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A Future with Less Down Syndrome?
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At 10 weeks

At 10 weeks

A paper in The New England Journal of Medicine, Cell-free DNA Analysis for Noninvasive Examination of Trisomy, reports on the effectiveness of a new proprietary method to screen for Trisomy 21, which is the cause of 90% of cases where individuals exhibit Down Syndrome. This issue is well known at this point. There are many methods to screen and diagnose Down Syndrome prenatally, but they all suffer from drawbacks, from invasiveness to false positives. Currently the vogue is for methods which analyze maternal plasma. That is, all that’s needed is a blood draw from the mother. This is one such method.

auc Their data set was large, N > 15,000, and not particularly old, with a mean maternal age of 31. Here’s a key point: “Among the 11,994 women with low-risk pregnancies on the basis of a maternal age under 35 years, cfDNA testing identified 19 of 19 women with trisomy 21, with 6 false positive results.” This is actually a good result, as older methods have a much higher false positive rate. But many people will not be reassured when they see that the true positive and false positive ratio is so high. Base rate neglect is always going to crop up. For many couples who get positive results confirmatory evidence is essential. That is why it is crucial that the mean gestational period of detection has to be pushed back beyond the beginning of the second trimester if these tests are to cause the minimum amount of discomfort for the couples. The later the abortion, the more psychologically and physically stressful the process.

But, I put a question mark in the title of this post because there is often an assumption that widespread screening will result in a massive decline in the number of individuals with Down Syndrome, to the point of extinction. Actually, I’m not sure about that. It seems that widespread adoption increases the pool of people who are getting tested, and fewer of these in the United States terminate pregnancies through abortion that the early adopters. As mean maternal age creeps up the number of people with Down Syndrome in the United States may not decrease nearly as much as we expect.

 
• Category: Science • Tags: Down Syndrome 
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  1. I expect a massive decrease in Down Syndrome incidence.

    This is the biggest issue that makes me pro-choice. I wonder why this topic never comes up in the abortion debate. When I became a parent, I was extremely grateful for the opportunity to do pre-screening for problems like these, with the option available for abortion.

    • Replies: @Glaivester
    This is the biggest issue that makes me pro-choice. I wonder why this topic never comes up in the abortion debate.

    Probably because anyone who would entertain the idea of abortion as a way to reduce birth defects would have to be pro-choice to start with? Arguing for abortion because of its material benefits would only be effective against an opponent who does not feel that abortion is the killing of a person, which rules out the vast majority of people you would be having the debate with.

    To the ears of someone who believes abortion is murder, bringing up kids with birth defects as an argument for abortion would be like arguing for legalizing the euthanasia of special ed kids.

    So bringing the issue up in a debate would imply one of two accusations: either the pro-lifers would be willing to euthanize special ed children, or that they are lying about what they believe about abortion.
  2. AG says:

    Though rare, today we just encountered a case of neonatal leukemia. Genetic test is pending. Most likely a Down newborn. Outcome is grim.

    http://www.ncbi.nlm.nih.gov/pubmed/12759620

    If people are more open to prenatal screening and termination of major genetic defect, such tragedy can be avoided.

    Emotionally, it is much more heart wrenching to see a newborn dying than termination of fetus which can not live independently. For that matter, most death from genetic disease often end up in their teens or young adults. People dying at their prime ages are mot disturbing events than people dying at old ages (again with waning independency). These unfortunate kids dying while other in the same age enjoy life at full.

  3. I notice that the moral argument in favor of aborting pre-screened DS babies is based on the emotional comfort of the parents, as if that were the most important thing.

    • Replies: @Razib Khan
    most of the time i hear it explained as "we don't want our child to live like that." of course that's somewhat self-serving. i think it's a complicated issue in terms of the ultimate motivations. though in practice the outcomes are pretty straightforward; 50 to 90 percent terminate on positive test.
    , @AG
    Well, that is the very reason that nobody feel sad about precious sperms wasted during masturbation or eggs wasted during sex with birth control. It is because gamets can not survive on their own. Human emotion is linked to the nature of biological usefulenss.

    There is saying about 3 types of saddest death for relatives.
    1. When you are child who lose parents.
    2. When you are aldut who lose spouse.
    3. When you are senior who lose grown children.

