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Selective abortion based on prenatal diagnosis of disability

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  • 1. EDUCATION 1 Selective Abortion Based on Prenatal Diagnosis of Disability September 18, 2012
  • 2. EDUCATION 2 “Fear of childbirth is common among moms-to-be. Most women have concerns about coping with pain, childbirth-related injuries and the possibility of having a cesarean section. Some moms have additional concerns due to previous life experiences such as sexual assault, having undergone invasive fertility treatments, previous traumatic birth experience or pregnancy loss” (Mazzoni: 2002). Pregnancy is a physiological process at which a fetus develops from the fertilized ovum in a female organism. Pregnancy of a woman is an important period of life for the whole mankind as the continuation of the family begins from this point. The uniqueness of a condition of pregnancy is difficult to overestimate. Someone distinguishes the positive sides of this period of life, someone - negative sensations, pains, illnesses. Pregnancy is an important stage of a woman’s decision to become a mother and to go through the further level of individualization. The childish desire to be identified with the primary object can be observed in games and imaginations of a girl long before a real possibility to become a mother. In the first pregnancy a young woman faces two ways of the solution of the psychological conflict. She can keep a fetus inside her, protecting it and allowing it to grow and mature month after month, or she can physically repudiate it by miscarriage or abortion. Thus, a mother can promote life of a fetus and own motherhood or destroy both. Incomplete pregnancy and refusal of a birth of a live child (on unconscious motives or owing to the conscious decision to make abortion) have an individual value for each woman. Many researchers consider that spontaneous miscarriages of the first trimester are the indicator of the natural selection as approximately 60 - 80 % of embryos with chromosomal anomalies are found during the research of abortions.
  • 3. EDUCATION 3 The causes of a sporadic spontaneous abortion are extremely various and are not always accurately designated. They include a set of the following social factors: bad habits, harmful factors, inability of family life, heavy physical work, and stressful situations. Besides, medical factors also play their roles. They are: genetic breakages of the parental karyotype, an embryo, endocrine disorders, developmental anomalies of uterus, infectious diseases, previous abortions, etc. According to the World Health Organization, about 2.5 % of newborns are born with various developmental anomalies. Thus, 1.5-2 % from them is caused by mainly adverse exogenous factors, and the others have mainly genetic nature. Among the exogenous reasons of developmental anomalies it is necessary to mention biological (infectious diseases: rubella, herpes, Chlamydia infection, etc.), physical (all types of ionizing radiation, radionuclide), chemical. Prenatal diagnostics includes the antenatal diagnostics for the purpose of pathology detection at the stage of pre-natal development. It allows finding more than 90 % of fetus with a Down syndrome; trisomy 18 syndromes (also known as Edwards’s syndrome) about 97 %, more than 40 % of the violations of heart disorders, etc. In case of fetus disabilities parents carefully consider the possibilities of modern medicine. As a result, a family makes the decision of a child’s destiny and solves the question of continuation or interruption of pregnancy. “The issue of selective abortion is not just about the rights or considerations of disabled people. Women’s rights and the rights of all human beings are implicated here. When disability rights activists challenge the practice of selective abortion, as we did in Vancouver, many feminists react with alarm. They feel “uncomfortable” with language that accords human status to the fetus. One woman said: “You can’t talk about the fetus as an entity being
  • 4. EDUCATION 4 supported by advocates. It’s too ‘right to life”. Disabled women activists want not to be associated with the violent anti-choice movement. In the disability community we make a clear distinction between our views and those of anti- abortion groups. There may have been efforts to court disabled people to support anti-abortion ideology, but anti-abortion groups have never taken up the issues of expanding resources for disabled people or parents of disabled children, never lobbied for disability legislation. They have shown no interest in disabled people after they are born” (Saxton: 2012). The analysis of the situation shows that the main difficulty of a solution of the problem of abortion is in this regard the question of the status of a human fetus. So far the problem of the definition of age from which the embryo of a person can be considered as the personality possessing the rights and protected by the legislation is not solved, despite an extensive discussion of this important problem for a person at the international level with the involvement of experts. Prenatal diagnostics (PD) in the sense it exists now and how it is understood by the applied medicine is not an equivalent to the antenatal check-up of a pregnant woman, and, formally making its part, specific content and purposes. According to the definition of the experts, prenatal diagnostics is a new scientific and practical direction of medical genetics, and the basis of PD is made by early diagnostics and the prevention of the birth of children with serious non-coregent congenital and hereditary illnesses by means of pregnancy interruption. There are several methods of prenatal diagnostics. They include: - indirect methods, including the selection of the women of a high risk for the further profound medical investigation;
