“Deciding not to screen for Down Syndrome”

Everyone who knows me are aware that I am an emphatic liberal Democrat. On issue after issue-food stamps, abortion rights, universal health coverage, the taxation of wealthy University of Chicago professors-I am found on the predictably liberal side of the ledger. Notwithstanding my frank partisanship (maybe even because of it) it’s a joy to be involved in one issue that resists the usual ill-will, posturing, sniping, and sheer self-righteousness that disfigure most partisan debates.

Across every political, economic, religious, and social boundary, people of grace and goodwill work hard to care for individuals with intellectual disabilities. Liberal union activists fight for higher wages for direct care workers. Socially conservative football coaches host golf tournaments, the Knights of Columbus sells Tootsie Rolls, for organizations that assist individuals and families who need help.

Also across the political spectrum, individuals and families struggle with difficult ethical issues that admit no perfect or painless resolution. As prenatal screening and diagnostic technologies become more accurate, cheaper, and safer, millions of pregnant women possess wider options to screen for Down syndrome and other disabilities. As millions of women delay childbearing and thus bear increased statistical risk of key chromosomal abnormalities, such technologies assume added importance.

As never before, our nation has opened its heart, its schools, its summer camps, and its wallet to embrace individuals with physical and intellectual disabilities. As never before, expectant parents can use screening technologies that allow them to avoid having children who show genetic markers associated with key disabilities. These technologies seem to have outrun our medical system’s-and our society’s—capacity to intelligently deploy or to humanely manage them.

Such screening raise unavoidable, discomfiting issues. Americans of different political, religious, and moral viewpoints will want to use these technologies in vastly different ways. We will deeply disagree about how our government’s regulatory and financial resources should be used to accelerate or slow the proliferation of these same technologies.

There will be fights about women’s reproductive autonomy, the moral claims of fetal life, the moral worth of disabled citizens, and more. These issues are so important, so intimate to our humanity, that political conflict is unavoidable. Too much is at stake.

Although political differences are unavoidable, people on opposing sides can press their case while recognizing the seriousness, the legitimate concerns, and the common humanity of their counterparts on the other side.

To see how this is done, read Amy Julia Becker’s New York Times story, “Deciding not to screen for Down Syndrome.” More to the point, read the 137 readers’ entries within the comment thread.

I’ll have more to say about this article, and about the ethical, economic, and health-system implications of prenatal screening technologies. I depart from Becker, and from most of her diverse commentators, in several areas. For now, though, I’ll leave things there. Read it for yourself. I’ll simply note that the diverse perspectives, the mutual respect, and the candor expressed by interested readers surpasses most House and Senate floor debates.