Ultrasound to Abortion: The Moral Permissibility of Genetic Testing

Ultrasound to Abortion: The Moral Permissibility of Genetic Testing

In contemporary society, debates about abortion have become a mainstream topic with the advent of advanced medical technology. When is abortion morally permissible? There are scholars, such as Adrienne Asch, who have attempted to answer questions like this by using examples of real life scenarios. In an essay “Can Aborting ‘Imperfect’ Children Be Immoral?” Asch says abortion in an involuntary pregnancy, or in a voluntary pregnancy after circumstances have changed in the mother’s life is, in fact, permissible. On the other hand, she says abortion is immoral for sex selection and in fetus’ with genetic diseases or as she puts it, in “imperfect” children. Asch draws on the distinction of when abortion is morally permissible and when it is not [1].  I believe Asch’s argument that abortion of fetuses with genetic diseases is immoral is not supported, but she does bring into light some important questions regarding the topic. Asch’s arguments specifically will be considered here to ponder a certain viewpoint of genetic testing. I will attempt to offer a not as popular of a response to one particular question that addresses some implications on the already existing disabled community.

Before considering Asch’s point of view, it is important to acknowledge the increase in use of genetic testing in American history in order to see why it has become such a point of debate. Medical technology does not simply mean the use of ultrasound anymore, but encompasses the use of techniques for the purpose of genetic screening and diagnosis. Technologies called Assisted Reproductive Technology (ART), including in vitro fertilization (IVF), are also used to increase fertility [2]. In little more than twenty years the number of United States clinics that offer ART has doubled (from 264 in 1995 to 464 in 2015) with rates of having a successful live birth with each ART cycle steadily increasing [3,4]. The use of IVF leads to an increase in the use of genetic screening and diagnosis techniques. For example, more women participating in IVF implies, by simple reason, there is more of a chance for genetic diagnostic techniques to be used because some require screening the embryo before implanting it into the womb. These genetic screening techniques will allow the doctors to see if the embryo has any chance of having a genetic defect, and in this situation if it does, the mother can “choose” not to have that embryo implanted [5]. But with such improvements in science many bioethical questions also arise regarding abortion one of which Asch responds to.

Asch begins her essay by stating the role of the woman’s autonomy in reproductive choice especially in involuntary pregnancy. She says, “pregnancy can impose financial, psychological, vocational, and social hardships” [4] on the woman, thus abortion is justified in any involuntary pregnancy. However, she also claims abortion is justified of a once-wanted pregnancy, if and only if, the “circumstances in her own life no longer enable her to be the type of parent she wishes to be” [1]. For example, if a woman who had consented for pregnancy has a tragic incident occur in her life, such as the husband dying or leaving her, is morally justified to get abortion according to Asch. If Asch agrees that this is morally permissible, then her argument of aborting a fetus with genetic disease that was found through genetic screening seems inconsistent to me. She claims there is a distinction between the two because one decision is because “one’s adult life has radically changed,” whereas in the other “we don’t like what we find out about the potential life we carry” [1], but does the adult’s life not radically change when they do find out about the potential life they carry? I believe it does. It is not necessarily about not liking the traits of the potential life, but more so of the capabilities of the adult taking care of this life. It may even put “psychological, vocational, and social hardships” on the adult as Asch puts it.

I do want to acknowledge this should be the last option; complete, unbiased information needs to be obtained by the potential parent before assessing their financial or emotional capabilities regarding raising a child of a genetic disease. The adult, after finding out all the information pertaining to life with a genetic disease, may genuinely believe he or she is incapable of raising a child with this disease, and may believe it might even adversely affect the child’s quality of life under their parenting. In my opinion, Asch should not claim abortion is morally permissible when the adult’s circumstances have changed while impermissible when a fetus has a genetic disease because I think they are the same; she should either say both are permissible, or both are impermissible.

Asch, even if her argument does not seem persuasive, does bring up several important points being addressed in the bioethical world today regarding genetic testing. Asch mentions that we would imply “no more of your kind” [1] through the use of genetic testing, but are we not creating a disparity by exactly that type of reasoning? If one thinks a person belongs to that “kind” then one is creating that societal negative disparity. This phrase suggests that society thinks of the disabled community as the disability and nothing more. The use of language is very important here; it is not a disabled person, rather it is a person with disability. When this distinction is made and realized that genetic testing is not attacking the disabled “kind”, but the disability itself I believe a more positive outlook of genetic testing can be seen. This point of view along with the idea of genetic testing being an option, not a requirement, can be used to ensure the disabled community can still be treated with respect.

I do, however, recognize this type of thinking will not justify abortion to certain theologies, or even mainstream “pro-life” believers, but I do think it is an important distinction to make to not only get a positive outlook on genetic testing, but also decrease ableism in our society.  

References:

  1. Asch, Adrienne. “Can Aborting ‘Imperfect’ Children be Immoral?” Christianity and Crisis 46, no. 10, 384-388.

  2. Johnston, Josephine, and Michael K. Gusmano. "Why We Should All Pay for Fertility Treatment: An Argument from Ethics and Policy." Hastings Center Report 43, no. 2 (2013): 18. doi:10.1002/hast.155.

  3. “2010 Assisted Reproductive Technology National Summary Report.” Centers for Disease Control and Prevention. Accessed November 22, 2017. https://www.cdc.gov/art/pdf/2010-report/ART_2010_National_Summary_Report.pdf

  4. “Assisted Reproductive Technology 2015 National Summary.” Centers for Disease Control and Prevention. Accessed November 22, 2017. https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicInfo&rdRequestForward=True&ClinicId=9999&ShowNational=1

  5. “Preimplantation Genetic Diagnosis: Benefits & Concerns.” American Pregnancy Association. July 15, 2017. Accessed November 26, 2017. http://americanpregnancy.org/infertility/preimplantation-genetic-diagnosis/

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