It is tempting to think that even if light drinking or drug use posesonly a small teratogenic risk, women are morally obligated to refrainfrom it. For instance, Elizabeth Harman (1999) claims thatany smoking during a pregnancy one plans to carry to term is“morally impermissible”, and Gilmore (2008) argues thatwomen who are or might become pregnant ought to abstain from drinkingany alcohol. But we cannot, of course, ask pregnant women to abstaincompletely from all voluntary activities carrying some fetal risk, forthey would be paralyzed into inactivity (which would itself come withsome risk). Indeed, we are not nearly so draconian in our attitudestowards other, more clearly risky behaviors during pregnancy, such asdriving a car. Elizabeth Armstrong (2003) and Janet Golden (2006) haveargued that widespread social anxiety over Fetal Alcohol Syndromeconstitutes a ‘moral panic’ over mothers engaging in whatwe imagine as self-indulgent or decadent behavior, rather than anevidence-based response to risk. Focusing on the consumption ofalcohol or drugs as a particularly pernicious form of risk-takingseems to have more to do with images and ideologies of maternalself-sacrifice, purity, and decadence than with rational concern forfetal well-being. The failure of extreme risk-aversion strategies toreliably decrease harmful behaviours and contribute to positive healthoutcomes for pregnant women and their fetuses should leadpractitioners and researchers toward alternative approaches tounderstanding, communicating about, and managing risks for pregnantwomen (Ballantyne et al. 2016). Alternative approaches call forclearer understanding of fetal risk among both clinicians and policymakers, and explicit consideration of the social and political valuesthat shape current forms of risk management in pregnant women.(Minkoff and Marshall 2016).
Several ethical concerns piggy back on those associated with prenataltesting generally; for instance, earlier and less risky testing mayfacilitate selective abortions, encourage the commodification ofchildren, or, conversely, amplify the coercive technological force ofprenatal testing as a medical intervention required for responsibleparenting (de Jong and de Wert 2014). Each of these concerns picks upon the likelihood of greater routinization of prenatal testing giventhe tests' non-invasiveness, low medical risk to the pregnant womanand fetus, and high accuracy. Some commentators worry that thesefeatures of NIPT, particularly its lower medical risk, may serve tojustify loosening, limiting, or even discarding informed consentrequirements (e.g., Deans and Newsom 2011). Other problems withincreased routinization may also include affirmation ofanti-disability bias and devaluation of disabled lives, particularlyregarding Down Syndrome (Kaposy 2013). NIPT carries most of the sameethical issues as traditional testing and screening methods, and mayexacerbate some.
main contender as one of the states’ with a high teenage pregnancy ..
Adrienne Asch (2000) responds that one cannot relevantly compare theproperty of being a fourth child to the property of having a specificdisabling trait, because the latter is an inherent rather than arelational property of the child. Hence to abort on the basis of thedisabling trait is to reject that kind of person in a different andstronger way. But Asch's response seems to push against one of themain points of the social model of disability, which she otherwisedefends: the view that disabilities are also relational rather thaninherent properties. More generally, the force of the expressivistobjection may rely on a view of disabling traits as identityconstituting, thereby endorsing an essentialist understanding ofdisability (Edwards 2004). For many, it seems possible to decideagainst bearing a child who has a property that in contextwill make that child more difficult to raise (whether it is deafness,a chromosomal disorder, or fourth-childness), without devaluing allpeople with that property in any decontextualized way. Notice thatthis response does not combat the idea that routinization isexpressively devaluing of some lives, even if it convinces us thatindividual uses of the technology are not.
Contraception | Reproductive Health | CDC
Indeed, even going out of one's way to create a disabled child(through genetic engineering, selective abortion, or preimplantationgenetic diagnosis) cannot count as harming the child, since thatparticular child has no options for existing other than as disabled.(This issue has most often come up with respect to deaf parents, whosometimes prefer to have a deaf child, e.g. in Wasserman and Asch2012). And yet, many writers have the strong intuition thatintentionally creating a disabled child is a wrong done to thechild—for instance, Dena Davis (2001) argues that sincedisabilities generally close down possible ways of living,intentionally creating a disabled child violates the child's right toan open future. The non-identity problem forces us to search for anexplanation of what sort of wronging or rights violation this couldbe, given that this child could have no non-disabled futureopen to her to start with.