    But they all share the same kind of death: a full grown adult in his or her prime age when the person can provide the most value for the survivors. The deaths of very young or old or long-term sicken always cause less emotional reaction. If you work in healthcare facility, you will notice the pattern.
    , @Tarkmargi
    @jtgw:

    In this case, the parents' emotional response to the suffering of their child is an excellent proxy for their distress at the evolutionary damage caused by a Downs child, who'll consume substantial resources, without providing any long term genetic propagation.

    I think it quite obvious that emotional responses and social concepts like morality have evolved to fulfill evolutionary purposes, and in this context, the evolutionarily correct path is abortion.

    I would go so far as to say that parents should be legally able to euthanize, with suitable regulation, already born offspring with severe genetic defects that were undetected during pregnancy, who are likely to be massive drains on their parents and siblings' wellbeing.

    Of course, emotional hardwiring can become obsolete and even counterproductive, such as the high rates of obesity owing to the instinct for overeating and calorie storage as fat.
  4. @jtgw
    I notice that the moral argument in favor of aborting pre-screened DS babies is based on the emotional comfort of the parents, as if that were the most important thing.

    most of the time i hear it explained as “we don’t want our child to live like that.” of course that’s somewhat self-serving. i think it’s a complicated issue in terms of the ultimate motivations. though in practice the outcomes are pretty straightforward; 50 to 90 percent terminate on positive test.

    • Replies: @James Kabala
    "50 to 90 percent" is an extremely wide range. Have any more precise studies been done?
  5. AG says:
    @jtgw
    I notice that the moral argument in favor of aborting pre-screened DS babies is based on the emotional comfort of the parents, as if that were the most important thing.

    Well, that is the very reason that nobody feel sad about precious sperms wasted during masturbation or eggs wasted during sex with birth control. It is because gamets can not survive on their own. Human emotion is linked to the nature of biological usefulenss.

    There is saying about 3 types of saddest death for relatives.
    1. When you are child who lose parents.
    2. When you are aldut who lose spouse.
    3. When you are senior who lose grown children.

    But they all share the same kind of death: a full grown adult in his or her prime age when the person can provide the most value for the survivors. The deaths of very young or old or long-term sicken always cause less emotional reaction. If you work in healthcare facility, you will notice the pattern.

    • Replies: @jtgw
    I wasn't questioning people's emotional responses. I was questioning whether these emotions ought to be the basis of moral reasoning and making decisions about abortion.
  6. @AG
    Well, that is the very reason that nobody feel sad about precious sperms wasted during masturbation or eggs wasted during sex with birth control. It is because gamets can not survive on their own. Human emotion is linked to the nature of biological usefulenss.

    There is saying about 3 types of saddest death for relatives.
    1. When you are child who lose parents.
    2. When you are aldut who lose spouse.
    3. When you are senior who lose grown children.

    But they all share the same kind of death: a full grown adult in his or her prime age when the person can provide the most value for the survivors. The deaths of very young or old or long-term sicken always cause less emotional reaction. If you work in healthcare facility, you will notice the pattern.

    I wasn’t questioning people’s emotional responses. I was questioning whether these emotions ought to be the basis of moral reasoning and making decisions about abortion.

    • Replies: @Razib Khan
    emotions are probably the basis of most moral reasoning. cognitively less taxing than reason ;-)
  7. @jtgw
    I wasn't questioning people's emotional responses. I was questioning whether these emotions ought to be the basis of moral reasoning and making decisions about abortion.

    emotions are probably the basis of most moral reasoning. cognitively less taxing than reason 😉

    • Replies: @jtgw
    I partly agree. I wouldn't say morals always need to be grounded in reason. I also wouldn't say they need to be grounded in emotion. As a religious person, I'd say they are grounded in faith and I'd distinguish faith from both reason and emotion, but that's getting us into some thorny philosophical discussion.

    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress.
    , @Uptown Resident
    Do you think it's possible to do moral reasoning without an emotional basis? If impossible, do you think that the emotional basis of reasoning is heritable? Specifically, do you think that Western attitudes toward Down Syndrome fetuses, toward the various "Other," to humanity at large, could reflect an evolved empathy for members of your own species? And why on earth would that be?

    I've often wondered this because, while I have empathy toward friends and family, people I work with, etc., I do not have species-wide empathy. At all. I tend strongly toward misanthropy. And I have extreme, sometimes crippling empathy for non-human animals that are suffering through human exploitation. I have deeply considered and researched reasons for this moral reasoning, but it is ultimately based in a gut-level horror at humanity and overwhelming pity for nonhuman animals. I've noticed that not many people are like this. Even Peter Singer seems to place every member of his own species before a member of the next.

