October 9, 2003


Impact of prenatal screening on the birth status of fetuses with Down syndrome at an urban hospital, 1972-1994. (Caruso TM, Westgate MN, Holmes LB, Genet Med. 1998 Nov-Dec;1(1):22-8)

PURPOSE: This hospital-based study has determined the change over time (1972-1974 and 1979-1994) in the methods of prenatal detection of fetuses with Down syndrome and the impact of elective termination on the portion that were liveborn. METHODS: Using a malformations surveillance program, all 265 affected fetuses and infants were identified among 161,560 births and elective terminations during the aforementioned period at Brigham and Women's Hospital in Boston, MA. RESULTS: From 1972 to 1974, Down syndrome was not diagnosed in any affected infants prenatally. In the early 1980s, amniocentesis was the primary method of diagnosis; later, maternal serum screening and ultrasonography were as likely to be the first method of detection. Most couples (86%) elected to terminate pregnancies with affected fetuses. CONCLUSIONS: The effect of prenatal detection and the choice of elective termination produced a significant decrease, between 1972 and 1994, in the portion of fetuses with Down syndrome who were liveborn.

Posted by David Cohen at October 9, 2003 4:37 PM

Good thing we can screen for those defectives, right?

I'll go puke in a corner, now.

Posted by: Chris at October 9, 2003 5:01 PM

Just think of all the conditions that could be "cured" by this method. Let's hope they don't develop a genetic test for a proclivity toward conservatism.

Posted by: pj at October 9, 2003 5:07 PM


No need to worry yet, but watch out if Jeff tells us about a new study that shows conservatives have longer middle toes than everyone else.

On the other hand, if we could prove socialists have narrower pelvis'...

Posted by: Peter B at October 9, 2003 5:57 PM

The distribution of Down's is random for any given age bracket.

And Down's certainly doesn't select for morally compromised secularists.

Which, on average, means nearly 9 out of 10 who say they would never do such a thing would find themselves hypocrites come the actual event.

Posted by: Jeff Guinn at October 9, 2003 8:14 PM


I don't disagree with your last paragraph at all. Which is the point.

Posted by: Peter B at October 9, 2003 8:42 PM

Jeff --

The only reason we need any law is because people will otherwise do these things.

Posted by: David Cohen at October 9, 2003 9:19 PM


Which is more moral? Bringing the Down's child into the world, or one without Down's?

The decision isn't a both, it is an either/or.

Posted by: Jeff Guinn at October 10, 2003 7:34 AM

Jeff --

As I've already said, I can't be sure what I would do in this situation. However, what could possibly be immoral about not aborting a child with Down's syndrome?

Posted by: David Cohen at October 10, 2003 8:54 AM


It is immoral in your view to knowingly have a child with a disability? "Darwinism applied" indeed.

Posted by: oj at October 10, 2003 11:17 AM


Nothing. But that doesn't make aborting it immoral, either.

My wife was 35 when she had our first child. We agonized over the prospect, and came to a decision. I have no idea whether we would have acted on it in the actual event.


That was a pure question, not a statement, or even a statement masquerading as a question.

Posted by: Jeff Guinn at October 10, 2003 11:34 AM

Jeff: Neither is more moral. One is less. The termination of a human because of "bad genes" is monstrous. I can illustrate the slippery slope for you, if you like.

Posted by: Chris at October 10, 2003 11:48 AM


How does your philosophy--not you personally--define "moral" in the context of this question? I'm getting the impression your brain is telling you this has nothing to do with morality and your heart is fighting back.

Posted by: Peter B at October 10, 2003 2:01 PM

The accuracy of the test is very low, so making decisions based on a test that is wrong about one time in 3 is foolish, even if no moral question is involved.

I am not going to state my position about keeping Down babies, but in answer to David's question, I can imagine a case in which not aborting a boby certain to be a big burden, bringing it into a family already on the edge, raises an interesting moral -- or if you are not moral, a darwinian -- question.

People in that circumstance are not likely to have access to ultrasound. Their solution, often, is to murder the burdensome newborn.

Posted by: Harry Eagar at October 10, 2003 4:16 PM

Harry: So better to get them before you can hear them scream?

Sorry. I don't know how to express that more civilly.

Posted by: Chris at October 10, 2003 6:12 PM

I was born with a severe hearing impairment due to my mother's having incurred rubella (German measles). I got a (very mild) case of cerebral palsy in the bargain. Would Jeff have suggested that I be aborted?

Posted by: Joe at October 10, 2003 8:04 PM

Chris, I said I'm not expressing an opinion. I'm just pointing out that, in fact, not only ideas but also actions have consequences.

If the idea is, no abortion ever, that does not affect only the potential abortee.

Posted by: Harry Eagar at October 10, 2003 10:27 PM

But, Harry, such cases arise on the edge of all moral issues. We can all think up situations where the committing of murder, war crimes, theft, etc. can appear to save lives or otherwise prevent the evil that will arise from not committing them. Moral codes aren't car repair manuals.

The issue is what kind of thinking leads us to conclude that, because of these tough cases, the moral rules themselves should be jettisoned.

Posted by: Peter B at October 11, 2003 5:23 AM

I was just wanted to ask if you had a very Merry Christmas / Holiday, and to wish you the very best for the New Year.

BTW, In saw something on another blog site I think it is a good idea to let as many people / bloggers know about. I was just organizing my vacation for later this year and stumbled across the above web site about Bali, where I was considering going. But just read what it says there and especially between the lines; unreal. A travel agent there Bali Discovery Tours of Sanur went to their friend the police chief and made trouble for someone visiting the island who had caught this travel agent offering unauthorized room rates on the Internet for the Hotel Santika Beach in Kuta, which is where I was going to stay, but thank God I am not now (I am not even going to Bali becuase of this) - seems to me like the hotel did not exactly help!

The poor guy was detained by the police for 4 days and had his passport illegally seized. He was not released until the British Embassy filed a formal complaint. Of course, there were no charges!! This is absolutely terrible. Please, please, please, join me in saying "Stuff Bali - I'm going somewhere where they treat people like guests, not enemies".

Posted by: George at January 4, 2004 2:08 AM