Selective abortion of Down Syndrome & Alasdair MacIntyre
Summary
Non-invasive prenatal testing (NIPT) is increasingly used to screen for Down Syndrome. As a
result, NIPT could prevent almost every child with Down Children to be born when people are open
to selective abortion after testing. The main research question is whether this combination of NIPT
and abortion is morally problematic. Both can of course be valued by themselves, NIPT for
informative purposes and abortion as a right of bodily integrity. But nonetheless, there’s a separate
concern about whether both procedures should be combined to decrease the number of Down
children. Some find this wanted because Down children experience more suffering, whereas others
point out that society should focus on reducing their suffering instead of avoiding their birth.
Observing that society remains divided over this dispute, one could argue from a liberal
perspective that only future parents as individuals should decide whether abortion and NIPT should
be combined. Yet this thesis uses the virtue ethics of Alasdair MacIntyre to contest this liberal
division between public institutions and personal decision making. This implies that the research
question must be answered by pointing out what the virtues of good parents and medical practice
are. First, by adding the work of different virtue ethicists it will be argued that the combination of
NIPT and abortion is wrongful because future parents have a prima facie duty to accept their child
the way it is. Secondly, virtue ethics learns that the end of medical practice is benevolence. So when
NIPT and abortion are only used to pursue ideals of family planning, medical practice is outstepping
its legitimate boundaries.
Nonetheless, whether these virtues can be applicable in case of prenatal care will eventually
depend on whether some moral status is assigned to the fetus. MacIntyre recognizes that there’ll
remain disputes on that matter, but also points out that dialogue is this still more reasonable than
moral relativism or institutional neutrality. In case of Down Syndrome, prenatal counselling should be
for example try to avoid that future parents have a stigmatized view on the disorder of the fetus.