thought that taxpayers should have the power to require a woman to have an abortion rather than using social services to support a handicapped child. If that was not what he meant, I apologize for misconstruing it, and would love to know what he actually meant.

If all you want to do is judge women for exercising their right to choose, rather than trying to force them to make the choice you think they should make, then I wouldn't say we're really in agreement though, because I think to truly be pro-choice means I don't get to judge other women's choices.
posted by hydropsyche at 3:31 PM on September 17, 2008

I think to truly be pro-choice means I don't get to judge other women's choices.

I think "to be pro-choice" means to favor the legality of abortion (and nothing more), but your view is amply represented in this thread and in some parts of the pro-choice movement.

Let me just point out that many pro-choice politicians do not think that their pro-choice views require them to have no opinion about whether abortions are right or wrong. Both of the Clintons are widely considered pro-choice. Both have opined that abortion should be "safe, legal and rare." The belief that abortions should be rare can only follow logically from a belief that abortions would usually be wrong in some sense -- it means they make some judgment of the moral character of abortion, but think it should be allowed anyway. Similarly, Mario Cuomo, a prominent pro-choice Democrat who was a stupid phone-call away from the Supreme Court, personally believes that abortion is wrong (he believes this is required by his Catholic faith). In other words, he believes the blanket judgment that when a woman has chosen abortion, she has chosen wrong (for our purposes it doesn't matter whether he believes there are exceptions). Nonetheless he believes the government shouldn't ban abortion, and for this reason he is widely regarded as pro-choice.

The true-believers in this thread would like to exclude all these views from the "pro-choice" label, but in everyday use "pro-choice" doesn't necessarily encompass the radical relativism you want it to.
posted by grobstein at 3:55 PM on September 17, 2008

(I am leaving for another day my case that this radical nonjudgmentalism requires an incoherent moral philosophy that almost no one really believes. Sneak preview: it's hard to develop a coherent relativism.)
posted by grobstein at 3:57 PM on September 17, 2008

grobstein writes "it means they make some judgment of the moral character of abortion, but think it should be allowed anyway."

Or maybe they realize that abortion procedure has some risk to the life of the mother (as does pregnancy), and that the safest abortion is the one you prevent from happening through proper planning?
posted by mullingitover at 4:10 PM on September 17, 2008

Or maybe they realize that abortion procedure has some risk to the life of the mother (as does pregnancy), and that the safest abortion is the one you prevent from happening through proper planning?

They don't usually give people credit for planning. Recall that abortion opponents are often into maximized baby production, a woman's duty and all that. One reason many argue for choice is the very common scenario of quiet forced breeding.

Dogmatic pro-life positions often remind me of communism. Every job, every worker's skill and every factory is worthy of state protection, antagonistic to the consumer and in direct spite of quality itself. But out with the choices goes the reason for working. Ultimately, it comes apart, because the slogans get old and everyone can see the flaws in everything and they would rather be somewhere else.
posted by Brian B. at 7:28 PM on September 17, 2008 [1 favorite]

Gooch, You & onlyconnect actually are still arguing against strawmen. I just observed that bringing a retarded baby to term is immoral. Eating meat may also be immoral. But you don't outlaw every immoral act.

All I'm saying here is that people who have some educated moral perspective will view a mother who brings a retarded child to term as having done something harmful and/or irresponsible. So we're talking mild social pressure. If your moral system is based on superstition about ghosts and sun gods, well obviously such social pressure isn't gong to impact you much.

hydropsyche, Yes, maximizing privacy is one reasonable & useful moral metric, but no privacy concerns do not refute either "abortion is bad" or "retardation suck." An act being immoral does not imply that said act should be illegal. Indeed passing a law against an immoral act may itself an immoral act. For example, it would be immoral to pass a law incarcerating people for cheating on their spouse.

Btw, Abortion itself has zero moral cost, but abortion procedures carry some risk, always way below the risks of child birth, but still risks. It follows that prevention is preferable to abortion for birth control, and hence abortions should be rare among birth control techniques. All this means is that condoms, pill, etc. should be cheap and widely available.
posted by jeffburdges at 9:14 AM on September 18, 2008 [1 favorite]

Gooch, You & onlyconnect actually are still arguing against strawmen. I just observed that bringing a retarded baby to term is immoral. Eating meat may also be immoral. But you don't outlaw every immoral act [and therefore it is no contradiction to hold something is morally required but should not be legally required].

