Lately it seems I’ve been writing lots of conservative sounding posts so I figured it was time to brush up on my liberal credentials and write a pro-abortion piece. In fact such a very pro-abortion piece that I’m sure most liberals would try to disown me and instead label me as a fascist. So to head off this line of attack let me emphasize that I’m not advocating any government action at all in this post, that is a hard and complex issue. I’m only talking about people’s personal moral responsibility. Also nothing in this post is meant to disparage the disabled only to acknowledge that most of us (disabled people included) would very much prefer not to be disabled

So my controversial claim is that expecting women (and their partners) who discover their fetus suffers from a developmental disorder or other condition that will cause it to be seriously disabled#[ser] have a moral obligation to abort that child. In fact not only do I believe this but I think anyone who doesn’t think abortion is deeply wrong and agrees to a few other reasonable assumptions is required to hold this position.

Let me stress that there is no sarcasm involved, this is not a “Modest Proposal” style shock piece, I really do hold this position and find these arguments compelling. I realize that many people will be outraged at this suggestion and tempted to dismiss it out of hand. However, I urge you to read my entire post and try to identify where I go wrong. Especially in issues like this we need to make sure our emotions don’t run away with our brains.

Below I will offer a detailed argument which does not suppose that abortion is a morally neutral act. However, let me first explain the intuition behind this conclusion before people stop reading in outrage. Basically the idea is we don’t believe it is wrong not to procreate or abort just because this this choice prevents some people from ever existing. Just because abortion prevents children whose parents would have aborted them from existing doesn’t make it morally wrong. The fact that the disabled are an easily identifiable and somewhat socially cohesive doesn’t change the basic situation

Yet if abortion itself is not wrong then aborting the disabled should be morally equivalent to sorting your eggs for genetically healthy specimens before conceiving and since eggs are just cells this should be morally equivalent to providing pre-conception therapy to your eggs to save your child from being seriously disabled. Yet if your only chance to save your child from a serious disability was pre-conception therapy not only would it not be wrong it would be morally required. Hence it is actually morally required to abort the disabled.

The Detailed Argument

If we don’t want to assume that abortion is completely morally neutral the argument becomes a bit more complex. The structure of this argument will be an initial moral judgement in a related situation and then an argument that the answer should be the same when we consider aborting fetuses known to be disabled. I will first give a quick sketch of the argument and then flesh it out later.

Suppose a lone doctor at a remote clinic only has time to either prevent an expectant mother from miscarrying or to save a five year old from becoming severely disabled#[ser] i.e., option 1 results in a healthy pregnancy but a severely retarded five year old option two results in a miscarriage and a perfectly healthy fie year old. It seems obvious to me that the doctor has a moral obligation to help the child rather than prevent the miscarriage. Yet this is essentially the same choice facing a woman who has learned her fetus will suffer from a congenital defect symptoms of which will appear at 5 years of age. If she carries the baby to term there will eventually be a disabled 5 year old (assume the chances it will survive that long are nearly 100%) on the other hand if she aborts it there will be an interrupted pregnancy but no disabled five year old boy.

Fleshing Out The Argument

So their seem to be two significant differences between the choice faced by the expectant mother and that faced by the doctor I outlined above. In order for the argument to be compelling I need to establish these differences shouldn’t change the outcome. The first difference is that the mother would be making a positive choice to end her pregnancy while the doctor would only be choosing not to intervene and stop a miscarriage¹. Personally I think the distinction between action and inaction is just a comforting story to stop us from feeling bad about all the altruistic actions we could be taking but aren’t. However, I recognize that most people do not share this attitude so let me explain why the active choice to terminate the pregnancy should not change the morally required outcome.

Of course if one thinks that abortion is the moral equivalent of murder this would make a significant difference. However, if you don’t think abortion is on the same level as murder but instead a choice which is morally acceptable for a women to make because she does not think she is prepared to carry a baby for nine months or similarly minor (compared to murder it is of course a major life decision) reasons this tactic is a non-starter. While a significant hardship being pregnant for nine months just isn’t on the same level of suffering as being seriously disabled for your entire life². In other words even if you think aborting a child is a moral harm all other things being equal it just pales into insignificance compared to the prospect of failing to save a child from a life of disability.

I think we can make this point quite clearly by modifying the example a little bit. Supposing it is not a miscarriage he is going to prevent but a mistaken abortion. Say during that time he would otherwise be tracking down a confused wife who is trying to abort a baby she is afraid isn’t her husbands. Maybe they have an open marriage and she only wants her husbands children but a condom broke when she was sleeping with some other guy. Even if the doctor could somehow share with her the information the other guy had a vasectomy (maybe the other guy was the doctor) and prevent an unwanted abortion at the cost of saving the child from serious disability he should still spend his time

The other way the doctor’s choice and the potential mother’s choice differ is that in one their is an already existing formerly healthy child who will become disabled while in the other we are talking about a fetus who would have the condition since birth. Admittedly a parent who has to adjust to a formerly healthy child’s disability may face more psychological hardship (we can assume the child’s disability involves such severe mental impairment or they are so young they are unaware of the change) than one who knows at birth their child will face serious disability. Once again though I think this additional harm is negligible compared to the overarching issue. A short time of adjustment just isn’t comparable to the difference between a life spent severely disabled and one spent healthy.

