Life is Complicated – Part 2

Rodin’s “The Thinker”

 

What qualities are you looking for when you go to a physician for advice?

Last time, I raised the issue of fetal sexing as a possible way to reduce the risk of having a child with ASD. I described a family who asked me to write a letter to the mother’s OB-GYN in support of their plan, and closed with the question “What would you have done, if you had been in my shoes?”

I received several thoughtful replies. It was clear that the writers put a good deal of heart and soul into their responses, which drew deeply on their own experiences – both as parents of children on the spectrum, and as persons who place high value on acting ethically. One particularly articulate mom wrote the following:

“I’m pro-choice, but when we were pregnant with our third child, we declined gender testing and all genetic testing, even though I was then 37 and of advanced maternal age. … I think that when you choose to become a parent, you choose the path no matter what. I have much compassion for women who find themselves pregnant and unable or unwilling to become mothers yet because of a million life circumstances that are theirs and theirs alone. Aborting due to disability has always felt trickier to me. Of all people, I know the strain of living with a nonverbal teenager who is bigger and stronger than me and whose behaviors are only mostly controlled.” Read the rest of this entry »

Life is complicated.

Dr. Coplan reflects on ethics, politics, and government

The State of Indiana has just passed a law banning abortions based upon the race, gender, or possible disability status of the fetus.  If you believe that all abortion is murder, you will have no problem with this bill (except, perhaps, that it does not go far enough). Otherwise, you will probably find this bill offensive, for various reasons.

You might regard fetal gender as reason that could not ethically be raised for termination of pregnancy, but life is not so simple. Many years ago, the parents of a child with severe autism approached me with a request: They wanted more children, but were afraid of having another child with autism. Since boys with autism outnumber girls by a factor of 4 to 1, they wanted to have only girls. This “girls only” strategy would seem to reduce their risk by 75%. (We know now that this logic is not exactly correct. In fact, the recurrence risk depends on the gender of the child already born with ASD, as well as the gender of fetus, in a much more complicate fashion than the simple male:female ratio of children with ASD in the overall population. You can read more here. But 20 years ago we didn’t have that information.) The parents’ request: Would I write a letter to their Ob-Gyn, laying out the rationale for fetal sexing and selective termination of male pregnancies? Read the rest of this entry »