Dr. O’Callaghan examines ethics, economics of disability-selective abortion at McGrath Life Lunch

One hundred years ago, the eugenics movement in America argued that the “unfit” should not be allowed to live. At a “Life Lunch” hosted by the McGrath Institute for Church Life on September 20, Dr. Mary O’Callaghan, a professor in the Mendoza College of Business and a presenter at the United Nations’s 2018 Down Syndrome Day, argued that this sentiment captures the zeitgeist of contemporary disability-selective abortion.

In the 20th century, 64,000 Americans were forcibly sterilized through eugenics-inspired state action. Influenced by the United States’s enthusiasm for “human perfectibility,” Nazi Germany carried out their own euthanisations, resulting in approximately 50,000 killings per year from 1939-1945. Today, approximately 3,000 fetuses, accounting for 70-90% of the fetuses who test positive for Down Syndrome through prenatal screening, are aborted annually in the United States.

It is especially alarming that a significant number of ​healthy​ fetuses die after erroneously testing positive for Down Syndrome. In a study conducted by JR Biggio, TC Morris, J Owen, and JS Stringer on a particular kind of sequential screening, more than half of the fetuses who died were healthy. These healthy fetuses are normally aborted or die from complications stemming from amniocentesis, an invasive test performed to confirm the results of initial prenatal screening tests.

One could argue that aborted fetuses are sacrificed as martyrs on the altar of removing disabled children from society. The notion that any person should be treated as a mere instrument of economic exigency would be energetically resisted by Immanuel Kant, who argued that all persons should be treated as “ends-in-themselves.” Kant’s dictum, which represents a starting point for much contemporary moral and political philosophy, has gained popularity since John Rawls’s ​Theory of Justice (1973) argued for a Kantian inspired social contract theory over and against utilitarianism. In the case of disability-selective abortion, the aborted fetuses are not treated as ends-in-themselves. Rather, they are treated as means to conserving economic efficiency or some other end.

O’Callaghan, who is the mother of a child with Down Syndrome, positioned contemporary disability-selective abortion in the tradition of eugenics and the racist ideologies within which the movement flourished. In her talk, she noted that the eugenics movement in mid-20th century United States and Nazi Germany was initially framed in two ways, both of which have been leveraged on behalf of disability-selective abortion. 

First, eugenics was depicted as a natural way to expedite the process of human evolution. According to this line of thought, just as nature selected those genes to be more likely to produce offspring, humans could prevent those with faulty genes from reproducing through the euthanization, forced sterilization, and institutionalization of those with faulty genes. 

Second, the eugenics movement was advanced under the auspices of economic efficiency. According to this line of thought, since the handicapped person contributed little to the economy while draining resources, the handicapped person should be removed from society.

O’Callaghan argued that both kinds of arguments have been revamped to meet the cultural ethos of a liberal market economy. The evolutionary line of thinking is now framed in terms of compassion. Proponents of disability selective abortion argue that it is compassionate to those with disabilities to prevent them from suffering (by preventing them from living). The economic line of thinking is often advanced within the context of expanding consumer choice. For example, the consumer choice argument was used to justify the state of California’s prenatal screening program, whose annual budget is $1 billion.

Kant would helpfully argue that if individuals are ends-in-themselves, those individuals should be able to make claims on others. A right is simply the expectation that the claim will be respected. Among those rights is the right to act in accordance with one’s conscience. It can be argued that the use of public funds for prenatal screening is a violation of conscience rights. Prenatal screening is a test done to see if the child has birth defects. In the vast majority of cases where there are defects, the fetus is aborted. In effect, taxpayers are coerced into funding a procedure whose results are used directly and immediately to justify an abortion.

O’Callaghan argues that the state’s motivation for spending $1 billion annually on prenatal screening is not the expansion of consumer choice, but rather reducing public expenditures on health care and education, which occupy ever-growing segment of public budgets. Since both private insurance and Medicaid cover most health care costs incurred by Down Syndrome, the costs of raising a child with Down Syndrome are dispersed across the insurance pool. Education costs are likewise distributed across society in the form of special education. According to O’Callaghan, the social costs of a child with Down Syndrome average $500,000-$700,000 per child. Based on a study by TA Sheldon and J Simpson, the average cost of diagnosing and eliminating a Down Syndrome fetus is approximately $260,000-$360,000. These costs do not incorporate the economic effects of the psychological trauma often incured by electing to have an abortion.

O’Callaghan cautioned pro-life advocates from engaging in an economic analysis of the cost of abortion. She argued that in disputing the economic efficiency of disability selective abortion, one implicitly endorses the idea that economic questions are relevant to the decision of when to have an abortion.

While most lecture attendees agreed with O’Callaghan’s assumption that both healthy and disabled fetuses should be treated as ends-in-themselves, O’Callaghan went further. She observed that treating the disabled with dignity confers dignity on the caretaker. Invoking Jean Vanier and John Paul II, O’Callaghan suggested that in taking care of the disabled, one becomes more aware of their own finitude, dependence on others, and vulnerability. In other words, in caring for the disabled, one becomes more human.

Stephen Evensen is in the Master of Theological Studies program, concentrating in moral theology and minoring in both systematic theology and historical theology. He is originally from Arlington Heights, IL and hopes to be a professor of both philosophy and theology. He can be reached at sevensen@nd.edu.