Americans United for Life published “Studies in Law and Medicine” in the 1970s and 1980s, spotlighting issues pertaining to the human right to life across the bioethics spectrum. As Americans United for Life celebrates our 50th anniversary, we are making these issues available for the first time since their print publication.
Prenatal Diagnosis and the Human Right to Life by Leon Kass, M.D., Ph.D.
Having lived with genetic diseases himself, Dr. Kass has a personal interest in the question of prenatal diagnosis. He knows that if his various genetic vices had been detectable in utero, he might have never made it. First, any discussion of the ethical issues of genetic counseling and prenatal diagnosis is unavoidable haunted by a ghost called the morality of abortion. Abortion is a moral issue. This means that the fetus is a living thing with some moral claim on us not to do it violence, and therefore, second, that justification must be given for destroying it.
Standing behind genetic abortion are serious and well-intentioned people, with reasonable ends in view: the prevention of genetic diseases, the elimination of suffering in families, the preservation of precious financial and medical resources, the protection of our genetic heritage. Some consider it a worth reason. Precisely because the quality of the fetus is central to the decision to abort, the practice of genetic abortion has implications which go beyond those raised by abortion in general. What may be at stake here is the belief in the radical moral equality of all human beings, the belief that all human beings possess equally and independent of merit certain fundamental rights, one among which is, of course, the right to life. They believe that fundamental human rights belong equally to all human beings has been but an ideal, never realized, often ignored, sometimes shamelessly. Yet it has been perhaps the most powerful moral idea at work in the world for at least two centuries.
Genetic abortion has powerful implications for groups other than unborn children. The practice of abortion of the genetically defective will no doubt affect our view of an our behavior toward those abnormals who escape the net of detection and abortion. A child with Down’s syndrome or with hemophilia or with muscular dystrophy born at a time when most of his fellow sufferers were destroyed prenatally is liable to be looked upon by the community as one unfit to be alive, as a second class (or even lower) human type. Secondly, genetic abortion may come to be seen not so much as the prevention of genetic disease, but as the prevention of birth of defective or abnormal children. Once the principle, “Defectives should not be born” is established, grounds other than cytological and biochemical may very well be sought.
Standards for justifying abortion include the needs and interests of society and cost-benefit analysis of the life of a child with disabilities. To this point is the argument that there are matters of social importance that are not reducible to financial costs, and others that may not be quanifiable at all. A second major alternative is the standard of parental or familial good. While this approach may allow for familial autonomy, is may be the most dangerous one in that it leads most directly to the idea that there are second-class human beings and sub-human beings. The very idea of nature is ambiguous. A fetus—even a defective fetus—is not potential, but actual. The right to life belongs to him.