    Yet I find Western humanitarianism baffling. Sometimes I can make sense of it as a secularization of Christianity. Secular attitudes toward Down Syndrome babies likewise smack of Christian anthropocentrism. But I feel like the level of emotion involved in Western humanitarianism suggests some hardwiring that does not bode well for the planet.
  8. @Razib Khan
    emotions are probably the basis of most moral reasoning. cognitively less taxing than reason ;-)

    I partly agree. I wouldn’t say morals always need to be grounded in reason. I also wouldn’t say they need to be grounded in emotion. As a religious person, I’d say they are grounded in faith and I’d distinguish faith from both reason and emotion, but that’s getting us into some thorny philosophical discussion.

    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress.

    • Replies: @wilzard
    @jgtw you claim to get your morals from your religion.

    However, you should be intellectually honest and admit that you, same as everyone else whether they are religious or not, reason or rationalize your morals.

    You may believe it is more important to stop abortion for any reason but I believe it is only ever the decision of the family involved.
    , @Razib Khan
    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress

    i probably agree. though i'd be cautious about offering this as disjoint options. there's a huge variation in DS individuals from what i've seen. some of them are not normal in function, but quite functional and can viably lead a life of semi-independence. in contrasts, others are not really verbal, and will require a lifetime's worth of very close parental and post-parental (when parents die) care. in the former case the argument about the suffering of the children and the parents' emotional distress is less persuasive. in the latter case, the situation differs. to my knowledge we don't know how to distinguish the two though.
  9. From my own observation, Downs children are noticeably less common than they were a generation ago. However, I think it should be pointed out that they are not always a “tragedy” to their families. People can and do love them as much as normal children. Charles Darwin, for example, was very affectionate toward his Downs syndrome child, but it’s probably much more difficult for those with limited means.

    Most abortions, IMO, stem from materialist motives. I am actually more sympathetic to people who admit that motive than excuses about preventing the child’s suffering, because raising a disabled child in poverty is essentially martyrdom for a parent, whereas disabled children (both mentally and physically) generally are happy to be alive.

    • Replies: @Uptown Resident
    Bill,

    I agree with you that, for some families, the Downs baby is not a tragedy. I have a Downs cousin who is cherished by her family.

    But even as a pregnant, emotional woman, I would enthusiastically abort a Downs fetus. And have zero qualms about it. In fact, my own feeling is that aborting a Downs fetus would be the *morally responsible* thing to do. The reasons are (1) I have limited reproductive years, and want to spend them gestating and raising children who will not only be fully independent and go on to raise their own children, but who will also be able to contribute to our civilization and perhaps to a body of knowledge; (2) there are too many humans on the planet already, and adding another consuming, polluting, destructive human to the world is justifiable only if the child will be capable of carrying on its parents' advocacy for the environment, western literature civilization, animal welfare, science, etc.

    It is worth pointing out that in poorer ages and societies, infanticide for deformed babies was the rule. Jared Diamond discusses this in The World Until Yesterday. You accuse people who would abort Down Syndrome babies of being materialistic. Arguably, it is precisely because our society is so material-rich that families even have the luxury of sparing retarded children.
  10. @jtgw
    I partly agree. I wouldn't say morals always need to be grounded in reason. I also wouldn't say they need to be grounded in emotion. As a religious person, I'd say they are grounded in faith and I'd distinguish faith from both reason and emotion, but that's getting us into some thorny philosophical discussion.

    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress.

    @jgtw you claim to get your morals from your religion.

    However, you should be intellectually honest and admit that you, same as everyone else whether they are religious or not, reason or rationalize your morals.

    You may believe it is more important to stop abortion for any reason but I believe it is only ever the decision of the family involved.

    • Replies: @Razib Khan
    chill on the patronizing tone. it's not conducive to optimal discussion.
  11. @jtgw
    I partly agree. I wouldn't say morals always need to be grounded in reason. I also wouldn't say they need to be grounded in emotion. As a religious person, I'd say they are grounded in faith and I'd distinguish faith from both reason and emotion, but that's getting us into some thorny philosophical discussion.

    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress.

