November 30, 2008
Eugenics Cuts Down's Syndrome In Half In Denmark

Eugenic abortion cuts the incidence of Down's Syndrome in Denmark.

A new national screening strategy in Denmark has halved the number of infants born with Down's syndrome and increased the number of infants diagnosed before birth by 30%, according to a study published on bmj.com today.

Many countries, including England, Australia and New Zealand, are trying to introduce national screening strategies for Down's syndrome, but are facing a variety of problems because of a lack of consensus about the screening policy and logistical challenges.

Owing to opposition to abortion by a substantial part of the American population do not expect to see such extensive systematic screening for Down's in the United States. This reduction in Down's births is coming as a result of abortions. Abortion opponents do not want women to know in advance they might be carrying a baby with a birth defect.

Since Denmark is a small country the number of Down's births is pretty small anyway. False positives and false negatives are both dropping.

They report that the number of infants born with Down's syndrome decreased from 55 per year during 2000, to 31 in 2005 and 32 in 2006. The total number of invasive tests fell sharply from 7524 in 2000 to 3510 in 2006.

The detection rate in the screened population was 86% in 2005 and 93% in 2006. With 3.9% (17) of women receiving a false positive result in 2005 and 3.3% (7) in 2006.

Down's will eventually become much rarer in the United States as a result of a much larger development. I predict a big shift toward in vitro fertilization (IVF) as we learn more about what all the genetic variations mean. Once genetic testing of embryos can provide enormous details about the future of potential offspring many prospective parents will opt to fertilize multiple eggs in vitro and then select the one that comes closest to matching their desires for offspring genetic inheritance.

Since the embryos will get screened for desired genes as a side effect major genetic problems will be avoided. The ability to select for smarter, better looking, more coordinated, stronger, more charming, and healthier children will lead to the widespread embrace of eugenics.

Share |      Randall Parker, 2008 November 30 10:40 AM  Bioethics Reproduction


Comments
JAY said at November 30, 2008 12:24 PM:

If you saw anyone mistreat a Down's syndrome child you would be horrified. Yet.......

Randall Parker said at November 30, 2008 1:24 PM:

JAY,

Not everyone agrees on when life starts. Not everyone even thinks they know when life starts. So what to you might seem horrifying to many others it is not.

I think the attractiveness of pre-implantation genetic testing is going to cause a lot of people to decide that embryos do not deserve rights.

Nature (or God if you prefer) does not show much respect to embryos. A lot of people started out with twins that spontaneously aborted. In fact, most twins spontaneously abort and a substantial fraction of all pregnancies (most of them very early before the pregnancies are diagnosted) abort. Some say God can do what he wants. I don't know that God exists.

But the fact remains that naturally reproduction has such a large error rate that a large fraction of all pregnancies do not make it. Nature uses abortion to weed out a lot of flawed embryos. Why can't we?

Mthson said at November 30, 2008 2:36 PM:

One of the basic questions intellectually curious people ask about their various ideologies is whether they're on the right side of history or not. (In my case, I used to be concerned about immigration, until I did the math and concluded nothing that was going to be able to be done about it at this point in history.)

The curve of history on superstition about the biology of human nature is clear. Liberals' opposition to the human sciences won't make sense anymore once realities like human biodiversity become subject to progressive improvement. Many religionists will stay adaptive, and others will become more isolated from society, as the Amish have chosen to do.

Randall Parker said at November 30, 2008 3:02 PM:

Mthson,

Just what is right side of human history is about to change. DNA sequencing and DNA testing have gotten so cheap that the meaning of tens of thousands of human genetic variations will become known in the next 10 years. Political ideologies and religions that have wrong assumptions about human nature (e.g. believing in a small role for genes in IQ differences or believing that bad people are mostly a product of environment) will get their belief systems undermined by the evidence.

I expect many secular and religious believers will find new reasons to support their policy preferences. But they'll take heavy hits.

I predict a big future for eugenics in spite of attempts to paint it as Nazi. As soon as millions of prospective parents see an advantage for them in choosing among genetic variations for their offspring suddenly they'll become deaf to the Leftist cries of fascism.

