From Baby Doe to Selective Termination for Down Syndrome

From the early 1980s to today, much has changed in the neonatal care of infants born with Down syndrome. Leading up to the Baby Doe case in the US in 1982, infants born with Down syndrome were often denied life-saving treatment solely because of their disability. These norms of non-treatment changed in the aftermath of Baby Doe. Around the same time, prenatal screening tests for Down syndrome became more widely available, leading to the prevalence of selective abortion for Down syndrome. This essay considers the question of moral progress during the era in which infants with Down syndrome were no longer denied life-saving treatment, but increasing numbers of pregnancies were terminated because of a prenatal diagnosis of Down syndrome. I look at three aspects of this history and of the debate in bioethics about Down syndrome in the perinatal context. First, I examine the comparison between the ethics of infanticide and abortion. Second, I discuss the historical contingency of the resolution provided by the Baby Doe case. Third, I present the view that ableism continues to underlie widespread selective abortion. I conclude that moral progress during this period from Baby Doe to the present day is tangible, but also fragile.