Santorum and Prenatal Testing: Read Tucker Carlson’s Classic Essay on the Abortion of Down Syndrome Babies

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Feb. 21 2012 2:45 PM

Eugenics, American Style

Santorum says prenatal testing leads to abortions. Read Tucker Carlson’s classic essay on prenatal testing and the abortion of Down syndrome babies.

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Having a Down Syndrome child is close to being raped? To dying?

Why such eagerness to prevent Down Syndrome children from being born? Undoubtedly, some physicians are motivated by a belief that children with birth defects pollute the gene pool. "There is nothing wrong with eugenics," said Dr. F. Clarke Fraser, founder of the genetics clinic at Montreal Children's Hospital, not long ago in an unusually blunt interview with the Montreal Gazette.

Many others, however, simply view abortion and Down Syndrome as parts of an economic equation. Amniocentesis "may cost about $1,000, but a reasonably conservative estimate is that it costs $ 100,000 for just the first year of a Down Syndrome baby's life," explained Dr. Mark Evans, director of Detroit's Center for Fetal Diagnosis and Therapy. "How many people would I have to test to balance the lifetime cost?" he asked a New York Times reporter in what must rank among the creepiest rhetorical questions ever posed. 'And then there are economic considerations nobody knows how to factor in, like the number of women who would have to quit their careers to care for these babies. "


Actually, Dr. Evans was wrong on at least one count: A number of people have "factored in" the various costs of Down Syndrome. A 1995 study led by Norman Waitzman of the University of Utah sought to calculate the toll birth defects take on the American economy. The results, published in a CDC report, found that each child born with Down Syndrome will, over a lifetime, cost society about $451,000. The total cost for all children born with the disorder in a given year, the study determined, is $ 1.8 billion. "Particularly in these times of fiscal squeeze," he concluded, "these costs provide a vivid picture of the value of research and prevention" (italics added).

Needless to say, Waltzman failed to point out that, in the case of Down Syndrome, there's no way to "prevent" the disorder, only the birth of those afflicted with it. Obscured by euphemisms or not, calculations such as Waltzman's have not escaped the attention of insurance companies, many of which have proved indecorously eager to cover testing for potentially expensive genetic defects, most recently for cystic fibrosis.

Nachum Sicherman of the Columbia Business School, another researcher who has examined the "enormous cost-saving potential of amniocentesis," is the sort of expert insurance companies doubtless will consult as they begin to sort out the growing number of prenatal genetic tests in order to determine which ones they should pay for. Sicherman figures the cost to society over the lifetime of a person with Down Syndrome is at least $ 1 million—most of which, he points out, "is not going to be paid by parents." Numbers like these—and Sicherman's are larger than most—have led Sicherman to recommend that amniocentesis be made available to all nearly pregnant women, regardless of age. "If you take all costs into account—costs to school districts, to Medicare, Medicaid, Social Security, lost days of work for parents," he explains enthusiastically, "there is nothing more beneficial than amniocentesis, if it is given under the assumption that if Down Syndrome is discovered, there is an abortion following. It's a great cost saving."

Sicherman does more than simply theorize on the subject. "When my wife was pregnant," he recalls, "we went to Lamaze class and I asked the women there if they'd ever heard of amniocentesis." Being a mostly young and lower-income group, he says, none had, and Sicherman did his best to remedy their ignorance. It was, after all, only the right thing to do. "Everybody should tell their patients about amniocentesis," he says.

Sicherman's views may be a bit blunt for the present state of public opinion in America. Not so in the Netherlands, however, where subjecting pregnancy to rigorous economic calculation is considered a civic responsibility. A 1991 report by the Royal Dutch Society of Medicine (entitled "Life Terminating Actions with Incompetent Patients, Part I: Severely Handicapped Newborns") studied a series of 2,816 amniocenteses given to pregnant women. The tests resulted in 75 abortions, 57 of which were of " defective fetuses."

"These 2,816 amniocenteses and the chromosome analyses cost approximately $ 1.5 million," the study said. "This is in the same order of magnitude as the costs for taking care of one patient with Down's Syndrome in a medical institution for a period of 60 years. Seen in the light of a cost-benefit analysis the conclusion is obvious."

From here, it is a short trip to killing handicapped children outright. Why, after all, stop the economizing simply because a child has left the womb? James D. Watson, who won the Nobel Prize for the discovery of DNA, believed that newborns who scored below a certain level on the APGAR test given immediately after birth should be euthanized.