Jerry Martinson said at November 30, 2008 6:47 PM:

So assuming that some day we have perfect genetic knowledge what is the line that should be drawn for aborting a fetus with condition 'X'?
- Down's
- low IQ?
- asperger?
- ugly
- male/female?
- sexual orientation (certainly deeply biological but possibly not entirely genetic)
- religious/political orientation

Some would say many of these aren't even diseases but rather socially constructed preferences. And then there's what's in fashion. A while back, musical talent would have been broadly prized. Now it is probably not as prized as it used to be since electronics has changed the market quite a bit. At some point within the next human generation "machine intelligence" stands a good shot at overtaking "human intelligence". Will a human's IQ even matter at that point?

Assuming the kinks are ultimately worked out of Gattaca-style PIGD: Is it ethical to try to get as many embryo's as possible and pick the best 'n' out of them or is it ethical to only abort serious diseases? How horrible is abortion? How horrible is embryo-cide? Even if you're an atheist like me, I think most atheists are a little unsure of how bad killing a pre-born life is. Should the criteria to abort/terminate be some sort of judgment as to whether some baby will grow up to have a negative net worth or should the criteria to be to get the best 'n' kids you can?

I guess I'm a wish-washy wussy and won't try to answer my own question.

Randall Parker said at November 30, 2008 7:37 PM:

Jerry,

People who can't reproduce naturally already try to get as many embryos as possible. Doing it in order to select genetic characteristics is just an additional reason to do something that already is legal and widely practiced.

Abortion for characteristics: Women are already aborting simply because they do not want to have a kid at all. If we allow abortion for convenience what is the the justification for disallowing abortion for genetic selection? It can't be an objection to abortion per se. It has to be an objection to genetic selection.

Suppose we disallow genetic selection in just America. What happens? First off, just forget about economically competing with East Asia long term. They'll soar above us in average IQ. We'll become big time also-rans. Second, we'll get bigger inequality as the upper classes travel abroad to start pregnancies. An awful lot of pregnancies will get started on "vacation" and "vacation abroad" will become very popular among those of family-starting age.

Even without regulatory barriers the ability to do eugenic selection will increase inequality anyway. The impulsive dummies will reproduce with natural sex at a much higher rate than the smarties who think ahead. But regulatory barriers will make a single country's inequality grow more than it would otherwise.


Doug said at November 30, 2008 8:36 PM:

Randall, first, here is one prolife Evangelical who genuinely appreciates your blog, even given the differences in perspective which show up. It would not be correct or fair to generalize that "Abortion opponents do not want women to know in advance they might be carrying a baby with a birth defect." It is obviously better to know your unborn child has a serious health problem, even if you are committed to the sanctity of human life. It would be more accurate to say that we are strenuously opposed to testing approaches presuming a willingness to engage in eugenic culling of the unborn. Big difference, I think.

As you are a scientifically oriented person, if you are serious about considering when life begins, may I suggest that facts are available to resolve the question. From conception, an embryo is genetically a member of the species homo sapiens. It possesses the attributes of life: it grows, it develops, it is nourished. Very soon it has a brainwave and a heartbeat. To be simple about it, if it were not alive, it would not need to be killed to prevent birth. There is much to discuss, but not "When does life begin?" The discussion is "What is the value of an unborn human life?" If we don't want children with birth defects this year, perhaps next year we won't want females, as in India. Then ... who knows?

Finally, I recently saw an article (I'm surprised you missed it, on the BBC website I think,) discussing research on a potential way before birth to mitigate the effect of Down's Syndrome on the child. What a wonderful thing that would be. A point of agreement?

Matthew said at November 30, 2008 9:30 PM:

I couldn't resist an answer.

In short the stock reply to pro-lifers question is ethics applies to persons, not embryos. Imagine a dilemma: You are in a fertility clinic and it's attacked by a crazy pro-life agnostic. The 3rd floor is about to collapse and you have two options: save the baby or a batch of embryos.

Clearly we value the real thing over potential, persons over life. I am not saying pro-lifers are wrong in general, it's that being pro life is missing the point. We care about individuals not embryos, persons not life.

Say it with me: human life means human persons not human embryos. Embryos are alive but they are not people.

When does an embryo become a person? Beats me. But pro-life is too general and sloppy. Once one has a child (in development) it's no longer a clump of cells but a future son or daughter. It's too difficult too admit we don't have an honorable beginning. Religion is to blame for this belief in particular but not for the desire to protect life. One need not read the bible to be pro-life, to understand the value of and protect life, even diseased or disabled life at all costs or burden - even it means more burden for that life and yourself, etc, forever onwards.

