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Published in: Journal of Bioethical Inquiry 3/2019

01-09-2019 | Intellectual Disability | Original Research

Epistemic Virtue, Prospective Parents and Disability Abortion

Author: James B. Gould

Published in: Journal of Bioethical Inquiry | Issue 3/2019

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Abstract

Research shows that a high majority of parents receiving prenatal diagnosis of intellectual disability terminate pregnancy. They have reasons for rejecting a child with intellectual disabilities—these reasons are, most commonly, beliefs about quality of life for it or them. Without a negative evaluation of intellectual disability, their choice makes no sense. Disability-based abortion has been critiqued through virtue ethics for being inconsistent with admirable moral character. Parental selectivity conflicts with the virtue of acceptingness (the commitment to welcome whatever child comes naturally) and exhibits the vice of wilfulness (the project of picking and choosing what children one will take). In this paper I claim that, beyond failures of moral virtue, disability abortion often involves failures of epistemic virtue on the part of parents. I argue two things: parents believe something false, or at least contested, about life with intellectual disability—and they do so because they are not epistemically conscientious. I first explain why a central motivation for disability abortion—that it prevents harm to the child—is mistaken. I next give a brief account of intellectual virtue and culpable ignorance. I then indicate why many parents fail to be intellectually virtuous when choosing to terminate pregnancy. I focus on elimination of intellectual disability and have little to say about physical and sensory impairments.
Footnotes
1
Kittay (2010, 403) contends that “most severely retarded people . . . can be and are involved in activities and relationships.” Her PID daughter Sesha has a definite personality—she is responsive to her environment, has formed deep relationships and enjoys classical music.
 
2
Things are more complicated than this statement suggests, since conditions causing ID vary in severity. While most people with Down syndrome, for example, have mild or moderate symptoms, some cases are severe—and it is impossible to predict the degree of impairment. Down syndrome also brings higher risk of depression, dementia, and Alzheimer’s disease as well as heart defects and vision and hearing problems—all of which affect well-being. I do not mean to suggest that Down syndrome and other conditions always involve mild or moderate ID. It might be simple awareness of the possibility that their child could have severe ID that explains Jack and Jill’s decision.
 
3
Numerous studies show that the link between objective impairment and subjective well-being is tenuous, and that people without disabilities are very poor at accurately judging the quality of life of people with disabilities—perhaps because we project onto them the transition costs we would experience if we were to become disabled. On quality of life, disadvantage, and disability in general, see Albrecht and Devlieger 1999 and Amundson 2005. On quality of life, disadvantage, and ID in particular, see the essays in Bickenbach et al. 2014, Brownlee and Cureton 2009, Parens and Asch 2000, Wasserman et al. 2005, and Wasserman et al. 2016.
 
4
Skotko (2009) reports that 92 percent of Down syndrome pregnancies are terminated; this same rate is reported in Choi et al. 2012. The most up-to-date systematic review (Natoli et al. 2012) shows rates in the United States of 60 to 90 percent.
 
5
In Korenromp’s study, survey responses were categorized as “related to the infant” or “related to the respondent or family”—participants ranked motivations related to the infant higher than their own. Dungan (2015, 51) cites multiple authors who find the most common reasons why parents abort affected pregnancies include 1. severity of phenotype, 2. prospects for cognitive impairment, 3. need for surgical correction of structural abnormalities, 4. life expectancy, and 5. family issues (impact on parents and siblings). The top four are motivations related to the child. Studies of actual decision-making after prenatal diagnosis of MID (Korenromp et al 2006; Hawkins et al. 2013) and of hypothetical decision-making if given a positive result (Bryant et al. 2010) indicate that concern for the future child’s welfare is a strong motivation for MDE. Also see Bijma 2008.
 
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Metadata
Title
Epistemic Virtue, Prospective Parents and Disability Abortion
Author
James B. Gould
Publication date
01-09-2019
Publisher
Springer Singapore
Published in
Journal of Bioethical Inquiry / Issue 3/2019
Print ISSN: 1176-7529
Electronic ISSN: 1872-4353
DOI
https://doi.org/10.1007/s11673-019-09933-1

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