I think jeffburdges is making my point much more clearly than I am, so let me just say: QFT.
posted by grobstein at 10:35 AM on September 18, 2008

Mental Wimp: I believe that the statements superficially resemble the opinions they putatively paraphrase, but they are different. The strawmanned statements are merely declaring the reasons the writer have for why they would choose to abort. I have seen no one yet on this thread claim that they would force anyone else to abort. So I used the term strawman to describe this mischaracterization. But, using Wiki's definition, I am wrong. You see, for it to be a true straw man under that definition, onlyconnect and Gooch would have needed to actually rebut the statements, which they did not do. They merely pointed a shaming finger, which clearly is not a rebuttal. So, you're right, no straw man, just very poor argumentation.

I apologize to all for the space this is going to take up, but Mental Wimp, please walk with me, if you will, through the history of this thread and the strawmanning that has occurred here. Nowhere did I ever say that other people in the thread were going to force me to abort. I said that people in this thread were condescending to tell me and other people what was the right thing to do with our own bodies in the case of a Down Syndrome diagnosis. Are you following this? Because that is exactly what they were and are doing. So it is you, and not I, who are creating a strawman by incorrectly stating my position so that you may more easily respond to it.

Let's look at our respective comments:

onlyconnect: Oh lordie, here we go again in the comments with the people who need to tell me that aborting a fetus with Down's syndrome is the best result for all involved, including the then-dead fetus with Down's. Make whatever decisions you'd like wrt your own uterus, but don't condescend to tell me that you know what's best for mine. Because you do not.

Mental Wimp: Strawman, oh Lord, strawman. Strawman my strawman, oh, strawman, that I may strawman my strawman and those strawmanless strawmen. In strawman's name, a-strawman.

Now let's take a look at what just a few people in this thread have said (cannot catalog it all):

0xdeadc0de: Therefore, aborting fetuses with Down Syndrome is a moral imperative."

jeffburdges: I see only one remotely morally tenable position "retardation sucks, pregnancies should be screened." Abortion has zero moral cost under any sane/modern moral metric. A retarded person may live a happy life, but they are a moral cost under many different moral metrics. So bring a retarded baby to term is an immoral act, period.

Are you getting this? At various points folks here have said that bringing a baby with Down Syndrome is objectively wrong - in such cases abortion is a "moral imperative" and not aborting is "an immortal act." Do you understand that this means they are not just saying it is wrong for them, but it is wrong for everyone? Okay. Here I am again saying that nobody else here should be dictating to me or telling me what the right thing to do with my own uterus is. I even carefully explain the strawman concept as applied in this thread to you, and what position I am specifically arguing against. NB: I never said "forcing me by law to have an abortion."

onlyconnect: I agree with The Gooch that "strawman" does not mean what Mental Wimp seems to think it means. I have no quarrel with people who choose to abort their fetus after they find out it has a genetic defect. In this position I can see myself choosing to do the same thing. But there are a host of voices in this thread saying straight up that it's wrong to make any choice other than abortion in this situation. It is not invoking a "strawman" -- i.e., misrepresenting my opponent's opinions for the purposes of more easily rebutting them -- to say in response to these voices that they are allowed to make their own choices, but my uterus is mine, and they have no business dictating to me what I should do with it. Abortion in this situation might be the right thing for you, but exactly where do you get off telling me what the right thing for me or anyone else is? Is that what pro choice means now?

So, I am sorry to be blunt, but are you even reading my comments before you respond to the version of them that you have made up in your head, or have you found that it is just easier to skip the initial reading altogether? The same goes for jeffburdges and grobstein. Nowhere in this thread have I said that people are trying to outlaw my ability to decide not to abort a fetus with Down's Syndrome. I have argued that I believe it is wrong for others to talk down to me and purport to tell me or anyone else that it is immoral or wrong or crazy or selfish to choose to carry a child with Down Syndrome to term. I am not against this because your disapproval will force me to choose abortion. I am against it because it is condescending of you to think that you understand the factors that went into my individual choice. But I guess I should not mind your comments that much since you have simply been very dismissive of arguments that I never made.

Am I being clear? I await with breathless anticipation your next distortion of my position and arguments. Will you say that I have taken the position that abortions should only be performed on cows and other farm animals? Will you say that I believe that tiny angels inhabit every fetus and when these angels fly around this is causes genetic mutations? I am ready to be impressed by your sheer creativity. (NB: Not really. Actually your dismissive distortions have exhausted me. MISSION ACCOMPLISHED!)
posted by onlyconnect at 11:50 AM on September 18, 2008 [3 favorites]

Am I being clear? I await with breathless anticipation your next distortion of my position and arguments.

