Monday, August 21, 2006

A Wolf In Sheep's Clothing?

Via Alas (a blog) I ran across this article by a Elizabeth Schiltz bemoaning improvements in prenatal screening technology. Her basic thesis seems to be something along the lines of
  1. pre-natal screening = eugenics
  2. eugenics = bad
  3. ∴ pre-natal screening = bad, by the Transitivity Property of Badness
Really, the reasoning demonstrated in the article is that bad; its not something that you would expect from a Professor of Law. I'll leave it as an excercise to the reader to determine if she's just being disingenuous. To me the ability to select against genetic defects pre-implantation seems like a win-win situation for all involved. What, pray tell, does she find objectionable in this practice?

While we are willing to mandate accommodation to make jobs or public transportation accessible to a person with spina bifida, the social cost of accommodating her birth is increasingly being seen as exceeding her worth.

Ok people, who can spot the flaw in her reasoning? Yes, you in the back with the hair... yes, that's exactly correct. I'll repeat it so that you can all hear the answer: An unimplanted egg isn't a person. Ms. Schiltz is confusing a person who's already been born with an unimplanted egg. The idea that an unimplanted egg somehow has intrinsic worth as a person is totally unsupportable, as is the idea that it somehow has a right to be implanted and brought to term. Of course we make accommodation for people with spina bifida, since they're actually people with an intrinsic worth. But wait, it gets better:

Do we truly endorse the implicit message we are sending to our disabled brothers and sisters—that our commitment to diversity does not extend to genetic diversity? We need to confront the disconnect between how we see ourselves—as an enlightened, liberal society committed to fully integrating people with disabilities in all sectors of life—and how people living with the disabilities we would identify for extinction must see us.

The idea that we have somehow failed in our commitment to genetic diversity by selecting againt fetal abnormalities is strained at best. I'm by no means an expert in disability politics, but I have a hard time believing that people with disabilities would see such selection in an unfavorable light. Ms. Schiltz's woman with spina bifida might value her condition for any one of a number of reasons, though I suspect that many such persons would prefer to have not been born with such a condition. But would any person with a disability go so far as to wish their condition on someone else? That's Ms. Schiltz's implication, that we are somehow lessened as a society by reducing the number of people born with disabilities. If so, why single out prenatal screening? There's lot of other ways that we can increase crippling conditions for the sake of diversity. Bring back polio, stop iodizing salt, and for god's sake get rid of safety standards for farm machinery. I have a hard time believing that she'd support those measures, though they would increase diversity as welll. This is why I think that she's being disingenuous. I can't help but feel that she's co-opting the language of liberalism to argue against prenatal screening when her true motive is altogether different. Maybe is has something to do with working for a Catholic University? It would certainly explain her focus on the dubious personhood of an unimplanted egg.

11 Comments:

Anonymous Anonymous said...

With all due respect, have you read much on this subject from the current disabled rights movement? That she sincerely holds the views she does, for the reasons she states, seems extremely plausible to me.

1:19 PM  
Blogger GG said...

Ampersand -

Thank you for the response. No, I haven't read much of anything from the disability rights movement regarding this subject. If you have any pointers to suggested reading I'd love to get my hands on them.

My primary concern is that the line of reasoning which Ms. Schiltz espouses seems to rely on treating an embryo as a person. You're probably well aware that this sort of tactic/argument is often used as a preliminary step in limiting the availability of legal abortion. I find it suspicious that this wouldn't influence the views of a professor at a Catholic university.

However, admitting my ignorance, is Ms. Schiltz representative of current thinking in the arena of disability right? If so, do disability activists find themselves at odds with the Pro-Choice community over their characterization of pre-implanted eggs? I'm interested in hearing your thoughts, please let me know.

2:46 PM  
Blogger Kay Olson said...

GG: There's no need to expect Schiltz is being disingenous, but neither is her argument as simplistic as the equation you try to represent it with.

