Article: ‘Will babies with Down syndrome slowly disappear?’
September 14th, 2009Writing in the Archives of Disease in Childhood (subscription required for full text), Dr. Brian Skotko reports that the number of babies born with Down syndrome has been steadily decreasing around the world as prenatal testing and selective termination have become more widespread.
Skotko reports that a trend toward later childbearing in the United States would have been expected to cause a 34 percent increase in the number of babies born with Down syndrome between 1989 and 2005 in the absence of prenatal testing. Instead, there were 15 percent fewer such babies born, a decrease of 49 percent between expected and observed rates.
With new and more sophisticated prenatal tests expected soon, Skotko called on the medical community to address the ethical questions raised by medical technologies that allow nations to decide what forms of human genetic variation are valued. He urged the medical community to:
– Develop guidelines for delivering a diagnosis of Down syndrome;
– Assemble current and accurate information on Down syndrome, in collaboration with parent support organizations, to be distributed to prospective parents;
– Offer comprehensive training to professionals on how to deliver a non-directive prenatal diagnosis; and
– Develop curriculum to give medical, nursing and genetic counseling students a richer understanding of Down syndrome.
An excerpt:
… In its support for Down syndrome prenatal screening, has the American College of Obstetrics and Gynecology endorsed a climate in which disability discrimination could more easily flourish?
… The age is swiftly coming where not all possible technologic advances may bring welcomed change. Parents who have children with Down syndrome have already found much richness in life with an extra chromosome. Now is the time for the rest of us to discuss the ethics of our genetic futures.
Dr. Brian Skotko is a clinical genetics fellow at Children’s Hospital Boston. ADC is the journal of the Royal College of Paediatrics and Child Health. Press release from Children’s Hospital Boston here.
Full article available for purchase here.


November 20th, 2009 at 3:08 pm
With more women have some method of birth control, wouldn’t that too might contribute to the decreased number of babies being born with Down Syndrome birthrate?
September 15th, 2009 at 12:49 pm
Kudos to Brian Skotko. This is a profound moral issue that our society has been ignoring or subsuming within favoring or opposing abortion.
September 14th, 2009 at 12:19 pm
Dr. Brian Skotko is a someone on whom I have come to depend to voice my ethical and other concerns regarding Down syndrome to the medical community. His personal knowledge of Down syndrome as well as his medical knowledge allows him to challenge medical ethics and make his colleagues think where others can’t. Just as important, his position allows him to change the conversation his medical colleagues have regarding Down syndrome from one of always despair to something more positive or at least one that has two sides. Please keep it up, Dr. Skotko!