One of the very valid criticisms of abortion which rarely gets raised in the public discourse is the intersection between abortion and concerns about disability rights. It’s a conversation that’s happening, but it’s not attracting nearly as much attention as other aspects of the abortion debate, even criticisms of abortion for purposes of gender selection. I think that people within the pro-reproductive rights movement don’t really want to discuss it because it’s an uncomfortable and unpleasant topic, but I can’t understand why people in the anti-reproductive rights movement aren’t bringing it up as a very real and important criticism of abortion practices. (Although a Google search for “abortion and disability” reveals some thought provoking results.)
I am just starting to explore this issue, and I don’t think I’ve really fully started to articulate my ideas yet, so consider this post an exploration and a starting point, rather than a decisive critical essay. I would really be curious to hear the thoughts of my readers (especially people with disabilities), because I’m not really certain what I think yet.
I am pretty sure that I oppose abortion for disability, just as I oppose abortion for gender selection. I have really struggled with this, especially after reading Bitch, PhD’s discussion about how support for abortion rights should mean support across the board. It initially really resonated with me, but lately I’ve come into a position of respectful disagreement. I do think that certain types of abortions raise some very uncomfortable ethical questions, and I think that there are actually certain cases in which abortion may be morally unacceptable, despite the fact that I do not accord a fetus the same respect that I do a human life. By not addressing or respecting those questions, we are doing the issue a grave disservice.
Abortion for disability is not the same thing as abortion of a fetus with abnormalities which are incompatible with life. Abortion for disability is a conscious decision to end a pregnancy because the baby doesn’t meet the standard of “normal” or “healthy.” Now, I have a read a lot of defenses of abortion for disability which focus on the extremely high expense of raising disabled children, the emotional and physical strain it can entail, and the fact that children with disabilities are largely considered unadoptable, so adoption is not a viable alternative.
But, the thing is, abortion for disability questions the value not of a life, but of a particular type of life. If, for example, an autism gene was recognized and parents could opt for genetic testing to identify it and the decision was made to abort a child with autism, those parents are placing a value judgment on people with autism. Likewise, abortion of a child with, say, Trisomy 21 suggests that life with Trisomy 21 is not worth living, although parents may argue that they are choosing abortion because they do not feel equipped to take care of a child with this condition.
Disability is often framed as “tragedy” and as some sort of “lesser life” and I find both ideas repugnant. Both ideas infantalize people with disabilities, and suggest that there is some sort of “normal” which we should all be aspiring to, that people with disabilities can only hope to get close to the normal, and that they therefore must be living half lives. It’s one thing to abort a child because you feel that you cannot give that child the life ou deserves; it’s another entirely to abort a child because you think that ou can never achieve “normal.”
I think it’s kind of impossible to address this issue without talking about the impact that the American health care system and lack of support for people with disabilities has on decisionmaking for prospective parents. I can see why people feel that they are not ready to raise a child with disabilities if they lack the privilege to access high quality health care and support networks. If you’re a person of color or you’re in the lower classes, you may genuinely not be able to raise a child with disabilities, which raises the spectre of institutionalization and the care of the State, which is not a pleasant picture, given the current way in which people with disabilities are handled by the State. In that case, parents are opting to abort because they feel like they can’t provide the child with the quality of life ou deserves, but this is because the child has disabilities, not necessarily because the parents couldn’t afford to raise a child in the abstract, although the expense of childrearing obviously plays a role in some abortion decisions. Until we have a medical system which provides complete care for everyone, including total support for people with disabilities, it’s going to be challenging to confront the core of the question about whether or not it is acceptable to abort for disability because people can hide behind concerns about expense and quality of care.
For parents who do have the financial ability to care for a disabled child, opting to abort a child with disabilities seems very morally questionable, to me, because it goes beyond the question of quality of life concerns caused by financial/access to care worries and into the realm of a value judgment about the life of a disabled person. And a judgment about the different levels of disability and where people draw the line when it comes to abortion. Trisomy 21? Trisomy 13? Autism? Bipolar disorder? A missing/malformed limb? A carrier gene for a genetic condition?
Many feminists oppose abortion for gender because gender selection involves some explicit, clear-cut value judgments which cannot be masked behind concerns about costs for care and the ability to provide a child with the quality of life he or she deserves (note that I do not assume that disability automatically confers a decreased quality of life). Abortion for disability is a slightly more complex topic, and it’s a tough one to explore in part because it’s so entangled in thorny issues, and in part because there’s so little discussion of disability issues in general in this society.