Pre-natal testing and a perfect world

A recent New York Times article revisits the issue of pre-natal genetic testing and selective abortions. Advances in testing technology now allow doctors to know months earlier, and with far greater certainty, if a child will have Down Syndrome or not. In the near future, "lab-on-a-chip" technology will allow parents to conduct hundreds of screening tests quickly and easily at home. Testing is getting earlier, more accurate, and more comprehensive results.

So this brings up a host of murky, difficult, and somewhat eerie scenarios: insurance companies that refuse to cover "known" conditions, fewer disabled people in society, more disabled among the poor and uneducated, parents trying to determine how severe a condition they are willing to care for or allow the child to live with.

The article also gives some statistics about abortion rates for disabled, unborn children:

One study of 53,000 women's choices, published in Obstetrics & Gynecology in 2002, found that the termination rate ranged from about 1 percent for conditions that were classified as having no impact on the quality of life, to 50 percent for those considered to have a serious impact.

Women were far more likely to choose abortions for disabilities that have a high probability of affecting cognitive functioning. For conditions that have little or no impact on the quality of life but might require medical or surgical therapy, the abortion rate was 16 percent, but doubled for those likely to cause mental dysfunction.

As for Down syndrome, doctors estimate that about 80 percent of women who get positive test results choose abortion.

I must confess that even though I am staunchly against abortion, I can imagine situations that would certainly give me pause. I remember reading one Washington Post Magazine profile about a year ago about one couple who decided to carry to term a child who would not be able to live on its own. The parents deliberately decided to have the child die in their arms. Re-telling the story here makes it sound crass, but I cried when I read the article.

There are a lot of tough problems to be worked out in the coming years. Has anyone seen Gattaca?