    I find the argument that DS babies should be aborted to prevent their own future suffering more (though not fully) persuasive, at any rate, than the argument that they should be aborted to save the parents emotional distress

    i probably agree. though i’d be cautious about offering this as disjoint options. there’s a huge variation in DS individuals from what i’ve seen. some of them are not normal in function, but quite functional and can viably lead a life of semi-independence. in contrasts, others are not really verbal, and will require a lifetime’s worth of very close parental and post-parental (when parents die) care. in the former case the argument about the suffering of the children and the parents’ emotional distress is less persuasive. in the latter case, the situation differs. to my knowledge we don’t know how to distinguish the two though.

  12. @wilzard
    @jgtw you claim to get your morals from your religion.

    However, you should be intellectually honest and admit that you, same as everyone else whether they are religious or not, reason or rationalize your morals.

    You may believe it is more important to stop abortion for any reason but I believe it is only ever the decision of the family involved.

    chill on the patronizing tone. it’s not conducive to optimal discussion.

  13. Another motive for aborting (or preventing the conception of in the first place) fetuses with Down Syndrome is to avoid placing a burden on one’s existing children. I decided to have only one biological child, and one – not the only, but one – of the reasons I didn’t have more is because at the age I had my daughter, I had a higher than normal risk of conceiving a child with Down Syndrome and I didn’t feel I could burden my daughter with responsibility for a sibling who would basically always be a child for the rest of his/her life. If I had conceived a second child who tested positive for Down Syndrome, I would almost certainly have had an abortion. However, I used a very effective birth control method so I was never faced with that decision (and now I highly doubt I’m fertile anymore).

  14. I am pessimistic about Khan’s prediction of a future with less Down Syndrome. Here’s why.

    (1) In my experience (33yo and 25 weeks pregnant with first child), antenatal medical professionals are uneasy about screening and abortion-track patients. Back in December, I was begging my genetic counselor to let me do the NIPT, a maternal blood serum test like the one examined in this study. According to our normal first trimester screen (blood test + nuchal translucency ultrasound test), there was something like a 1 in 5,000 risk of a false negative for Down Syndrome. The GC said that a NIPT would just increase the risk of a false positive, and that they wouldn’t do it. (We also did a genetic screen through Inherigen. I figured from our 23andMe raw data that we weren’t carriers for anything scary, but I wanted more certainty than my own interpretation of our Promethease results afforded.)

    Naively, I was very open with my OB and genetic counselor about my desire for the *most information possible* so we could make a decision about whether to terminate the pregnancy. I assumed that getting an abortion in the case of a positive result for trisomies, etc. was the whole point of testing. Nope. It’s so families can be prepared to deal with their Down baby, my GC suggested. The GC, in particular, took a disapproving and emotional tone toward my cavalier attitude toward a trisomy fetus. I didn’t particularly care–there is nothing anyone could do to shame me into keeping a fetus with serious genetic abnormalities–although the thought crossed my mind that she might hide a positive result, knowing how I intended to act with that information.

    (2) My sense is that our tolerance-mongering culture is telling women that discriminating against Down Syndrome fetuses is bad. For instance, when I talk to women who have testing done, they are quick to add, “not that we would abort–we just wanted to know to be prepared.” And many women I know opt *not* to get tested: “We already know that we wouldn’t abort the baby so why test?” One friend who opted not to test for that reason ended up having to get a late-term abortion because it was discovered that her fetus was missing a brain (anencephaly). Could have caught that in the first trimester! There’s also the whole personification/infantilization of the fetus–I’m not talking about Christian right-to-lifers, but rather mainstream pregnancy websites like the bump.com, which gives you weekly updates on what your baby is up to in the womb, and the ubiquity of ultrasounds, including 4-D ultrasounds, that encourage bonding with the fetus.

    (3) Delayed childbearing continues apace, and no one warns you about the hazards of being old and pregnant when you decide, say, to spend your prime reproductive years traveling abroad or beginning a PhD program. Most smart, secular girls are not even thinking about marriage and childbearing until they hit 30. By contrast, one of my very religious younger sisters is pregnant with her fourth child as I’m pregnant with my first. So maybe we’ll just see the gradual extinction of secular types as they fail to bear children, or bear infertile children.

