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Inclusion begins at conception

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Inclusion begins at conception

Lethal discrimination is taking place in medical institutions, world-wide. And the trend is leading towards an extermination of people with Down Syndrome. But there are those who are fighting against this injustice, and providing hope.

Kristina Artukovic by Kristina Artukovic
October 14, 2021
in Foreground, Life
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Inclusion begins at conception
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As per current estimates, there are 5,275 people with Down Syndrome living in Serbia. The estimated number for Croatia is 2,232, for Bosnia and Herzegovina 2,063, and for Montenegro 440.

These figures would be significantly higher if it were not for elective abortion. If the upward trend of pregnancy terminations continues in the generations to come, the entire population of people with Down Syndrome in Europe could be completely exterminated.

The colorful panel of inclusion belies the frightening reality of lethal discrimination that takes place in medical institutions, aided by the absolute anathema on questioning the private exercising of the “right to choose”; which, in this case, almost always means abortion in the fourth month of gestation and often even later.

Abortion laws in Serbia and the region, as well as across Europe (with the exception of Poland and Malta), allow for elective abortion until birth in case of a Down Syndrome diagnosis. The latest statistics indicate that 100% of pregnancies with a confirmed diagnosis of Down Syndrome are terminated in Iceland. Denmark has a rate of 98%. Great Britain, France and Germany have rates that exceed 90%.

Medical councils and ethics committees of health institutions in Serbia routinely and without exception approve termination requests in late pregnancy based on a Down Syndrome diagnosis. The lack of transparent statistical data is noticeable (and symptomatic), but it is clear that the percentage of abortions that follow the prenatal diagnosis of Down Syndrome throughout Serbia is close to 100%. In Croatia, depending on the area, it ranges from 60% to 100%.

This shocking international reality can hardly be changed by raising awareness of how lovable children and adults with Down Syndrome are, or by promoting inclusion and implementing government incentives. What we have here is a tacit eugenic agreement between a large part of the medical community and the government that promotes the importance of “providing information” to pregnant women based on prenatal tests. Once the test comes back positive, abortion is tacitly implied and explicitly suggested, while those who voice their wish to continue the pregnancy can expect pressure and the most inappropriate patronizing. But at the end of the day, the system shifts the responsibility for eugenic practice and extermination to the parents, thus further masking this rather consistent medical practice and dispersing it into countless “private decisions” that result in the global extermination of an entire human population.

However, the eugenic consensus in the medical community is sometimes not so tacit, as evidenced by this quote from one of the few Serbian scientific articles on prenatal diagnostics (please ignore the grammatical irregularity of the sentence, we cite it here verbatim):

“By propagating the possibilities provided by invasive prenatal diagnostics, it is necessary [sic] in promoting public health and preventing the birth of children with chromosomal aberrations.”

INCIDENCE OF CHROMOSOME ABERRATIONS DETECTED PRENATALLY (…), Medical Journal of the Special Hospital for Thyroid Diseases and Metabolic Disease Zlatibor, 2014, vol. 19, No 55

These rules and practices stand in sharp contrast to the UN Convention on the Rights of Persons with Disabilities, which was also ratified by the Serbian Parliament.

Anti-eugenic struggle in Europe

Fortunately, things are slowly changing. In early 2021, a decision of the Polish Constitutional Court came into force, rendering unconstitutional the part of the abortion law which allows abortion on the grounds of prenatal disability diagnoses.

In the UK, two initiatives are currently underway to repeal the article on prenatal diagnosis from the abortion act. In Northern Ireland, amendments to the law on abortion are underway, and if adopted they would prevent the elective termination on the grounds of mild congenital fetal anomalies. Also, two brave women–Máire Lea-Wilson, mother of a boy with Down Syndrome, and Heidi Crowter, a young woman with Down Syndrome–are taking legal action against the government because of the discriminatory abortion act which allows abortion of babies with Down Syndrome through all nine months of pregnancy.

In July this year, their lawsuit was heard in the High Court of Justice in London. Sadly, they lost their court challenge on September 23rd. If Máire and Heidi had won, the UK Abortion Act would have become the first law in Europe that would prohibit prenatal discrimination based on Down Syndrome. Crowter plans to appeal the ruling, stating “the fight is not over”.

Laws against prenatal discrimination in the USA

Several similar initiatives are currently underway or have taken effect this year in certain states of the USA. As of this writing, such laws have been adopted by more than a fifth of federal states: Arizona, Arkansas, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Ohio, Oklahoma, South Dakota, Tennessee and Pennsylvania.

The Federal Court of Appeals dismissed the appeal of Planned Parenthood and affiliated abortionists, and revoked a moratorium on a law banning abortion in the state of Ohio based on Down Syndrome diagnosis. On the other hand, in January this year, the federal court of appeals, whose jurisdiction includes Arkansas, assessed a similar law in that state as unconstitutional. Ohio’s great anti-eugenic victory and the existence of mutually contradictory second-degree decisions most likely mean the involvement of the Supreme Court, which, given the current balance of power in the SCOTUS, gives hope of a very likely possibility that this issue will most likely be finally resolved in the USA–in favor of the pro-life stance.

We hope that these developments will send a clear signal to all ethics committees of hospitals across the European continent, including those in Serbia, which are too quick to approve late-term abortion requests based on the diagnosis of Down Syndrome. We also hope that thanks to these developments, the way persons with Down Syndrome are talked about and the way their parents are treated in various genetic counseling and gynecological offices abroad–and here in Serbia–will become at least a little less dehumanizing than it currently is.

Tags: abortiondisabilitydiscriminationDown syndromeeugenicsHeidi CrowterinclusionMáire Lea-WilsonPlanned Parenthoodprenatal screeningSerbiaUK Abortion Act
Kristina Artukovic

Kristina Artukovic

Kristina Artuković is an advocate with Saving Down syndrome, an international social justice advocacy for people with Down syndrome with a special emphasis on prenatal justice and anti-eugenics. Founder of Etički front (Ethical Front), Serbia-based organization that ​​provides a life-affirming stance on human bioethics issues and protects and promotes the dignity of human life from conception to natural death. Writes for Saving Down’s and Rehumanize International. Has MA in Philosophy and Logic. 

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