We all live in glass houses, so caution is advised before throwing any stones. However, sometimes we read of and hear about things in the world that don't lie well in our moral landscape, and we judge. We'd like to think that we wouldn't have done this, or we would have done that, had the choice been ours to make.
Spiderman famously said, 'with great power, comes great responsibility', and he was on to something. Modern technology, in particular, ultrasound screening and neonatal testing gives us great power, because it gives us knowledge. This, in turn gives us great responsibility, because we then need to decide whether and how to act on that knowledge. We judge these actions to be good or bad; right or wrong. The scanning isn't inherently bad; the knowledge, although possibly unwelcome isn't 'morally bad', but, in the absence of a universally agreed absolute moral framework, the choices people make are the subject of moral judgment. Some may argue that an absolute moral frame work does exist, but since not everyone agrees that that is the case, or what exactly such a framework would hold, we cannot say that it is universally accepted. This seems to point towards a broadly 'pro-choice' position, within which individuals may hold strong absolute moral positions, including 'pro-life' ones.
The case of the Australian couple who have taken the twin, but not the Downs syndrome sibling from the surrogate Thai mother, which has been in the news this week raises some interesting ethical issues. I don't mean to comment directly on that case here because the facts of that particular case are far from clear. The only thing that is clear is that it is very sad that it has happened. But what were the alternatives?
I have had several surgical procedures after my miscarriages. I remember sobbing over the 'phone to my Dad on the eve of the first one that I didn't know how someone could go into that operating room knowing that their baby was still alive and go through with a termination. And truly, at that moment in time, I really could not have understood it, I was deep in shock and grief. Why would anyone do this voluntarily? That is not to say that I did not intellectually understand that some women (and girls) find themselves in terrible situations and feel that there is no other realistic option. But at that moment, I could not have empathized with it.
However, since then I've lost a daughter to Turner Syndrome, a randomly occurring genetic condition (a missing chromosome) which affects only girls. 96-7% of baby girls who have this condition miscarry, but some do survive and have a range of complex medical needs throughout their relatively short lives. This experience got me thinking about what I would (could) do if I knew that the baby had a life limiting condition. I don't consider Downs to be necessarily life limiting (although it can be more or less severe and complicated). I mean the kind of condition that is 'incompatible with life', like Anencephaly (where the brain or skull are seriously malformed or absent). In a way, I was 'lucky' that my Turner's baby died and I didn't have to make that choice, but I can't pass judgment on those who would terminate for those kinds of reasons.
Some also consider their existing children who they don't want to make 'carers' for the long term (although aren't we all carers in families at some point?). I have not walked a mile in their shoes. The instinct to protect your living children, the ones that are already here, for whom you have such hopes, and in whom you see such amazing potential, is a powerful one.
The problem is that once you accept some terminations for medical reasons, drawing the line is far from easy. This is why, as long as scanning is available, the pro-choice voice is important; there has to be room for a case by case analysis. However, it certainly isn't a 'green light' to terminate every 'imperfect' baby.
Conversely, if you already firmly believe that all termination is wrong, perhaps screening is inappropriate, since the knowledge you gain won't make a difference. This is an over simplified view, but a dichotomy worth exploring.
Can screening per se be inherently 'good', since it provides that information upon which these kinds of decisions are based? Increasingly earlier, more and more 'defects' can be picked up through screening, (http://www.bbc.co.uk/news/health-28640873) and there is an argument that, if you can prevent people from being born with these problems, you are doing them a favour. But if this is used to justify terminations for cosmetic or 'non-life limiting' conditions, or even gender, have we abused the technology? If so, ought it to be used at all?
Conversely, recurrent miscarriers such as myself are recipients of reassurance scans because TLC of sufferers seems to positively affect outcomes, anecdotally, at least.
Some Christians (and I am sure followers of other faiths and Humanists, and atheists - I should have just said people...) such as Joanna Jepson argue that, if we select for perfection in the womb, we are sending a message to the living disabled that they are 'worth less' than 'normal' people. (I hesitate to use the word 'normal', as, really, who is 'normal' anyway?) Whilst no-one would want to wish adversity on to individuals or families, I'm inclined to agree with this point. Then again, I'm not the one pacing the hospital corridors as a disabled child of mine undergoes repeated heart surgeries.
People base their choices on their personal circumstances at the time. Sometimes they appear selfish. Perhaps the real question is, is it always morally wrong to be selfish? I can't answer that. So, whilst it is surely beneficial to the human conversation to debate moral choices, I wonder whether it right to judge them?
Adapted from my post on http://justonemoretimeagain.wordpress.com/. Check it out for more of my thoughts.