Doctor says Canadian bio-parents demanded termination; Surrogate mom refused, then relented

‘Should the rules of commerce apply to the creation of children?’

From the Vancouver Sun, [UK] Daily Mail:

A Canadian surrogate mother reluctantly terminated her pregnancy at the insistence of the fetus’ biological parents after it was learned that the fetus had an elevated risk of Down syndrome, a Vancouver-area doctor revealed at a recent fertility medicine conference.

The case, in which the surrogate mother initially resisted the abortion and later relented, has sparked a spirited ethical debate over legal oversight of surrogacy arrangements.

Dr. Ken Seethram of the Pacific Centre for Reproductive Medicine in suburban Vancouver said the surrogate had signed a contract with the biological parents that would have absolved the couple of all financial responsibility for raising the child. He did not disclose the identities of the parties, but said the case had occurred within the past year and involved an embryo that had been created with the parents’ egg and sperm.

A bioethicist who has studied the issue extensively argues that contract law should not apply to the transaction, unless human life is to be treated like widgets in a factory.

“Should the rules of commerce apply to the creation of children? No, because children get hurt,” said Juliet Guichon of the University of Calgary. “It’s kind of like stopping the production line: ‘Oh, oh, there’s a flaw.’ It makes sense in a production scenario, but in reproduction it’s a lot more problematic.”

Related editorial in the Calgary [Alberta] Herald: ‘Vital debate needed on surrogacy and other IVF issues’

An excerpt:

It could be argued that the terms of the contract need to be spelled out clearly be-fore the surrogacy gets underway, but then that lends the resulting infant the status of a manufactured good — and nobody should be comfortable placing a human being on such a level.

… What needs to be kept uppermost in mind while sorting through the moral and ethical ramifications of the complex scenarios in vitro fertilization has engendered, is that a human being — not a commodity or product — is the subject matter.

From the Melbourne, Australia, Herald Sun:

Health Department officials in the Australian state of Victoria report that the number of women who terminated their pregnancies after receiving a prenatal diagnosis of Down syndrome almost tripled in the decade ending in 2006.

Government figures showed 146 abortions for Down syndrome in 2006, including five late term abortions, compared with 54 in 1995.

They also show more than twice as many babies with Down syndrome were aborted than were born with the condition — in 2006 146 were terminated and 62 were born.

A spokeswoman for the Royal Australian and New Zealand College of Obstetricians and Gynecologists attributed the increase to more advanced screening.

Related story:

Two couples suing doctors for failing to diagnose Down syndrome — Melbourne, Australia, Herald-Sun

Two Victorian couples are suing doctors for failing to diagnose Down Syndrome in their unborn babies, denying them the chance to terminate the pregnancies.

The couples are claiming unspecified damages for economic loss, continuing costs of care of the children, and “psychiatric injury”.

Both say they would have aborted their pregnancies had they been told their children would be born with Down Syndrome.

From the Miami Herald:

A Florida doctor has had his license revoked after botching an abortion in a twin pregnancy. Asked to abort a fetus with Down syndrome, Dr. Matthew J. Kachinas mistakenly terminated the twin fetus that did not have the genetic anomaly.

Immediately after the hearing by the Florida Board of Medicine, the physician said he intended to kill himself and was involuntarily hospitalized.

The couple involved, who were not named, had become pregnant through in vitro fertilization using an egg donor. They aborted the remaining fetus the week after Kachinas terminated the first one at 15 weeks’ gestation.

From the New York Times:

A parliamentary hold has been placed on the nomination of autism self-advocate Ari Ne’eman to the National Council on Disability amid a growing controversy about his views. President Obama’s seven other nominees to the council were confirmed by the Senate this month.

Ne’eman, 22, has a diagnosis of Asperger syndrome and is the founder of the Autistic Self-Advocacy Network. He has said that autism is a naturally occurring form of “neurodiversity” that should be embraced and accommodated, not cured. Critics, including the co-founder of the advocacy group Autism Speaks, say Ne’eman’s view fails to represent individuals on the autism spectrum who lack basic communication and self-care skills.

Historically, the kind of genetic research supported by many parents of children with autism, Mr. Ne’eman has said, has been used to create prenatal tests that give parents the ability to detect a fetus affected by a particular condition, like Down syndrome, so that they can choose whether to terminate the pregnancy.

“We just think it makes more sense to orient research to addressing health problems or helping people communicate rather than creating a mouse model of autism or finding a new gene,” Mr. Ne’eman has said.

Earlier posts here.

(Photo from “No Myths” PSA)

From the Washington Post, [Norfolk] Virginian-Pilot:

As detractors organized an online petition calling for his resignation, Republican Virginia state delegate Bob Marshall apologized for public remarks suggesting that women who have abortions risk having children with disabilities as a punishment from God.

“The number of children who are born subsequent to a first abortion who have handicaps has increased dramatically,” Marshall said last week at a news conference calling for an end to state funding for Planned Parenthood. “Why? Because when you abort the firstborn of any, nature takes its vengeance on the subsequent children.”

“In the Old Testament, the firstborn of every being, animal and man, was dedicated to the Lord,” he added. “There’s a special punishment Christians would suggest …”

In a statement on his website, Marshall said he regretted his “poorly chosen words.”

He said his broader point was that published medical research suggests abortion raises the risk of miscarriage and birth defects in subsequent pregnancies, and that those findings echo the Bible’s teaching that abortion is wrong.

“I’m saying look at the medical journals,” said Marshall, who produced two studies to buttress his contention. “That’s not saying ‘Bob Marshall thinks a Down syndrome baby is a punishment.’ “

UPDATE: Press release from The Arc: Arc of VA families outraged by elected official’s remark

From NBC Washington and Gainesville [Va.] Times,  with audio from Virginia Commonwealth University (VCU):

Virginia state delegate Bob Marshall told a gathering in Richmond last week that children with disabilities are a punishment from God to women who have aborted their first pregnancy. The remarks prompted a wave of criticism, and Marshall later said they had been taken out of context.

“The number of children who are born subsequent to a first abortion with handicaps has increased dramatically. Why? Because when you abort the first born of any, nature takes its vengeance on the subsequent children,” said Marshall, a Republican.

“In the Old Testament, the first born of every being, animal and man, was dedicated to the Lord. There’s a special punishment Christians would suggest.”

Marshall was addressing a press conference at the state capitol called by opponents of Planned Parenthood. They urged Virginia lawmakers to stop allocating funds to the organization because it provides abortions.

Arthur Caplan, writing at MSNBC.com, reacts to a report by the Associated Press that genetic testing is leading to the birth of fewer and fewer children with Down syndrome and other genetic diseases in the United States. An excerpt:

On a trip to Ireland a few years ago, I was struck by a number of faces among the crowds. They were children with the tell-tale look of Down syndrome.

What struck me was the realization that I hardly ever see these young faces out on the street in the United States.

… Reducing the burden of disease is obviously a good thing. But genetic testing of parents, and, as is now happening with increasing frequency, embryos, raises some difficult ethical challenges as well.

… As some families with a Down syndrome child have noted, fewer kids with Down may mean fewer public programs, fewer resources in schools and for housing and less political clout. If some genetic diseases begin to fade away, will society’s willingness to provide support for the diminishing numbers of those born with such diseases fade as well? And are we headed to a time when parents who choose not to be genetically tested find themselves condemned as morally irresponsible parents?

Caplan is director of the Center for Bioethics at the University of Pennsylvania.