There is no slippery slope to argue over. But the problem still remains. Perhaps we need to develop better technology to prevent conception. And when it does happen we'll end it in a few days...or hours...no heart beat or brain to deal with and no ethics or sadness. But why are more evangelicals not clamoring for a technological solution? Or would most evangelicals really save the embryos rather than the baby? Are they really that strongly pro-embryo?

Every scientist who works with embryos gives them incredible respect with how he talks about them. He doesn't want a really crazy agnostic pro-lifer to burn his house down. But the fact is, the embryos will be thrown away.

Doug, even though I may come off as condescending, I am very interested in your opinion.

In fact, you should try reading this blog to see how far physicalism and agnosticism/atheism can go:

http://robinhanson.typepad.com/overcomingbias/

In particular, the last couple of posts are about the nature of the nascent (delusional) transhumanist dominion.


Randal, thanks for the great blog. I’ve been reading it for years.


Randall Parker said at November 30, 2008 9:57 PM:

Doug,

Understand that for all I know God exists and he agrees with you. I'm not trying to tell you that you are wrong. I have no idea. Though the laws of nature do not suggest to me that the Christian characterization of God is correct if he does exist.

Women knowing they carry a fetus with a birth defect: With that knowledge some will abort. So a screening program will increase the abortion rate, all else equal. As for:

testing approaches presuming a willingness to engage in eugenic culling of the unborn

That willingness exists in a substantial part of the US population and certainly a substantial part of the Danish population. Given the knowledge some will act on the knowledge by aborting. Testing will result in more aborting. So I would expect many abortion opponents to oppose widespread screening as long as the only decision one can make with the information is whether to abort. Am I wrong on this point?

Where does life begin: It does not look simple to me. I can come up with lots of examples of things that happen out there in nature that really make the definition of a human life difficult to figure out.

For example, suppose one takes two embryos and causes them to fuse. Then that develops into a single person. Well, was one life snuffed out? Exactly what I described happens naturally and some people are chimeric mixes of cells from two embryos. Suppose scientists find a way (and I think it is only a matter of time) to fuse two embryos at will. Did they kill an embryo? Or create a life form that has two souls?

Learn a lot about developmental biology and genetic regulation and suddenly the "When does life begin?" question becomes a lot more difficult to answer. I therefore draw a line between cells which have a complete human genome and a rights-possessing being. Heck, I do not even see the rights possessing being question as an either-or. I think there are gradations of rights possession and this will become much more clear (not to me but to others) when people start genetically engineering higher intelligence into other species. I already see many reasons with existing humans to see rights possession as a really complicated question. There are genetic criminals for example. They do not belong in civilization.

A way to mitigate Down's: Does it provide a way to totally prevent the symptoms?

Mthson said at November 30, 2008 10:47 PM:

Embryo-rights folks tend to ascribe just as many rights to embryos that don't have heartbeats or any nerve cells (i.e. the embryos have 0 feeling), so I think the model they're working with is one of a binary possession or lack of possession of a soul. It seems to me that a model allowing for gradations fits the observable data better.

Jerry Martinson said at December 1, 2008 6:54 AM:

Randall,

I fully agree the question of whether it will be legal or not already seems to be decided as a subset of Roe v. Wade etc... In most of the world, it will be up to the parents to decide individually.

I guess the question is what is the threshold that most parents have. The evidence already is that most US parents at risk for Downs will screen and 85%+ abort if positive. Seeing this shows that even in the US, eugenics at some level has support at the personal level. Most people all publicly say one thing about how wonderful Down's children are yet they are apparently choosing (in what must be a agonizing decision since most in the US say they are opposed to abortion) to abort.

I just wonder what parent's personal threshold will be for conditions that are either less severe or more politically/philosophically controversial (such as sexual, religious, or political orientation). Will the future social norm be that the value of unborn life be merely the inconvenience to the mother to terminating fetus/embryo 'x' to try to get better fetus/embryo 'y' in the future.