I'll do my best. Again, no one has suggested they would force anyone to do anything, they have just expressed why to them it would be a moral imperative to abort the fetus. Please don't mistake this or mischaracterize this as them forcing their morality on anyone. We can all express moral opinions, even strong ones, without it being some sort of OMG KILL YOUR BABY NOW OR YOU WILL GO TO HELL! I suspect most of them would leave that to the fundies.

You don't share their moral view, so their statements have no weight. I don't particularly agree with them either. They are not saying what is right for you or me (probably; I'm not a woman so I really, really don't have a dog in this central issue). They can allow you your choice without prejudice or cost. They may expect you to bear the burden of your choice, but it's still a choice. They may believe you did the wrong thing in keeping it, but no your uterus i yours and your strawman against which you rail is the imaginary one telling you you have to abort. That person is not in this thread.
posted by Mental Wimp at 4:41 PM on September 18, 2008

Mental Wimp, can you not understand the English language? Do you see how they have used their words? They are not just saying it is wrong for them. They are saying it is a "moral imperative" and that not having an abortion in such situations is an "immoral act." The context of these statements is not that it is immoral for them, but that it is an immoral choice for everyone. They are making moral judgments about my or someone else's decision not to have an abortion. That is what I have complained about in this thread. I have never railed against the strawman you keep thrusting on me that someone is going to force me to get an abortion. How many times do I have to say this before you will stop insisting that this is my position? I am criticizing the condescention of their moral judgment. Can you see how my words say that, and not what you continue to insist that they say? Can you man up and admit that I have not been arguing against a strawman here, but expressing disagreement with someone else's casual dismissive moral judgment of what it a very difficult and personal decision for many people?

Never mind. I am done with you.
posted by onlyconnect at 5:11 PM on September 18, 2008 [2 favorites]

Would you tell your hypothetical friend, sibling, etc. not to cheat on their spouse? Would you feel their cheating is immoral? Yes, I'd suspect so. Is this a problem? No.

I don't buy Mental Wimp's relativism, I'd say not aborting a DS baby is plane immoral, but morality need not lead to coercion. You take a whole bunch of quasi-quantifiable solid moral metrics, ask what the impact is. If you find that an act is immoral by many measures, without significant contrary arguments, then you can reasonably claim that act is just plane immoral. So you've very solid ground for making moral arguments against said act. But you may not coercively prevent people from performing that act unless you know the costs of the coercion are negligible realitive to the gain. A mere "net profit" does not suffice since this isn't likely universal (i.e. fair).

Would I tell a friend she should abort a retarded child. Hell yes. I'd even advise her to give it up for adoption if she'd had it already. Would I attempt other coercion? No. Why? Here coercion is an excess that violates universality, i.e. I don't want people pushing me around either.
posted by jeffburdges at 9:57 PM on September 18, 2008

- Abortion is no more or less immoral than killing animals for food or shelter or in defense. You're destroying a non-sentient living being. I've no moral qualm with that.

-You are not killing a person with Down Syndrome, you are aborting a mass of cells

-a fetus as "a bundle of cells" or the like -- distinctly not-human, not viable, and with no rights whatsoever -- would be bothered by tossing that bundle of cells for another. It's not an imperative. It's completely pragmatic.

-Actually, for many women who don't want children (me, for instance) THERE'S NO 'EXCRUCIATING PAIN' AT ALL. I don't want children. I got pregnant. I got an abortion. No big deal.

and then some of you wonder about Palin's appeal. If you think that a fetus is just a bunch cells, essentially a zit that needs to be popped, then you will come off to many other people who believe something different about these cells as callous to the point of sociopathy. Then they think that if that is the type of person having abortions then perhaps they really are bad. You take this right for granted and have seemingly zero appreciation of how endangered this right is. Your callous indifference only makes it more endangered. It hangs on a single Supreme Court decision which employs less than dominating arguments to justify this right. One more conservative justice and it is gone - poof. Those Palin voters hear you completely dismiss any moral implications, completely treat that fetus as a mere mass of cells, and they are engaged to not only vote, but get out the vote. Ask any woman who has ever had a miscarriage (OK, perhaps not any, there are female sociopaths as well) whether they experienced an incredible loss, ask them how they felt about that baby growing inside, even ask their spouses. Miscarriage, especially once into the second trimester or later, is generally quite devastating. It is devastating because to most parents that is much, much more than a mere mass of cells.

A fetus (before a certain point) is not a person. It has no soul (there being no such thing), it has no self-awareness, it has no personality, it does not love anybody, it does not have emotions. Many people love fetuses and think about them as if they already are little people, but that does not make it the truth.

