The abortion of Down Syndrome babies, from December 2, 1996.
Testifying before Congress in the spring of 1990, Arkansas state health director Joycelyn Elders took an unusual tack in her defense of legal abortion. "Abortion," she said, "has had an important, and positive, public- health effect," in that it has reduced "the number of children afflicted with severe defects." As evidence, the future surgeon general cited this statistic: "The number of Down's Syndrome infants in Washington state in 1976 was 64 percent lower than it would have been without legal abortion."
Her remark went all but unnoticed at the time and has received little attention since, even during Elders's contentious tenure as surgeon general in the Clinton administration. But it was a significant statement nonetheless, if only because it represents one of the few occasions on which a public health official has publicly acknowledged the eugenic utility of abortion. Terminating a pregnancy, Elders argued, is not simply a difficult personal decision, an agonizing last resort. When guided by public-health objectives, abortion can also be a positive act — a means of improving the species.
Stylized and dulled by euphemism as it is, the debate over abortion in America rarely allows for statements as clear and direct as Elders's, and the words may sound almost unrecognizably harsh to ears accustomed to intentionally opaque terms such as "choice" and "life." But what Elders said is nothing new. For 30 years, nearly every element of Western medicine — physicians, geneticists, insurance companies — has, explicitly and not, encouraged the use of abortion to reduce the incidence of birth defects.
The effort has succeeded dramatically, particularly in the case of Down Syndrome, the most frequently occurring genetic disorder. Far more women now are able to detect Down Syndrome pregnancies, and far more end them with abortion. Yet even as it becomes easier and more common to prevent children with Down Syndrome from being born, the justification for doing so grows murkier.
Unlike many other genetic anomalies, such as Tay-Sachs and anencephaly, Down Syndrome (also known as Down's Syndrome or Trisomy 21) is not a terminal disorder. Children born with Down Syndrome are not vegetables, nor are their lives demonstrably not worth living. Indeed, advances in science and changes in public perception have combined to make Down Syndrome a relatively mild birth defect: The average child born with Down Syndrome in America today can expect to reside at home, go to school, learn to read, hold a job, and live to the age of 55. He will grow up cognizant of ethics and events, and will be mildly to moderately retarded, with an IQ of between 55 and 70. It is one of the triumphs of modern society that the life of the average person with Down Syndrome has become strikingly normal. Except that, unlike normal people, people with Down Syndrome have been targeted for elimination.
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