Bioethics Lecture 5 Reproductive Tech Prenatal Testing

PHIL2001 Bioethics: Reproductive Technologies & Parental Choice

Topic: Prenatal Testing

• Lecture 5

• WEEK 3 Theme: Prenatal Testing

• Reading Prompts:

  1. Why is blindness considered a neutral trait for Kent?

  2. What is Steinbock’s view on selective abortion?

Overview of Key Concepts

1. Prenatal Testing and Disability - Steinbock

2. Disability Rights Critique of Prenatal Testing

   • Marsha Saxton and Adrienne Asch's perspectives.

3. The Expressivist Argument against prenatal testing and selective termination.

4. Challenges to the Expressivist Argument.

Bonnie Steinbock’s Perspective

• Steinbock argues that disability is not simply a variation, and some disabilities are not entirely socially constructed.

• It is morally acceptable to prevent the birth of a child with serious disabilities, paralleling the acceptance of abortion to end unwanted pregnancies.

Ethical Implications of Prenatal Testing

Prenatal Testing as Preventative Measures

• There is ethical concern over using prenatal testing to screen for conditions that allow for the termination of fetuses identified with serious but manageable conditions.

• A key question raised is whether such screening is analogous to unethical gender-selective abortions.

Two Conceptions of Prenatal Testing

1. Technologically-Mediated Prenatal Care:

   • Provides essential information for family planning.

2. Medical Model of Disability:

   • Functions as a method to identify and abort "defective" fetuses, being framed as a "search and destroy" initiative.

Harms of Prenatal Genetic Testing (PGT)

• Elizabeth Dietz identifies two main harms concerning individuals with disabilities:

  1. Elimination: A systemic approach to eliminate individuals with disabilities such as Down Syndrome.

  2. Perpetrator Perspective: Misrepresenting complex societal issues as individual legal problems.

Marsha Saxton's Contributions

• A leading figure in disability rights, Saxton's work emphasizes the topic of prenatal genetic testing and the mythos surrounding disability.

• Saxton shares her experiences with eugenic ideologies prevalent in medical treatment during her youth as a child with Spina Bifida.

• Through storytelling, Saxton highlights the emotional weight of discussions surrounding the implications of disability, emphasizing the importance of recognizing the human experience behind the ideologies.

Saxton's Views on Selective Abortion

• Saxton critiques that prenatal genetic tests encourage a societal view that suggests people with disabilities are burdensome.

• She draws attention to the disparity between choosing to terminate based on timing versus the intrinsic worth of a child with a disability.

• According to Saxton, the implications of selective abortion reflect a harmful message about disability, stating that it conveys that non-existence is preferable to a life with a disability.

Adrienne Asch’s Standpoint on Disability Rights

• Asch advocates for the views that society should eliminate discrimination rather than individuals with disabilities.

• She supports abortion rights but believes that decisions should stem from genuine understanding of disabilities rather than fear or stigma.

• Asch highlights the importance of reimagining societal perceptions about living with disabilities, pushing for a narrative that sees people with disabilities as valuable members of society.

Synecdoche in Prenatal Decisions

• Asch argues against the synecdoche in abortion decisions that reduces complex realities to a single characteristic, which often leads to an unjust assessment of a potential child's worth.

• The practice of making decisions based on partial information signifies a troubling ethical stance about the value assigned to lives with disabilities.

Expressivist Argument Against Prenatal Testing

• Overview of the Expressivist Argument:

  • P1: Prenatal testing largely seeks to identify fetuses with potential impairments.

  • P2: It is expected that those identified will be terminated.

  • P3: Termination based on impairment implies that these lives are less worthy, which perpetuates harmful views regarding individuals with disabilities.

  The core of the expressivist objection is that prenatal testing and selective termination of pregnancies based on fetal traits, particularly disabilities, imply that a life with a disability is undesirable or less valuable.

Probing the Expressivist Argument

• Challenges arise regarding the presumption of whose expectations guide termination decisions and how they reflect societal values.

• The debate includes whether this perspective confines the understanding of disability ethics too narrowly, neglecting the broader implications.

   

Reformulating the Premises

• Arguments challenging the expressivist view include:

  • Prenatal testing primarily empowers parental choice.

  • It seeks to optimize the likelihood of healthy births.

  • Multiple motivations for termination exist beyond societal biases.

Upcoming Discussions

• Savulescu, Julian and Guy Kahane 2009.  The Moral Obligation to Create Children with the Best Chance of the Best Life.  Bioethics 23: 274-290.

• Barker, Matthew J. and Robert A. Wilson 2019. Well-Being, Disability, and Choosing Children, Mind 128: 305-328.

• Video conversation between Rob Wilson and Kaz Bland (available on LMS).

Reading prompts: (7) Procreative beneficence requires disability.  True or false, according to Savulescu and Kahane, and why?  (8) Are Barker and Wilson sceptical about appeals to well-being?  Why or why not?