  15. @Bill P
    From my own observation, Downs children are noticeably less common than they were a generation ago. However, I think it should be pointed out that they are not always a "tragedy" to their families. People can and do love them as much as normal children. Charles Darwin, for example, was very affectionate toward his Downs syndrome child, but it's probably much more difficult for those with limited means.

    Most abortions, IMO, stem from materialist motives. I am actually more sympathetic to people who admit that motive than excuses about preventing the child's suffering, because raising a disabled child in poverty is essentially martyrdom for a parent, whereas disabled children (both mentally and physically) generally are happy to be alive.

    Bill,

    I agree with you that, for some families, the Downs baby is not a tragedy. I have a Downs cousin who is cherished by her family.

    But even as a pregnant, emotional woman, I would enthusiastically abort a Downs fetus. And have zero qualms about it. In fact, my own feeling is that aborting a Downs fetus would be the *morally responsible* thing to do. The reasons are (1) I have limited reproductive years, and want to spend them gestating and raising children who will not only be fully independent and go on to raise their own children, but who will also be able to contribute to our civilization and perhaps to a body of knowledge; (2) there are too many humans on the planet already, and adding another consuming, polluting, destructive human to the world is justifiable only if the child will be capable of carrying on its parents’ advocacy for the environment, western literature civilization, animal welfare, science, etc.

    It is worth pointing out that in poorer ages and societies, infanticide for deformed babies was the rule. Jared Diamond discusses this in The World Until Yesterday. You accuse people who would abort Down Syndrome babies of being materialistic. Arguably, it is precisely because our society is so material-rich that families even have the luxury of sparing retarded children.

    • Replies: @Bill P
    I certainly understand point #1, and respect your honesty there. However, I'm not so sympathetic on #2.

    Advocacy, as practiced in the West, counts for nothing. I consider myself a conservationist, but have feelings of contempt for environmentalists. Largely because I've walked the walk, living as a de-facto poor person for some time (following a divorce) with a carbon footprint on the order of your typical Albanian. Most environmentalists I've met are big spenders, big consumers and enormous hypocrites. I've never met someone with Downs syndrome, on the other hand, who regularly vacations overseas and drives a car.

    If your kid is a successful Westerner, he or she is going to burn a lot of fuel and leave a lot of trash behind. A Downs kid would work at Goodwill, take the bus and live a simple life in which going to Chuck-E-Cheese would be just as fulfilling as a trip to Milan. This is why, incidentally, it's hard for me not to like kids with Downs syndrome.

    But I do understand the burden it puts on parents. I know how hard it is to potty train a normal kid. I'm fully aware of all the years of cleaning up shit and wiping faces and trips to the doctor, which would be magnified by maybe a factor of three for a Downs kid. If you can't handle it, I understand. People in my generation don't have enough kids as it is, so the burden may be intolerable.

    But for God's sake please don't try to justify it with some moral gymnastics about global warming and the environment. Just be honest and say you're doing it for the same reason we used to stop nursing stricken babies and then bury them under one of those little stones you see standing with such awe-inspiring humility in old graveyards.
  16. @Razib Khan
    emotions are probably the basis of most moral reasoning. cognitively less taxing than reason ;-)

    Do you think it’s possible to do moral reasoning without an emotional basis? If impossible, do you think that the emotional basis of reasoning is heritable? Specifically, do you think that Western attitudes toward Down Syndrome fetuses, toward the various “Other,” to humanity at large, could reflect an evolved empathy for members of your own species? And why on earth would that be?

    I’ve often wondered this because, while I have empathy toward friends and family, people I work with, etc., I do not have species-wide empathy. At all. I tend strongly toward misanthropy. And I have extreme, sometimes crippling empathy for non-human animals that are suffering through human exploitation. I have deeply considered and researched reasons for this moral reasoning, but it is ultimately based in a gut-level horror at humanity and overwhelming pity for nonhuman animals. I’ve noticed that not many people are like this. Even Peter Singer seems to place every member of his own species before a member of the next.

    Yet I find Western humanitarianism baffling. Sometimes I can make sense of it as a secularization of Christianity. Secular attitudes toward Down Syndrome babies likewise smack of Christian anthropocentrism. But I feel like the level of emotion involved in Western humanitarianism suggests some hardwiring that does not bode well for the planet.

  17. In Ancient Greece, the Spartans would throw handicapped infants over a clif. Zero Down syndrome children in Sparta.

    The History Channel once showed history.