I happen to be currently reading the book Defiant Birth: Women Who Resist Medical Eugenics, where Schiltz is one of dozens of women telling her personal experience with pre-natal screening. I'll blog about the book myself, before long, but the basic theme is that pre-natal testing is all but compulsory for many pregnant women, with the medical expectation that any women found to be carrying a flawed fetus will abort it. That's the medical purpose of the tests since very few fetal abnormalities can be medically treated at that point. As such, just the act of being pregnant and getting "responsible" pre-natal care presupposes women will only accept certain fetuses that meet particular criteria. Schiltz resists that and believes it to be her choice to do so.

Her being a law professor at a Catholic school has much less to do with her beliefs than the following: She's been pro-life all her life. Her oldest brother has Down syndrome and is a successful part of the workforce and his community. And she grew up in Germany literally in the shadow of one of the state hospitals where people exactly like her brother were killed by the Nazis a mere decade before his birth.

While her perspective has much in common with the disability right activists who find pre-natal testing highly problematic, being pro-life is not remotely a criteria for being a disability activist on this topic.

Hope that helps clarify a bit.

5:11 PM  
Blogger GG said...

blue -

I wholeheartedly agree with you that the automatic expectation that a woman carrying an abnormal fetus will abort the pregnancy is problematic at best. But what about the case when there is no pregnancy?

Part of the problem I have with Ms. Schiltz's critique is that it fails to distinguish between pre- and post-implantation screening. PGH, the technique which she discusses in the article, doesn't involve a pregnancy; it involves screening fertilized eggs prior to implantation. In this scenario the question to abort or not is moot.

On what grounds, then, is the decision not to implant a particular egg morally problematic? (I'm particularly keen to hear any arguments you may have regarding this question)

Please correct me if you perceive differently, but it seems to me that Ms. Schiltz proffers two reasons, the intrinsic personhood of the egg and "genetic diversity". I'm unaware of any secular philosphy which posits the personhood of an unimplanted egg and, as I mentioned earlier, the "genetic diversity" angle seems to be a stretch.

It may very well be that she has no covert motivation. But if that's the case then she seems to have no theoretical basis for her claims against PGH.

6:03 PM  
Anonymous Anonymous said...

GG, with respect, I don't think you've correctly understood the arguments in the BW article. I don't think she does proffer any argument based on "the intrinsic personhood of the egg," for example. She was responding to an argument about born people and how much they allegedly cost society.

Let's say that some economist sat down and figured out that allowing black male babies of single mothers to be born, rather than aborting, costs society X amount of money (due to the higher likelihood of time in prison and suchlike). In response to this argument, someone else says to measure the worth of black men in this fashion is intrinsically offensive.

Would it make any sense for the economist to defend his work by saying "an egg is not a person"? I don't believe it would. Believing that measuring the value of people's lives in such a fashion is wrong, does not require believing that an egg is a person.

That's Ms. Schiltz's implication, that we are somehow lessened as a society by reducing the number of people born with disabilities. If so, why single out prenatal screening? There's lot of other ways that we can increase crippling conditions for the sake of diversity. Bring back polio, stop iodizing salt, and for god's sake get rid of safety standards for farm machinery.

I think there's a difference between trying to actively prevent new disabled people from being born, and going out of our way to create more disabled people.

If we believe that disabled and nondisabled people have equal value, then it makes no sense to try to create extra disabled people. The only reason to remove safety standards from farm machinery is if we believe that disabled people are more valuable than nondisabled people. But since we don't believe that, your suggestions make no sense.

However, the issue of trying to make sure that fewer disabled people are born is thornier. If we don't believe that nondisabled people are, in some sense, more valuable people, then why is it worthwhile to use medical technology to make it less likely that disabled people will be born?

5:32 AM  
Blogger Nick Kiddle said...

That's the medical purpose of the tests since very few fetal abnormalities can be medically treated at that point.