Aside from this small point the fact that in one case we are considering a child who already exists while in the other we are talking about the quality of life of a child who is yet to exist should not make any difference. The life of a child who is born with a congenital defect, symptoms of which will manifest at 5 years of age, will be substantially the same as a child who develops the same symptoms for other reasons ate age five. Moreover, we do not generally accept the principle that a yet to be born child’s quality of life is less important than that of already existing children³. A company which knowingly releases a chemical into the air immediately harming children 5 and younger is no worse than one which dumps that chemical knowing it will seep into ground water and cause similar harm to 5 year olds and younger but not for five years down the road. Or in other words the future (after birth) quality of life of child who has yet to be born is just as important as that of one who has already been born. Hence the fact that in the doctor’s choice the child is five while in the mother’s choice the child will be five if she chooses to have it do not give a reason to treat the two situations differently.

Summary of the Argument

Now that I’ve taken you through the details let me spell out the argument in it’s entirety. The starting point was the intuition that given a choice between preventing a child from becoming seriously disabled and stopping a woman from miscarrying the doctor’s duty was to prevent the child from becoming disabled. From this we reasoned that the harm brought about by the termination of a pregnancy wasn’t as much as the harm brought about by allowing a child to become disabled. Then we argued that replacing the natural termination of a pregnancy with the abortive termination of a pregnancy did not change this conclusion, i.e., a doctor given a choice between preventing an undesired abortion (an abortion the person really doesn’t want) and saving a five year old child from serious disability should still save the give year old child.

Next I argued that a saving some boy who is already five from a life of serious disability is morally equivalent to preventing some boy who hasn’t yet been born (or even conceived) from becoming disabled at the same age. Hence we can conclude that the harm of an abortion is less than the harm of a child being born with a serious disability. Now faced with the choice of choosing to bear a disabled child to term or have it aborted by definition the least harmful choice, aborting the child, is the morally better one⁴. Hence the moral obligation to abort a disabled fetus.

If this result still doesn’t seem right ask yourself the following. Suppose a couple goes in for in-vitro fertilization where they naturally fertilize more eggs than they implant. If more than enough eggs are harvested and inseminated but one of them turns out to carry a serious congenital disability isn’t it reasonable that the parents have an obligation to avoid using that embryo? If so why should the answer be any different if they haven’t pre-fertilized a bunch of other eggs? Isn’t abortion just the choice not to use a fertilized embryo?

The “But Then I/We Wouldn’t Exist” Argument

Their is a standard response to any statement that even suggests this sort of argument ought to be considered. The critic demands to know if the person making the suggestion is saying disabled people are worthless and we would be better off without them. If the critic is disabled themselves they equate the suggestion with the claim that they shouldn’t exist. While containing a kernel of truth these responses horribly distort the issue.

No this argument does not imply in the slightest that disabled people are worthless. What it says is that pretty much everyone would rather be healthy than seriously disabled. So in a sense it is saying we would be better off without disabled people, in the same sense someone who wishes to cure these disabilities is saying the same thing. It is a very different sense then the one which is being suggested, that we find the disabled so burdensome we should kill them off.

Ultimately this entire argument trades on am ambiguity in being ‘better off without’ some group. We make a huge moral distinction between eliminating or not taking care of those people who are actually born and choosing not to carry certain pregnancies to term. We can believe with perfect consistency both that we wouldn’t ‘better off without’ children whose existence is the result of failed birth control in the first sense of the term while supporting increased reliability for birth control. Similarly we can perfectly well value and respect those people who are disabled while believing the world would be better if fewer of them were born in the future. The language looks startling but is really saying nothing more disparaging of the disabled than a statement which says we would be better off without a world population over 3 billion is disparaging of some 3 billion people.

The “What About Stephen Hawking” Argument

The other response one frequently hears in this discussion goes something like this, “But if you aborted all the babies with congenital defects you wouldn’t have people like Stephen Hawking.” This is true but once again misleading. No doubt if we had another 7 billion homo sapiens we would have several more minds on Hawking’s level but this certainly doesn’t mean we should let the world population soar by this many people. The question is not whether some disabled people make amazing contributions to society, of course they do, it is whether they are any more likely to make them than healthy people which is doubtful and certainly false if we restrict our attention to the severely mentally retarded.

Moreover this argument once again misses the point. No one is saying the disabled are a drag on society we ought to get rid of them (at least no one I know). What I am saying is that pretty much everyone would prefer not to be disabled. If we can fulfill that preference don’t we have an obligation to do that?