In the United States, many citizens agree that the government may impose limits on the freedom of individuals when individuals interfere with the rights of others, but the extent of these limits is often a topic of debate. Among the most debated of bioethical issues is the issue of abortion, which hinges on whether the fetus is a person with rights, notably the right to life.
The U.S. Supreme Court recognized a limited Constitutional right for a woman to choose an abortion in Roe v. Wade in 1973, only to eliminate that right nearly 50 years later in Dobbs v. Jackson’s Women’s Health Organization in 2022. The Dobbs decision places abortion rule-making in the hands of the U.S. Congress, which seems unlikely to reach a consensus any time soon, and the state legislatures, which are widely split on abortion issues. For example, in the first half of 2022, 11 states passed laws to protect or expand abortion care and 12 states enacted restrictions. In the first citizen vote after Dobbs, Kansans voted to retain a right to abortion.
As legislatures around the country continue to debate the scope of permissible abortions, it is clear that much attention will be paid to the issue of prenatal medical testing. At least two-thirds of diagnoses of Down syndrome lead to a decision to abort where that is permitted. Many states permit abortions where prenatal testing has revealed genetic testing abnormalities in fetuses, but several states have specifically prohibited abortions performed for the purpose of avoiding giving birth to a baby with Down syndrome.
In early 2023, more than 40 pro-life organizations wrote every Republican member of Congress to urge enactment of pro-life laws that would, among other things, prohibit abortions based solely on a diagnosis of Down Syndrome (the “Protecting Individuals with Down Syndrome Act”).
Those who oppose prenatal testing bans on abortion argue that laws based on intention or motivation to terminate a pregnancy would be unenforceable. “This is interference with a medical decision following a complicated diagnosis,” according to Kellie Copeland, executive director of NARAL Pro-Choice Ohio, “Not knowing the family and the circumstances, the legislature can’t possibly take into account all the factors involved.”
Supporters of the “Protecting Individuals with Down Syndrome Act” have described this as a way to limit the number of abortions and protect babies born with disabilities. Mike Gonidakis, president of Ohio Right to Life, stated, “We all want to be born perfect, but none of us are, and everyone has a right to live, perfect or not.”
In November 2022, the Court of Appeal in Britain ruled that the country’s Abortion Act that allows abortion up until birth for a fetus with Down Syndrome was legal and did not interfere with the rights of the living disabled. The plaintiff in the case, Heidi Crowter, who has the condition, complained that the decision “doesn’t respect my life.”
Bioethics examines the moral dimensions surrounding the use of medical technology, raising questions such as: Should all scientific advances in medicine be made available to all? Do some advances conflict with society’s values and morals? What role should the government play in the moral decision-making of individuals insofar and with respect to limiting or expanding choices available? These are broader questions to keep in mind while reading and discussing this case study.