  18. Uptown Resident says “I tend strongly toward misanthropy.” Not surprising from your comments. You appear to be a high-functioning psychopath.

    • Replies: @Uptown Resident
    Lol. Very kind of you!
  19. @Uptown Resident
    Bill,

    I agree with you that, for some families, the Downs baby is not a tragedy. I have a Downs cousin who is cherished by her family.

    But even as a pregnant, emotional woman, I would enthusiastically abort a Downs fetus. And have zero qualms about it. In fact, my own feeling is that aborting a Downs fetus would be the *morally responsible* thing to do. The reasons are (1) I have limited reproductive years, and want to spend them gestating and raising children who will not only be fully independent and go on to raise their own children, but who will also be able to contribute to our civilization and perhaps to a body of knowledge; (2) there are too many humans on the planet already, and adding another consuming, polluting, destructive human to the world is justifiable only if the child will be capable of carrying on its parents' advocacy for the environment, western literature civilization, animal welfare, science, etc.

    It is worth pointing out that in poorer ages and societies, infanticide for deformed babies was the rule. Jared Diamond discusses this in The World Until Yesterday. You accuse people who would abort Down Syndrome babies of being materialistic. Arguably, it is precisely because our society is so material-rich that families even have the luxury of sparing retarded children.

    I certainly understand point #1, and respect your honesty there. However, I’m not so sympathetic on #2.

    Advocacy, as practiced in the West, counts for nothing. I consider myself a conservationist, but have feelings of contempt for environmentalists. Largely because I’ve walked the walk, living as a de-facto poor person for some time (following a divorce) with a carbon footprint on the order of your typical Albanian. Most environmentalists I’ve met are big spenders, big consumers and enormous hypocrites. I’ve never met someone with Downs syndrome, on the other hand, who regularly vacations overseas and drives a car.

    If your kid is a successful Westerner, he or she is going to burn a lot of fuel and leave a lot of trash behind. A Downs kid would work at Goodwill, take the bus and live a simple life in which going to Chuck-E-Cheese would be just as fulfilling as a trip to Milan. This is why, incidentally, it’s hard for me not to like kids with Downs syndrome.

    But I do understand the burden it puts on parents. I know how hard it is to potty train a normal kid. I’m fully aware of all the years of cleaning up shit and wiping faces and trips to the doctor, which would be magnified by maybe a factor of three for a Downs kid. If you can’t handle it, I understand. People in my generation don’t have enough kids as it is, so the burden may be intolerable.

    But for God’s sake please don’t try to justify it with some moral gymnastics about global warming and the environment. Just be honest and say you’re doing it for the same reason we used to stop nursing stricken babies and then bury them under one of those little stones you see standing with such awe-inspiring humility in old graveyards.

    • Replies: @Uptown Resident
    I understand that it's unusual, when reasoning about the morality of keeping or aborting a DS fetus, to consider the environmental or animal-welfare implications. But it's a low blow to dismiss such reasons out of hand. As a woman, there is nothing I can do to help the environment--a vegan diet, composting, conserving water, recycling, donating to PETA,etc.--that would reduce my ecological impact MORE than NOT having children. Having children simply multiplies your net ecological impact (as does population growth, at a national scale). There are many environmentalists who forego childbearing altogether out of concerns for the environment and other animals (why mainstream environmentalists no longer advocate for population stabilization/moratorium on immigration is a mystery to me). My husband and I deliberated long and hard whether or not to have children. I've always *wanted* to, having a really strong maternal instinct, but feel guilty about it. We considered how dysgenic fertility patterns are today, and figured that as well-educated, happy, affluent and healthy adults it would be better for us to have children than not to. There's also some evidence that environmentalism is heritable (Paul Watson, the Sea Shepherd captain who goes after Japanese whalers talks about this), and so we hope to pass on to our children our advocacy.

    But your suggestion that having a DS baby would be ecologically preferable having a normal baby is interesting. You're right, the DS child will probably have a lower ecological impact--but not for the reasons you mention. Most of our ecological impact comes from the food we eat. The energy and resources expended to make the grain that feeds the cow and get the final product to table. *The DS baby would be ecologically preferable in the longterm if he or she were infertile or did not have children for other reasons.* (Doug Stanhope actually has a comedy routine about this) I would guess that DS children have lower fertility rates than normal children.

    "Advocacy, as practiced in the West, counts for nothing."

