Disability

Some thoughts on disability (to be developed into a longer piece)

In 2019, when my wife was pregnant with what would be our second child, a prenatal test diagnosed the foetus as having trisomy 21, the genetic basis of Down Syndrome. We chose to carry the pregnancy to term. This is a statistically unusual choice - across much of the world, the majority (often the vast majority) of pregnanacies where the foetus is diagnosed with trisomy 21 end in abortion. Was ours the correct choice? Are these abortions wrong?
For those who, like myself, are broadly pro-choice, prenatal testing and foetal disabilities raise difficult issues. On one view (defended by Peter Singer and Richard Dawkins), disabilities which would compromise the child's quality of life or welfare are grounds for abortion. One some versions of this view, abortion on these grounds is not only permissible but should be encouraged. This view provokes strong opposition from people with disabilities or parents of disabled children.
I suggest this view rests on at two contestable assumptions. First, while notions like ‘quality of life’ or ‘welfare’ clearly apply in some situations (e.g., someone being tortured is unlikely to be enjoying a high quality of life), there are many more where they do not apply very clearly. A person’s quality of life will often involve a number of very different factors, such that it may be practically impossible rationally justify an overall judgment. For instance, people with Down Syndrome have cognitive limitations and are at higher risk of certain health issues, but evidence suggests they are very happy with their lives. It is not obvious whether this means they have a lower quality of life than a person with great cognitive powers who is deeply miserable about themselves.
Second, even if a child would have a quality of life which is limited in certain respects, this may not be a sufficient reason to prevent that child from being born. A great deal depends on what attitude it is reasonable for prospective parents to take. Parents should try to provide their children with the capability of living a good life. However, beyond that, I suggest one’s attitudes can vary greatly, in large part depending on what one thinks a good life might involve. In addition, while parents can reasonably try to incline children towards certain pursuits or values, it is not reasonable to think that they should fully determine the lives of their children. This is true even if the child will be for their whole life extremely dependent upon others, as is the case with many people with Down Syndrome.