-Jerry

Tj Green said at December 1, 2008 7:59 AM:

Pacific Biosciences reckon they can sequence the human genome, within half an hour, for about $100. With technology like this available to everyone, then it becomes the choice of the individual to decide. Perhaps the decisions will be made more by females than males.

Doug said at December 1, 2008 10:22 AM:

Uh, Randall, I never mentioned God.

Just please don't mischaracterize or stereotype prolife folks. You said that we don't want couples to know if their unborn child has a health problem. That is not correct. Parents of special-needs kids obviously can use time to get organized to try to meet those needs.

You also mentioned the question of when life begins. I offered an objective and fact-based basis for considering an embryo to be a human life. I did not demand agreement with my position, but a fact-based countering argument would be quite an accomplishment, as it is on its terms a simple question. Is the embryo living or not living? Is it human or some other species? QED.

It does seem to me that, the tenor of the commenting is on the hugely important question of the value of an unborn human life, not its humanity or "aliveness".

And, yes, once the dike is breached, we must think about what we will do with those who are inconvenient or burdensome to have around. Expedience is pressing and resources are scarce and need to be more efficiently allocated. I recommend a little book "A Modest Proposal" by Franky Schaeffer.

Oh, and the Down's research is probably at some extreme early stage. Some doctor's idea.

Dave Gore said at December 1, 2008 10:31 AM:

I agree with Randall that people will take vacations to undergo whatever medical procedures they can't find at home. There won't be one future of genetic engineering; there will be multiple futures, each in a different place. People will gravitate to the place and culture where they feel most comfortable. The question is whether the different cultures will tolerate one another.

Frank said at December 1, 2008 3:34 PM:

Who gets to decide, and what will they decide?
While working in Omaha, NE (around five to ten years ago) a local couple caused a bit of a stir by asking for testing on their embryo. They wanted to abort it if there were any genetic defects. One of the defect items they wanted to test for was average intelligence.
It wasn't that long ago that a deaf couple wanted to try making sure that any child they had would also be deaf.
I'm *fill in the blank* and proud of it. Will we really end with genetically improved humans, or an increase on the genetic load?
Or, could we go another way and wind up with a genetic monoculture?

lot said at December 1, 2008 5:47 PM:

Just as biology shapes our culture, in the future culture will be shaping our biology. And since our culture is heavily influenced by what the ruling elites prefer, so will our biology be shaped according to their wishes.

Randall Parker said at December 1, 2008 6:04 PM:

Doug,

Respond to what I said rather than to a strawman. Here is what I asked:

So I would expect many abortion opponents to oppose widespread screening as long as the only decision one can make with the information is whether to abort. Am I wrong on this point?

Would most anti-abortion people oppose widespread screening for Down's as long as the only decision expectant parents can make with the information is whether to abort? Today that's the only substantial decision they can make.

Then you say:

You also mentioned the question of when life begins.

I break up this question to include questions like "when does a rights-possessing being begin?".

I offered an objective and fact-based basis for considering an embryo to be a human life.

And I cited an example from developmental biology that makes your basis look less than bulletproof.

Look at what happens during development. Embryos merge. Embryos split apart. The "moment of conception" model has serious holes as a starting point. If two embryos are going to merge then are each a human before the merger? If an embryo is going to split is it one or two humans before the split?

I did not demand agreement with my position, but a fact-based countering argument would be quite an accomplishment

And I provided one.

, as it is on its terms a simple question. Is the embryo living or not living? Is it human or some other species? QED.

Scientists will some day be able to chop a dying person (or an otherwise not dying person) up into parts and keep some of the parts alive indefinitely. If they can keep the body and the head alive separately which piece is the human?

Suppose a person gets into a traumatic accident and their body gets severed from the head and the body can be kept alive but the head is too smashed. Is the body a human? Or did the loss of the head mean it is no longer a human?

Similarly, suppose the head gets cut off in an accident, frozen immediately using nanotech to immobilize it, and the body is gone burned in the car that the head separated from. If the head can be kept alive and attached to a newly grown body is that a human?

I can tell you that in the future that traditional views of what constitutes a human are going to take some serious hits by what will become possible. At the same time, developmental biologists already have discovered enough to, at least in my mind, challenge traditional definitions of what is a human.

Randall Parker said at December 1, 2008 6:08 PM:

Frank,

I'm expecting a more rapid splitting of the human race into incompatible species. Humanity has already been genetically diverging for tens of thousands of years. But I expect this to accelerate. People will make kids even more strongly like them in various ways. The center will become smaller.