  • 5. EDUCATION 5 - direct methods, including the age of a woman older 35, the experience of two miscarriages or abortions at early stages of pregnancy, the presence of a fetus or a child with a Down syndrome, other chromosome diseases, and congenital defects from the previous pregnancies, majority of diseases, earlier diagnosed in the family or among the nearest relatives, etc. The direct methods of prenatal diagnostics include the X-ray screening, invasive methods, diagnostics of chromosome diseases, DNA diagnostics of genetic diseases, and biochemical diagnostics. The purpose of the prenatal diagnostics, unlike medical diagnostics, is not the detection of pathology for the justification of the most optimum method of its treatment, and detection of mainly incurable hereditary anomalies of a fetus for its destruction by means of abortion. According to the majority of researchers, the abortion is indicated at the identification of a Down syndrome (in 92 % of cases), Turner’s syndrome (in 72 % of cases), backbone crevices (in 64 % of cases) and Klaynfelter’s syndrome (in 58 %). The prenatal diagnostics the purpose of which is the detection of hereditary pathology till the birth - for a pregnant woman to have the possibility to make a selective abortion and to prevent the birth of a sick child - is widespread in the world. The parents, having diagnosed disability of a child during pregnancy have three options: 1. not to have more children; 2. to deliver a new sufferer to the world; 3. to make prenatal diagnostics and selective abortion in one of four cases. Modern medicine has a limited set of methods for the treatment of congenital diseases at a fetus, and in most cases of their detection a pregnant woman is suggested to make abortion. Abortion is an unnatural operation for a woman; it roughly harms a woman’s health
  • 6. EDUCATION 6 and hormonal background and often leads to the emergence of numerous complications. They include both lethal and non-lethal outcomes; an absolute infertility is one of them. The pregnancy, following selective abortion becomes complicated more often than the one without abortions. The complications may include the germination and fusion of placenta, premature birth, a spontaneous death of a fetus, a complicated childbirth and a death of a newborn. Thus, the frequency of prenatal death of a fetus reaches 10 - 60 %, and the frequency of congenital developmental anomalies of a fetus - 6.9 - 11.6 % (a backbone crevice, microcephaly, hydronephrosis, doubling of kidneys, and congenital heart diseases). Except the somatic diseases, abortion causes an internal devastation, personal changes and other violations in the mental sphere which received the name “a post-abortive syndrome”. Its main symptom is a continuous prosecution endured at a subconscious level of women. After the abortion with genetic defects women suffer from the depression in 82 - 92 % of cases. The fetus with chromosomal pathology is defined at 3.2 % of women from “a group of risk” by means of invasive prenatal diagnostics. This group is formed on the basis of age criterion (35 years old and older), and also the results of a triple ultrasonic research and the analysis of biochemical markers in blood of all pregnant women (preliminary screening). It means that in order to reveal the prenatal deaths of 2400 sick children, it is necessary to subject about 80000 women from the groups of risk to invasive prenatal diagnostics. Thus, the percent of complications (death of fetuses as a result of abortions) makes 1 - 2 %. It means that except 2400 of the aborted babies with a Down syndrome as a result of such a “prevention” 800 - 1600 of healthy children die (even at mothers who wanted to deliver babies).
  • 7. EDUCATION 7 At the expense of the limited accuracy of invasive prenatal diagnostics and existence of the false positive results the frequency of which, according to the different data, makes from 1 % to 4 %, the number of the killed healthy babies can appear higher several times. In some cases, the prenatal diagnostics gives erroneous results, and the killed fetuses in the result of abortion do not have the predicted diseases. Certainly, the prenatal diagnostics is applied not only for the detection of such terrible pathologies. In particular, children with a Down syndrome can live long enough and quite happily - provided that both parents and society love them. The admissibility of selective abortions at the prenatal diagnosed disability is a subject of disputes. Some people consider that on early terms of pregnancy a question of the pregnancy preservation or interruption is only the business of a pregnant woman. The others believe that already monocelled zygote which is a human being and should be protected by the law - though only the few aspire to criminalize abortion under any circumstances in the civilized countries. It is not easy to achieve the only one criterion for decision who is right and who is wrong.
  • 8. EDUCATION 8 References Balkin, Jack M. (2007). “Abortion and Original Meaning”. Constitutional Commentary 24, no. 2: 291+. Bettelheim D, Kolinek B, Schaller A, Bernaschek G. (2002). “Complication Rates of Invasive Intrauterine Procedures In a Centre for Prenatal Diagnosis and Therapy”. Ultraschall Med. Vol. 23, № 2. P. 119-122. Calda P., Viskova H., Bezdickova D., Zima T. (2006). “Prenatal Diagnostics during the First Trimester in the Clinical Praxis”. Vol. 145, № 7. P. 575-577. Caughey, A. B., Luell D., Washington A. E. (2006). “Ultrasound Screening of Fetuses at Increased Risk for Down syndrome: How Many Missed Diagnosis? Prenatal Diagnostics. Vol. 26, № 1 P. 22-27. Mazzoni, C. (2002). “Maternal Impressions: Pregnancy and Childbirth in Literature and Theory”. Ithaca, NY: Cornell University Press. Medda E, Donati S, Spinelli A, Di Renzo GC. (2003). “EUROPOP Group Czech Republic, Finland, France, Germany, Greece, Italy, the Netherlands, Slovak Republic, Spain, Sweden”. Genetic Amniocentesis: a Risk Factor for Preterm Delivery? Eur J Obstet Gynecol Reprod Biol. Vol. 110, № 2. P. 153-158. Murray, Charles. (2005). “Measuring Abortion”. Public Interest, Wntr, 131+. Vaknin Z., Ben-Ami I., Reish O. et al. (2006). “Fetal Abnormalities Leading to Termination of Singleton Pregnancy: the 7-year Experience of a Single Medical Center. Prenatal Diagnostics. Vol.26, № 10. P. 938-943. Saxton, M. (2012). “Disability Rights and Selective Abortion”. World Institute on Disability, United States. Available at: http://www.gjga.org/conference.asp?action=item&source=documents&id=17

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