I got a booklet when I had my test that discussed the options if the results show abnormalities. It mentioned abortion, but it also talked about continuing the pregnancy and preparing for the special needs the child might have. The latter would most likely have been my choice, and I think it's valuable for parents to be forewarned if their child isn't going to be quite how they expected so they can educate themselves about the challenges ahead.

2:34 PM  
Blogger Kay Olson said...

On an individual level, I support choice absolutely, regardless of my problems with the larger social results to any trend in these individual choices. But I have a big problem with the choices the medical community makes for women (and society) through testing. And I find Schiltz's observation that these screening practices contradict societal claims that disabled people deserve to be free from prejudice and discrimination to be valid, timely and accurate.

If making sure disabled people are part of what society embraces as diversity, and giving them access to all aspects of our society is a social value and right as our laws claim it is, then the medical/scientific priority of screening out any "abnormality" it is possible to detect conflicts philosophically with the first mindset.

For reasons science doesn't understand, people with cystic fibrosis have a resistance to cholera. And people with sickle cell anemia have a resistance to malaria, which is one of the biggest killers worldwide. There's a lot of unexplored value in genetic diversity, perhaps as much in human diversity as in other species we find it morally and scientifically valuable to protect from extinction.

I have much more I'd like to add but I'll leave it there for the moment.

Regarding your suspicions of her motives, I don't find them relevant to the validity of what she argues, so I don't know what more to say about that.

1:12 AM  
Blogger Kay Olson said...

Nick Kiddle: I haven't been through the pregnancy/pre-natal screening process, but many accounts I have read don't really present keeping a fetus with "abnormalities" as much of a true option. For example, access to resources that don't just represent non-lethal fetal differences as tragedies is apparently common.

Of 55 couples who contacted an adoption organization specializing in children with Down syndrome in 1990, only two couples opted for adoption and none for abortion. Contrast that with the British doctor who was acquited for starving a baby with Down syndrome and there's a stunning difference in judgments made regarding the same genetic condition.

FWIW, some women I've been reading about report that learning about fetal conditions early combined with the societal pressure to either abort or view those conditions and the fetuses who carry them as total disasters ruined the joy their pregnancies should have held for them. One even claims it's had a lasting impact on her relationship with her healthy "normal" daughter, whose testing was apparently a false positive.

1:27 AM  
Blogger Redaspie said...

I rather suspect that Ms. Schiltz may be being disingenious if she is pro-life. However, there is none the less a serious point to make here - and reading your posting, GG, I couldn't help notice a particularly blatant assumption - although a very common one. This is that to be disabled is to be misfortunate. That disability is A Bad Thing. Now, I think this assumption is highly questionable in a world where we have deaf pride, and increasingly autistic pride, with adherants of such movements vehemently opposing *any* attempt to treat, ameliorate or cure something that they see as nothing but a positive.

I also think there's a confusion between the right of women to control their own fertility, which is an absolute right, in my view, and the tendency towards mass abortion of fetuses with disabilities, which is a product of a society that devalues people in general, not just disabled people.

3:51 PM  
Blogger Ettina said...

"Ms. Schiltz's woman with spina bifida might value her condition for any one of a number of reasons, though I suspect that many such persons would prefer to have not been born with such a condition. But would any person with a disability go so far as to wish their condition on someone else?"

The answer is yes.
I'm an autistic person. I would love to have an autistic child. Since I'm not planning to marry, I have a plan of looking through the personality descriptions some sperm banks give for sperm donors and picking the guy who seems most autistic-like to get sperm from.
There is a well known case of a deaf lesbian couple who got sperm from a man with an autosomal dominant genetic form of deafness so that their children would be deaf. http://jme.bmjjournals.com/cgi/content/full/28/5/283
What to you is a tragic affliction or whatever that should be prevented is to us the kind of people we are, and we value children like us. Not that I'de be sad if I had a normal child, but I'd love to have a kid like me. I think there is value in the way I am, therefore "wishing my condition on someone else" is not a bad thing from my perspective, and in fact something I have done.

1:50 PM  
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