That is at least a far deal more intelligent and far less heartless. It acknowledges the value of the fetus. You can argue the semantics of whether a fetus is a person or not a person, but at least acknowledge that it is something more than a mere lump of cells. A tumor is a mere lump of cells.

Yes, I struggle with the morality of pregnancy termination. However, you have to weigh that against the alternatives. We don't need to return to the coat hanger, and yes, some people truly make mistakes that could ruin their and their baby's lives, and some genetically damaged babies are better off not even coming to term. Abortion is a huge balancing act. There are some quite dogmatic people on both sides who are too stupid, zealous, or worse to recognize that fact. I am glad that I have never had to face this decision. I sympathize with those who do. I would hope that most would at least consider what is at stake, rather than be callous. However, you can not legislate that and so I support this right even for the callous, although I find their actions abhorrent. The alternative of no abortion rights is even more abhorrent.
posted by caddis at 11:26 PM on September 18, 2008 [2 favorites]

Would I tell a friend she should abort a retarded child. Hell yes. I'd even advise her to give it up for adoption if she'd had it already.

And your friend would have every right to tell you to go to hell and never speak to you again.

I seriously cannot imagine in a million years ever telling anybody this, especially not using words like "immoral". I can't imagine ever thinking anybody's reproductive decisions were my business. If my friend wanted to talk about this decision with me, I would listen to her reasons and, if she asked me to, offer her my opinion based on her unique personality, financial, and familial situations. But I would never dare to tell her what she should do.

And no I wouldn't tell a friend who cheated on a spouse that they were being "immoral" either. I might try to reason with them, but I would also listen to them to hear what their reasons were for the cheating, and help them resolve their problems without being judgmental, because I'm not sure how my judging them would be helpful.
posted by hydropsyche at 7:43 AM on September 19, 2008

Would you tell your hypothetical friend, sibling, etc. not to cheat on their spouse? Would you feel their cheating is immoral? Yes, I'd suspect so. Is this a problem? No.

Is the immorality of cheating equal to the immorality of bringing a child with DS into the world? I think we are smart enough to know that those are two completely different problems. Genetics may encourage cheating in some sense, but cheaters make the conscious decision to do so because of ideas and social reasons. The physical conception of a child with DS has nothing to do with social mistakes, unless of course you think we have the ability to foresee (reasonable person test) the choosing of a wrong mate who may carry 'bad genes' which leads to the dangers of eugenics. Since the problem of moral cost is nascent (aborting an embryo; not murdering a sentient human life) the moral cost is to the mother, not to society. If you measured a human life by how much it can contribute to 'society', i.e. the workforce, you are only reinforcing what the dangers of communism showed us. Yes, trying to universalize a morality around what you think is best for everyone's genetics is morally wrong. Even if I completely agree with gene-centric improvements of society, I would not want my ideas being controlled by condescending opinions. You say coercion is excessive but when doctors or scientists are *strongly encouraging* a person to make a personal decision that they *may or may not have* made alone, how is it not encouraging breeding and thus all of the ideas that lead up to it? I am all for the ethical use of science for the enchancement of human abilities, but what is needed is a greater emphasis on the 'ethics' involved in the decision making process so as not to A) impose your moral metric on a private party and B) transform a private party's decision into a universal 'moral imperative'. Would you incessantly try to convince your friend to stop cheating? No. If social probelms aren't any of your business, why should other people's genetic problems be your business?

Oh and furthermore, Jeffburdges, by acknowledging an adotion facility exists, you acknowledge that there is such a demand and a place in the world for DS children (i.e. what is useless to some is not useless to others) but you refute relativism because it does not work for you.
posted by johannahdeschanel at 12:21 PM on September 19, 2008

caddis:

Oh noes, if I talk about my beliefs I'll help the republicans!

Give me a break: I was responding to a ridiculously false statement that "everyone must admit abortions are immoral," by comparing them to the only thing that seems logical to me: the murder of animals for food or convenience or fun or what have you. This doesn't mean that abortions (or the killing of animals) isn't emotionally charged, or that some people feel uncomfortable doing them, or even that some people have belief systems under which these things are really very immoral, but simply that I myself think they're morally neutral.

