Dramatic advancements in medical research, technology and science have done little to solve bioethical dilemmas. Society has gone a long way to achieve the current level of development, but it has never managed to overcome the historical, cultural, and religious controversies surrounding abortion. Even in cases of abnormal pregnancy, abortion is an ethical challenge for parents and nurses. At the center of the abortion debate is respect for human life as a foundational principle of bioethics. If the embryo is a living being since the first moments of conception, then abortion is impermissible and constitutes a serious ethical violation. However, in abnormal pregnancy, the problem of physical and emotional suffering moves to the forefront of the ethical agenda. Abortion is a legal and ethical option for women whose babies are likely to be born with a serious genetic disorder, but if a woman chooses to keep her baby, no law or moral argument will prevent her from doing so.
What does it take to have a child with a serious genetic disorder? Carol Ann Vetter knows the answer. Her son David was born in September, 1971, with severe combined immunodeficiency (SCID) (Anonymous, n.d.). Since birth and until a few days before his death in 1984, the boy had to live in a sterile isolator, which is why he was called “the bubble boy” (Anonymous, n.d.). The physical and emotional suffering that his family had to endure is difficult to measure. Suffice it to say, Carol Vetter had never touched her boy until a few days before his death, when he was 12 years old (Anonymous, n.d.). What mother would want a “bubble” life for her child? What boy or girl would want to live their entire lives in a bubble, without being able to experience the world, socialize, meet friends, or create a family? Yet, even when a child is facing a life-threatening condition, it takes moral courage to disconnect him or her from life support. Likewise, even when parents know that their unborn baby has a genetic abnormality, they will need moral courage to make an abortion decision.
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Abortion is a serious moral challenge. Parents must make a decision that will be best suited to protect the rights and interests of the unborn baby (Walker & Zyl, 2015). Respect for human life is the fundamental principle of bioethics. However, respecting a life that leaves little room for anything except suffering is neither logical nor rational. Being alive is not everything. A person who is alive but is in a permanently vegetative state cannot enjoy the benefits of life that are available to a person who is alive and healthy. For women who receive abnormal results of genetic screening, abortion is often the only way to protect their unborn babies from unnecessary sufferings. It is the principle of child’s welfare that guides their decisions (Lacey, Peterson, & McMillan, 2015). Parents who choose to pursue this course of action should be able to do so. However, no screening test can and should keep individuals from getting married or prevent married couples from having children.
Even the best screening tests are not 100-percent accurate. Walker and Zyl (2015) suggest that most prenatal diagnostic tests can predict fetal abnormalities but will say little about their severity. For example, in spina bifida, some children will be born with minor deficiencies and live a life close to normal, whereas others will suffer during their entire lives (Walker & Zyl, 2015). Any abortion or no-to-abortion decision should be made by parents. Should they decide in favor of an abortion, they will have the right to receive supportive therapy and care to overcome the physical and emotional legacy of their loss. Should they decide to move ahead toward birth, they will have the moral and legal right to receive high-quality medical care for their baby. Some organizations still want couples to avoid getting married if they have a history of genetic disease. Dor Yeshorim, the organization founded by Rabbi Joseph Ekstein, works to prevent the birth of children with Tay-Sachs disease (Anonymous, n.d.). However, such screening is morally contentious: no screening test can determine if individuals are fit for marriage or if married couples are fit for parenthood (Lacey et al., 2015). These ethical violations can give way to legal action.
The legal side of the problem also deserves attention. Abortion can be conceptualized as a form of civil liberty that may or may not be available to women. For example, most states and countries do not allow abortions after 20 weeks of gestation. Meanwhile, many birth defects do not become obvious until that time (Walker & Zyl, 2015). If a woman decides to terminate her abnormal pregnancy at 20 weeks or later, she may not be able to do it legally. Simultaneously, no law can forbid a woman to give birth to a child with genetic defects. A decision to make an abortion or to keep a child with a genetic disorder is always made by parents if it does not violate the existing laws and regulations.
In conclusion, there is no tragedy for a woman greater than losing an unborn baby. However, having a child who suffers every minute can be particularly difficult. No one says that abortion is the most ethical decision. It is surrounded by considerable moral and legal controversy. Parents are morally and ethically positioned to decide what they want to do if chances to give birth to a healthy child are uncertain. Whatever decision they make, they deserve support and understanding in their struggle to protect the interests and welfare of their unborn babies.
- Anonymous. (n.d.). The prenatal testing debate I: Embryo screening.
- Lacey, S.L., Peterson, K., & McMillan, J. (2015). Child interests in assisted reproductive
technology: How is the welfare principle applied in practice? Human Reproduction, 30(1), 616-624. - Walker, R., & Zyl, L.V. (2015). Surrogate motherhood and abortion for fetal abnormality.
Bioethics, doi: 10.1111/bioe.12157.
