Richard Dawkins has stepped in it again, tweeting that aborting a Down syndrome fetus is the moral thing to do. With Dawkins’s serial controversies, there’s nearly always a question whether he’s just a klutz, or whether his “missteps” are calculated.
The evolutionary biologist and Royal Society Fellow and best-selling author–and perhaps the world’s preeminent assertive atheist–has been in the public eye for much of his life. Over the years he has been thoroughly thrashed by his colleagues (about his science) as well as by the outraged nonscientific citizenry (about his politics, and his policy positions and, of course, his hooting at the idea of God, which is what really fires up the ire.)
So it’s hard to believe he was clueless about the likely reaction to a declaration like the one he tweeted last week. It’s hard to believe he wasn’t inviting it. In fact, this is a rerun, as Paul Vale shows in his piece on the 12-stage evolution of a Dawkins Twitter brouhaha. I see that my own post (this one), as well as Vale’s own, comes in at No. 11 on the Vale list: “Attempting to squeeze a few last hits out of the now-subsiding ‘outrage’, a journalist will write a meta-piece attempting to explain the anatomy of a Dawkins Twitter scandal.”
Welcome to the meta-piece
Dawkins has said his original tweet was in reply to a friend who declared she would be faced with “a real ethical dilemma” if she found she was pregnant with a Down syndrome fetus. His response: “Abort it and try again. It would be immoral to bring it into the world if you have the choice.”
The ceiling quickly fell in, a storm of furious tweets and other vilification. Dawkins speedily issued a semi-apology, Step 10 on Vale’s list. He reasserted his belief that a Down syndrome prenatal diagnosis should be followed by abortion, but he did at least acknowledge that the decision was not his to make. Whether to end the pregnancy would be up to the pregnant woman.
Nobody seems to have mentioned that Dawkins’s strong-version opinion, that a woman has a moral obligation to abort a Down syndrome fetus, is by no means his alone. It is shared by many, even though they may refrain from tweeting it for the sake of keeping the peace.
Especially in the early days of prenatal diagnosis — Down syndrome detection in a fetus was one of the first prenatal diagnosis success stories — there were tales of docs who declined to perform the test unless the prospective parents agreed in advance to abortion if it disclosed an abnormality. Prenatal diagnosis was more complex and technically challenging then than it is today, and it posed some risk too. It involves invading the womb to get a sample of the amniotic fluid surrounding the fetus. Sometimes pregnancies were lost, a rare event today.
Majority view
The somewhat different opinion presented in Dawkins’s apology — that abortion is an acceptable outcome of a Down syndrome prenatal diagnosis if the woman so chooses — is today the majority view. Very much the majority in some places. In England and Wales between 1989-90 and 2007-8, almost 92 percent of pregnant women who received that particular bad news chose to terminate the pregnancy.
We know this because the UK has established a registry that tracks the data. The decision may have posed a dilemma for them, but nine out of 10 women resolved it in favor of abortion. That’s an acceptable choice all over the world, even in places where religion is strong. A 2011 study in Pakistan concluded dryly, “Attitudes towards prenatal testing and termination of pregnancy demonstrated that a belief in the will of Allah was not necessarily associated with a rejection of these technologies.”
In the U.S. there is no registry comparable to the one in the UK that has tracked English and Welsh live births and prenatally diagnosed Down syndrome fetuses that were aborted since 1989. But from indirect data, U.S. women appear to be taking advantage of the opportunity to choose whether to bear a Down syndrome baby. A U.S. study published in 2011 estimated that, in the absence of prenatal diagnosis and abortion, 110,968 Down syndrome children would have been born in the United States between 1989 and 2006. The researchers estimated that the actual number was 56,727, 51.1 percent of the expected number.
Which would mean that nearly half of US women pregnant with a Down syndrome fetus chose abortion. Keep in mind also that an unknown but probably substantial proportion of the estimated 56,727 women who bore a Down syndrome baby probably were not even offered prenatal diagnosis and in some cases didn’t know the possibility existed. In the UK, only 70 percent of pregnant women over 35 have prenatal diagnosis even though this age group is at highest risk of a Down syndrome fetus.
No cure in sight
A review of the 50-year history of genetic research on Down syndrome in 2009 noted that it has included a great many frustrated attempts at curing the syndrome. What these attempts have revealed is that the syndrome’s variable array of abnormalities, while due to a single extra chromosome, is not the result of something so simple as a single gene or even group of genes on that extra chromosome. Prospects for fixing this condition are not hopeful.
The review authors, Giovanni Neri of the Universit a Cattolica del S. Cuore in Rome and John M. Opitz of the University of Utah Health Sciences Center, concluded mournfully, “Gene therapy or effective pharmacological treatment are still not in sight. Are we eventually going to give up on DS, and follow the mainstream of prenatal detection and suppression of the affected individuals? This appears to be today’s prevailing view, judging from the money and effort invested into prenatal diagnosis.”
I haven’t quantified the outcries over what Dawkins said, but even skimming a few dozen tweets and commentaries it’s clear that most of the outcriers oppose abortion pretty much whatever the reason, generally on religious grounds. Other objections came from parents of people with Down syndrome who spoke warmly of their children.
Down syndrome does indeed pose a harder choice than many more severe types of mental deficiency now accessible to prenatal diagnosis. Down syndrome people often have serious medical conditions, heart defects for instance, and eventually Alzheimer’s disease. But with a loving family and community support, many can live for decades. They can be charming, affectionate children. They usually have language. They can hold simple jobs. They can contribute for much of that time.
Even so, that 92 percent figure in the UK is instructive. The data show that nearly all women, nine out of 10, who receive a prenatal diagnosis of Down syndrome take Dawkins’s advice: they abort and retain the option of trying again.
Tabitha M. Powledge is a long-time science journalist and a contributing columnist for the Genetic Literacy Project. She also writes On Science Blogs for the PLOS Blogs Network. Follow her @tamfecit.
I’m sorry but sometimes Richard Dawkins makes even atheists pray that he’ll go away.
I read this hoping for a clear statement on the reason why aborting a human with Down’s Syndrome is recommended. The gist of the article suggests it is a choice made for the convenience of parents. I would wish for a better basis in fact. People may properly be nervous if a leading geneticist and 92% of the public agree that convenience is a reason.
I’ve read about the high abortion rate of Down Syndrome too, and the reason I infur women, and couples in general, usually choose to terminate a DS pregnancy is they want to avoid the consequences of having a child with such setbacks.
Not everyone who had a problem with his tweets was anti-abortion, some found it ableist. “They can contribute for much of that time.” >This is offensive. You imply if they cannot contribute they do not deserve to live. What about people with chronic illness who cannot work? Are our lives meaningless?
yes its called “functional discrimination” -you ahev to be useful to make the cut.
I keep abreast of all research related to Down syndrome. Here is an article which describes very encouraging research, no less than five clinical trials to mitigate the effects of the extra chromosome. http://www.lozierinstitute.org/downsyndrome/
I would support the parent’s right to post natal abortion if after birth it was found medical science had missed a complication the parents had decided they would abort for. The point is this is my position. I would never dawn the cloak of celebrity scientist and morally lord over the parents right to make their decision.