Honestly, I don't know why people find this comparison so terrible. Human beings exploit the mass of other animal life on this planet for their own ends, or exterminate it if it's convenient to them. Why is that so much less reprehensible for most people than abortions?
posted by TypographicalError at 3:41 PM on September 20, 2008

zomg hoomins are different
it's in their DNAs
posted by grobstein at 6:48 PM on September 20, 2008

Coming from the guy who thinks it's cool to say women who carry a child with Down Syndrome to term are cruel and wrong, that "sarcasm" is pretty rich.
posted by onlyconnect at 8:29 PM on September 20, 2008

that "sarcasm" is pretty rich.

Oh no, I don't think so.

Seriously, though, what to make of this remark? The word "sarcasm" is not like "humor;" it doesn't convey any approval. You can use it without the scare quotes and no one will worry that you are impure.

Sarcasm doesn't even have to be especially qualified: failed humor is an everyday occurrence; failed sarcasm is almost inconceivable. And so I don't feel especially arrogant saying that my sarcasm succeeded, and thus can safely be described as sarcasm without cautionary punctuation.

Further, what I was saying with the sarcasm was both straightforward, and totally in line with my other remarks in the thread (which means it's not "rich"). Although I disagree with some of what Typo says, I was expressing agreement with his rhetorical point about the "exploit[ation of] the mass of other animal life." I expressed my agreement by sarcastically ridiculing a hypothetical response ("But humans are different because. . . [insert sophistry].").

Does this somehow contradict the unforgivable heresies I wrote upthread? Or is it just that everything I say is now "rich," since I've outed myself as someone who doesn't respect your pieties?
posted by grobstein at 10:44 PM on September 20, 2008 [1 favorite]

BUT let me make a slight correction to your statement of my views (it is mainly right, but sometimes little things count). You call me "the guy who thinks it's cool to say women who carry a child with Down Syndrome to term are cruel and wrong." Actually, in my comment, I describe the act of bringing a grievously compromised child to term is cruel. The person performing the act may not be cruel, and probably means well, in some sense. Cruelties are committed by otherwise decent people all the time. But it's better to call decent people on cruel lapses than to refrain because it's somehow wrong to "judge" people who are otherwise decent.
posted by grobstein at 10:48 PM on September 20, 2008

and then some of you wonder about Palin's appeal. If you think that a fetus is just a bunch cells, essentially a zit that needs to be popped, then you will come off to many other people who believe something different about these cells as callous to the point of sociopathy.

Palin's appeal relates to fundamentalism, which is a sociopathy on so many levels, in part because they want to outlaw abortion and welfare, the latter of which reduces abortion and cares for the child. Whether or not the fetus is more than a bunch of cells is irrelevant. Whose bunch of cells are they? We're talking about rights and responsibility for them upon rejection of the mother, and fundies have already rejected the responsibility. Fundies want to assert control over the mother since they sense a sudden vulnerability there, but which are the keys to everyone's family. (Sociopathy is also defined in terms of rights, at antisocial personality disorder). Since Palin is widely regarded to be an incompetent and callous wannabe by so many who have examined her short stint at civic management, I think that bringing her appeal into this is a net positive for the pro-choice side. She is sending a message loud and clear that she isn't about traditional motherhood, and it's obvious that lording over other families is more important than her own. A clear case for "sociopathy."
posted by Brian B. at 9:40 AM on September 21, 2008

I think there is a basic disagreement here that is unlikely to get settled no matter how long we continue to spin our wheels on this thread.

Group A, while believing women have the right to carry a non-genetically perfect baby to term if she so chooses, also believes the condition of Down Syndrome to be so horrendous and debilitating that to intentionally carry such a fetus to term is an inherently cruel and immoral act.

Group B, while believing women should have the right to abort a fetus for any reason, including because it has Down Syndrome, also believes that people with Down Syndrome are perfectly capable of living worthwhile, happy lives and further find it offensive than an uninvolved 3rd party feels qualified in any way to determine someone else's potential quality of life.

Obviously, my comments in this thread out me as being a member of Group B, but aside from seeing if my sister will allow me to invite a bunch of metfites to my nephew's 9th birthday party in a couple months so I can illustrate that having Down Syndrome doesn't automatically correlate to a 24/7 horrible, miserable existence, I guess we're just going to have to agree to disagree.
posted by The Gooch at 11:50 AM on September 21, 2008 [1 favorite]

Gooch, well said. I just have to say, though, that anecdote is as poor argumentation as straw men, unless backed by data and reasoning. One (or several) happy trisomy 21 children do not equal an argument that carrying to term is the right thing to do. I may get away with stealing a bundle from the bank and live a happy and productive life afterward, but that isn't an argument for bank robbery.
posted by Mental Wimp at 1:22 PM on September 21, 2008

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