    You are absolutely right (and I also have feelings of contempt for mainstream environmentalists). But I would argue that it's precisely because we think of conservation in terms of individual actions --individual carbon footprint, lifestyle choices, etc.--instead of scale. Our environmental crisis is not the result of rich Westerners driving hummers and flying around the globe. If the USA were still the nation of 2 million it was at its founding, it really wouldn't matter what people were doing. Too few to make an impact. It's the *size* of today's human population that makes all of our activities destructive. Remember that because of preindustrial fertility and mortality patterns, the human population remained always below a billion. In the West, fertility rates were kept well below the biological maximum by delaying the age of marriage, by limiting marriage to those who could support families, and by virtually no illegitimacy. (Gregory Clark discusses this demographic history at length in "A Farewell to Alms".) Our ecological crisis is the result of a population explosion (from 1 billion humans in 1800 to 7 billion and growing today) and the massive demand on resources that this unsustainably large population puts on other animals and the resources that support us all.

    Ultimately, I think it's the moral burden of humanists, especially non-religious humanists, to justify their speciesism. Why is it morally unquestionable to assert the value of the lives of all members of your species above the lives of non-members? Species is just a grouping merely reflecting (mostly) a genealogical similarity: you and I share a last common ancestor more recent than the lca we share with a chimpanzee. I appreciate the necessity of recognizing laws and governments that artificially ascribe rights to citizens, and I would like governments also to recognize certain rights of nonhuman animals (like the right not to suffer needlessly). Human children, whatever their chromosomal status, consume and eat a lot. How many individual animals does an average omnivorous American eat over the course of his life? How many of those animals suffered during their squalid and crowded lives and deaths on factory farms? Is such treatment of sentient animals (if you're a Darwinist, presumably you believe in the common origin of all species, and our own animal status) morally justifiable?
  20. WJ says:

    Such incredible ignorance and irrationality on this site regarding Down Syndrome. As a parent of a child with DS and who had the option of finding out prior to birth, I can say that many of these commenters know nothing this topic. DS is not a tragedy. They children are not grotesque ogres. They don’t inflict suffering on their parents and they don’t suffer any more than any other kid.

    To kill these kids because you don’t want them suffering is an irrational feeling. I can assure you that every one of your normal children will suffer at some point in their life and as will all of us, they will die. Get over it. If you are too lazy and self centered to have anything other than a boutique child then just simply admit it.

    • Replies: @Razib Khan
    future comments shouldn't be so dismissive about other peoples' opinions if they want to be published.
    , @Jim W
    If you believe that abortion is equivalent to murder, then I suppose you'll be against it in any case.

    If you believe abortion is morally neutral (moral equivalent of not having sex in the first place), or even in an in-between moral grey zone, then I don't see the point in keeping a fetus with serious problems when you have the option of aborting and trying again.

    Yes, everyone suffers, but on balance both the child and parents are better off (on average and all else equal) if the child does not have Down's Syndrome.
    , @Emilia
    I respect your choice to carry a Down Syndrome's child to term. My brother and sister-in-law, for instance, said that if they had conceived a Down Syndrome baby, they would have continued the pregnancy (now a moot point; they've both been sterilized). And no, I wasn't looking for a 'boutique child.' If, for instance, I was found to be carrying conjoined twins, I would have continued the pregnancy. So I wish you all the best in your parenting, but please don't disparage those who have taken, or would have taken, a different course of action.
  21. @WJ
    Such incredible ignorance and irrationality on this site regarding Down Syndrome. As a parent of a child with DS and who had the option of finding out prior to birth, I can say that many of these commenters know nothing this topic. DS is not a tragedy. They children are not grotesque ogres. They don't inflict suffering on their parents and they don't suffer any more than any other kid.

    To kill these kids because you don't want them suffering is an irrational feeling. I can assure you that every one of your normal children will suffer at some point in their life and as will all of us, they will die. Get over it. If you are too lazy and self centered to have anything other than a boutique child then just simply admit it.

    future comments shouldn’t be so dismissive about other peoples’ opinions if they want to be published.

  22. @WJ
    Such incredible ignorance and irrationality on this site regarding Down Syndrome. As a parent of a child with DS and who had the option of finding out prior to birth, I can say that many of these commenters know nothing this topic. DS is not a tragedy. They children are not grotesque ogres. They don't inflict suffering on their parents and they don't suffer any more than any other kid.