I could be wrong. But this is my expectation.

Ben said at December 1, 2008 8:19 PM:

"Nature uses abortion to weed out a lot of flawed embryos. Why can't we?"

Nature does all kinds of horrible things. We are better than that.

John said at December 2, 2008 5:29 AM:

No one talks about what this means to people with disabilities. Will this make life harder for the few who are born with this?

Tj Green said at December 2, 2008 8:14 AM:

Cause and effect and feedback (effect influencing cause). The feedback mechanism is sex, but sex is like the law, slow, expensive, and sometimes gets things wrong. Our species would benefit from a much faster feedback response so that we can remove damaging mutations, and obsolete polymorphisms.

Engineer-Poet said at December 2, 2008 5:26 PM:

Quoth John:

No one talks about what this means to people with disabilities.
The people who say this have a distinct aversion to talking about what this means to the rest of us.  It means compassion fatigue and huge fiscal burdens, among other things.
Will this make life harder for the few who are born with this?
There are people all over the world who are one of a few with a certain condition.  Are their problems decreased by the larger masses of people with other disabilities, or increased because they can't make themselves heard and resources are scarcer?

If you want the people with some debilitating condition to have more company so their lives will be easier, would it be asking too much for you to begin with yourself?

Randall Parker said at December 2, 2008 6:20 PM:

John asks:

No one talks about what this means to people with disabilities. Will this make life harder for the few who are born with this?

Actually the opposite will happen. As the number of disabled goes down our ability to take care of the remaining disabled will go up. More resources will be available per disabled person. Also, fewer disabled people will compete for jobs that they are capable of doing. Also, with a higher average level of ability more wealth will get generated.

Allan said at December 3, 2008 1:35 PM:

Actually, I think it's a bit more simplistic than either side is willing to admit.

At the point that there is a heartbeat and brain activity then it becomes a human life. I don't where in the process that occurs or if the testing can be done before that point, but it's a pretty clear point for me ...

Andy Start said at January 30, 2009 12:00 PM:

It seems nobody this conversation can have ever seen the ultrasound of a 10-week old baby or met a Down syndrome child.

It's easy to envision life without a Down child - childless couples aready know what it's like. Envisioning life with one is virtually impossible unless you personally know parents of a Down syndrome child and so this conversation is a little theoretical for me.

As termination rates increase as a result of shot sequencing and other new techniques, people can now make a termination decision earlier in pregnancy when they believe it's "safe" (in other words, they're probably not killing a child in their view).

I am the proud father of a Down syndrome boy, Andrew. My wife and I are pro-choice but, obviously for us, we are pro-life.

My wife and I offer an opportunity for couples faced with the decision to terminate or not to come visit a Down child and learn the up-side of keeping their embryo: we're on the list of geneticists at one of our local hospitals and provide this service as volunteers.

It's clear from the comments here that education about Down Syndrome is rarely sought and not often available for most people.

If you actually could experience the wonder of a Down child, you'd come down to earth with a bump, I think!!

Elmer Lapena said at February 24, 2010 7:59 PM:

Andy,

I am also a parent of a child with Down syndrome and certainly cannot imagine life without our son, Jeremy.
I will not deny the disappointment, grief, and denial that took place before the acceptance, love and understanding set in.
Jeremy has opened up a whole new world for us, we have two lovely daughters as well, and a big family who all undertand and care a whole lot about Jeremy.
There are likewise many, many other parents and families who are like us, and we are very much pleased to have gotten to know them... many of them have developed into really close friendships, all because of our children with Down syndrome, and out of this, a lot of good things have happened.

Like you, we are on the list of geneticists, not because pre-determination is practiced widely where we come from, but because it is so much different for a parent to re-assure another parent that they will be alright and that their newborn child is indeed a blessing, like all our other children. This is one of the primary objectives of the association that we have joined.

Dr. Jerome Lejeune was acclaimed for his work on this topic, and the most valuable lesson he told us was to, "Love the child as a child first, and the child will bloom."

Sincerely,
Elmer Lapena
President, Down Syndrome Association of the Philippines, Inc.
dsapi@hotmail.com
catch us on FB :)

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