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What's wrong with abortions for fetal abnormality?

A new report reveals that young people are becoming more hostile to abortions carried out because the fetus is abnormal. Co-author Ellie Lee thinks this 'ethical' outlook needs to be challenged

A MORI poll carried out in 1997 found that 64 per cent of respondents believed that abortion should be made legally available for all who want it. In 1980 just over 50 per cent gave the same answer to a similar question. It seems that these days, outside of a minority of 'pro-lifers' who continue to believe that abortion should be illegal, most people think it better that a woman can terminate an unwanted pregnancy than be compelled to carry a pregnancy to term.

But if abortion in general is now widely accepted, abortions carried out specifically because the fetus is abnormal have become increasingly controversial. In the 1980 MORI poll, 84 per cent said they approved of abortion in cases of mental disability and 81 per cent for physical disability. By 1997 these figures had dropped to 67 and 66 per cent respectively. Approval ratings for abortion on the grounds of disability among those aged 15-24 were lowest of all. In this age group only 50 per cent said they approved of abortion for mental handicap, and 47 per cent for physical handicap.

It was against this background that the Pro-Choice Forum decided to carry out some research about young people's attitudes to abortion for abnormality. The report, 'Attitudes to abortion for fetal abnormality', was published in September.

We conducted a questionnaire survey of 300 school and university students, aged 15-24, and did focus group interviews with 10 groups of students. While the small size of our sample means the results cannot be taken as definitive, the report does tell us some- thing about changing perceptions of the abortion issue.

The results of the Pro-Choice Forum research confirmed the findings of previous research about attitudes to abortion law: 76 per cent of our sample called themselves 'pro-choice'; just over 45 per cent said they agreed with the 1967 Act (which allows legal abortion up to 24 weeks where two doctors agree that continuing the pregnancy represents a threat to the physical or mental health of the woman or to her existing family, and allows legal abortion with no time limit where there is substantial risk of serious abnormality); and more than 30 per cent said the Act is too strict. It seems that young people have no desire to see the law make women continue a pregnancy against their will. And this includes where there is abnormality detected: 76 per cent also said that abortion on this ground should be allowed.

However, while the idea of the law 'telling women what to do' has little support, the same young people see aborting an abnormal fetus as more 'ethically difficult'. 'I think that limiting what women could abort for would be impossible', said one 20-year old woman: 'It would be dodgy to ask the government to decide, but there is a moral duty to educate people. The danger becomes that choice can end up being unlimited. It would mean that people could act out their prejudices about what makes a good person, such as white children or straight children.'

The notion that abortion for abnormality is 'acting out a prejudice' on a par with discriminating against disabled people, is commonly held-especially among young people-and usually unchallenged. Yet there is no reason why having an abortion for fetal abnormality should demonstrate 'prejudice' against the disabled. There is a significant difference between a person and a fetus. As Raanan Gillon, professor of medical ethics at Imperial College, has said: 'There is no logical obligation to feel that, just because somebody decides not to have a baby because it has a disability when it is a fetus...that therefore it follows that this person will have hostile intent and hostile attitudes towards people who have got disabilities.'

To suggest that support for abortion for abnormality leads down a 'slippery slope' to treating disabled people badly is ludicrous, as would be the suggestion that support for the right to abortion in general leads to the ill-treatment of people in general. Today's technologies allow more detection of abnormality prenatally than ever before, and yet at the same time there is a greater desire in society to provide resources and support for disabled people.

Women who choose to end an abnormal pregnancy are motivated by a practical recognition of what life would be like bringing up a disabled child, not a general prejudice against the disabled.

There is no getting round the fact that when a woman aborts for abnormality she is making a judgement about the quality of her pregnancy and about the kind of child she wants to have. Unlike abortion where the woman simply does not want to be pregnant and have a child, where the abortion is for abnormality the woman normally wants a baby but has decided that she does not want that particular pregnancy to be carried to term.

To many young people today it seems to be unacceptable that a woman should make that judgement. To me it is completely understandable. Having a child with Down's syndrome or cystic fibrosis, or a child that is blind, is a very different prospect to having a child who does not suffer from these problems. That is why the vast majority of women who find out there is abnormality in the fetus choose to abort the pregnancy (around 90 per cent of women opt for abortion where Down's syndrome is detected). They are making the choice to avoid bearing a child with a medical condition that will mean that child cannot be the child they want to have: I support their right to do so.

It worries me that young people can be so cavalier about the importance of a woman's right to judge for herself whether or not she wants to have a disabled child. I am disturbed by the patronising notion that women who end pregnancy for abnormality need to be 'educated' or 'made more aware' about disability. For me, it represents a real problem if the next generation are not prepared to rely on the judgement of the pregnant woman herself about what should be the outcome of her pregnancy, and instead think she needs input about this decision from those who are 'more aware'.

It also worries me that we live in a climate where there seems to be a desire to encourage the notion that it is good if young people have 'ethical concerns' about abortion. In the excited media response to the Pro-Choice Forum report, there has been a real desire to emphasise and even applaud the fact that young people are morally ambiguous about abortion for abnormality. Some journalists seemed relieved to discover that young people are still anxious about abortion and are not prepared simply to support a woman's right to choose without qualification. In contrast, I would like to see such 'ethical' concerns among the young challenged through a forthright defence of a woman's right and ability to make choices for herself.

Some of my colleagues have suggested that young people are so upset about abortion for abnormality precisely because they are young. They have yet to experience the reality of having to decide whether or not to have a child, and having to think what it will mean for them if they opt to have a child with a disability. I hope my colleagues are right, and that age and experience will temper young people's views. But I am not holding my breath waiting for it to happen. The current vogue for 'disability awareness' seems to be leading to a view that stigmatises the desire to bear a healthy child, a desire that I think pregnant women deserve the right to have.

'Attitudes to abortion for fetal abnormality', by Ellie Lee and Jenny Davey, is published by the Pro-Choice Forum. To order copies call 01227 781920 or email ellie@easynet.co.uk

Ellie Lee is also editor of Abortion Law and Politics Today, published by Macmillan

What young people say about abortion for abnormality

'I think that women should only have an abortion if there is a serious risk to them or the child, not just if it's something like Down's syndrome.'

'That's what worries me about abortion for fetal abnormality. You don't know how far it will go. Should you be allowed to have an abortion if it hasn't got a hand, say?'

'Right now I have no problem with having an abortion for any disability that we can detect before birth. However, I am concerned that as technology develops and we can detect smaller abnormalities such as congenital blindness that things may go too far.'

'Many kids with Down's syndrome are great and they can have a perfectly good life. It's not like the child is in pain all the time. If the child was in pain I think the woman should have an abortion though.'

'I think it's a problem if people say I don't want to have a Down's syndrome child, purely on the basis of its disability. It would be like saying I want to have a blonde child or I want my child to be six feet tall.'

'I don't know why people think we should have the right to choose, it's the consumer idea that you can get exactly what you want. Why should people be allowed to do that?'

'I think it's really scary that people want to change what children will look like when they are born. It'd be horrible if everyone was the same.'

'The population should be as diverse as possible because you can learn a lot from disabled people. They are probably more loving and understanding than people who are caught up in a rat race. They don't take things for granted.'

Reproduced from LM issue 114, October 1998

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