Counseling in medical genetics / Sheldon Reed.

  • Sheldon Clark Reed
Date:
[1980]
Catalogue details

Licence: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

Credit: Counseling in medical genetics / Sheldon Reed. Source: Wellcome Collection.

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    52 / Amniocentesis and Prenatal Diagnosis Philosophy One could ask whether the arguments that support the early abortion of genetically diseased fetuses also support infanticide of the same infants who shpped through the amniocentesis screen and have been born? It is not the same question. These are two different questions. The first question concerns the early fetus which is totally dependent upon the mother and cannot survive elsewhere. The second question concerns a baby which can be raised by the mother or some¬ one else and, therefore, must be accepted as a rightful member of society. It has not committed any crime against society, which would call for its imprisonment or execution. Development of the fetus is a gradual process but cutting of the umbilical cord signals a new status for it. Birth is a good place to draw a moral line; usually it is difficult to draw the line on any continuous variable, but birth as as determined by cutting of the cord is a definite point on the developmental curve. A frequent question is when does life begin? Life does not begin with the fertili¬ zation of the egg. It began millions of years ago and has continued ever since then. It never starts anew. Both the egg and the sperm are living material, as is obvious to anyone who has seen them through the microscope. How long each person's life lasts is entirely conditional upon the genotype of the person and the environ¬ ment it experiences. Death can occur at any time and is the usual fate of all un¬ fertilized eggs and sperms. All life is an extension of preexisting and continuing life. The egg has the potentiality of becoming a human being after elaborate developmental changes have occurred. But as a simple human cell it has none of the attributes of a human being and does not deserve to be considered a human being. The question becomes, At what point does this blob of cells become a human being? The answer is a purely arbitrary determination, which results from one's philosophy. The genetic counselor has an indirect interest in the subsequent mental health of the mother who has chosen an abortion for genetic reasons. Greet et al [1976] followed for two years a series of 360 women who had first trimester vacuum aspiration terminations. These were not abortions primarily for genetic reasons, but the study is the most appropriate one known to me. Each woman had received brief counseling before termination. The detailed, structured interviews at 3 and 18 months were of good quality. Compared with the ratings of psychosocial adjustment before termination, significant improvement had occurred at follow- up in respect to psychiatric symptoms, guilt feelings, and interpersonal and sexual adjustment; there was no significant change in marital adjustment. Adverse psychiatric and social sequelae were rare. Many reports related to abortion are of an emotional nature, but this one seems to be free of bias. One might make the comment that the psychologic state of the women would have improved if the fetuses had come to term and the babies were born. The point is that the termina¬ tion did not damage the psyches of the mothers; rather, there was improvement — for whatever reason.
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