    To kill these kids because you don't want them suffering is an irrational feeling. I can assure you that every one of your normal children will suffer at some point in their life and as will all of us, they will die. Get over it. If you are too lazy and self centered to have anything other than a boutique child then just simply admit it.

    If you believe that abortion is equivalent to murder, then I suppose you’ll be against it in any case.

    If you believe abortion is morally neutral (moral equivalent of not having sex in the first place), or even in an in-between moral grey zone, then I don’t see the point in keeping a fetus with serious problems when you have the option of aborting and trying again.

    Yes, everyone suffers, but on balance both the child and parents are better off (on average and all else equal) if the child does not have Down’s Syndrome.

  23. @MattinLA
    Uptown Resident says "I tend strongly toward misanthropy." Not surprising from your comments. You appear to be a high-functioning psychopath.

    Lol. Very kind of you!

  24. @Bill P
    I certainly understand point #1, and respect your honesty there. However, I'm not so sympathetic on #2.

    Advocacy, as practiced in the West, counts for nothing. I consider myself a conservationist, but have feelings of contempt for environmentalists. Largely because I've walked the walk, living as a de-facto poor person for some time (following a divorce) with a carbon footprint on the order of your typical Albanian. Most environmentalists I've met are big spenders, big consumers and enormous hypocrites. I've never met someone with Downs syndrome, on the other hand, who regularly vacations overseas and drives a car.

    If your kid is a successful Westerner, he or she is going to burn a lot of fuel and leave a lot of trash behind. A Downs kid would work at Goodwill, take the bus and live a simple life in which going to Chuck-E-Cheese would be just as fulfilling as a trip to Milan. This is why, incidentally, it's hard for me not to like kids with Downs syndrome.

    But I do understand the burden it puts on parents. I know how hard it is to potty train a normal kid. I'm fully aware of all the years of cleaning up shit and wiping faces and trips to the doctor, which would be magnified by maybe a factor of three for a Downs kid. If you can't handle it, I understand. People in my generation don't have enough kids as it is, so the burden may be intolerable.

    But for God's sake please don't try to justify it with some moral gymnastics about global warming and the environment. Just be honest and say you're doing it for the same reason we used to stop nursing stricken babies and then bury them under one of those little stones you see standing with such awe-inspiring humility in old graveyards.

    I understand that it’s unusual, when reasoning about the morality of keeping or aborting a DS fetus, to consider the environmental or animal-welfare implications. But it’s a low blow to dismiss such reasons out of hand. As a woman, there is nothing I can do to help the environment–a vegan diet, composting, conserving water, recycling, donating to PETA,etc.–that would reduce my ecological impact MORE than NOT having children. Having children simply multiplies your net ecological impact (as does population growth, at a national scale). There are many environmentalists who forego childbearing altogether out of concerns for the environment and other animals (why mainstream environmentalists no longer advocate for population stabilization/moratorium on immigration is a mystery to me). My husband and I deliberated long and hard whether or not to have children. I’ve always *wanted* to, having a really strong maternal instinct, but feel guilty about it. We considered how dysgenic fertility patterns are today, and figured that as well-educated, happy, affluent and healthy adults it would be better for us to have children than not to. There’s also some evidence that environmentalism is heritable (Paul Watson, the Sea Shepherd captain who goes after Japanese whalers talks about this), and so we hope to pass on to our children our advocacy.

    But your suggestion that having a DS baby would be ecologically preferable having a normal baby is interesting. You’re right, the DS child will probably have a lower ecological impact–but not for the reasons you mention. Most of our ecological impact comes from the food we eat. The energy and resources expended to make the grain that feeds the cow and get the final product to table. *The DS baby would be ecologically preferable in the longterm if he or she were infertile or did not have children for other reasons.* (Doug Stanhope actually has a comedy routine about this) I would guess that DS children have lower fertility rates than normal children.

    “Advocacy, as practiced in the West, counts for nothing.”

    You are absolutely right (and I also have feelings of contempt for mainstream environmentalists). But I would argue that it’s precisely because we think of conservation in terms of individual actions –individual carbon footprint, lifestyle choices, etc.–instead of scale. Our environmental crisis is not the result of rich Westerners driving hummers and flying around the globe. If the USA were still the nation of 2 million it was at its founding, it really wouldn’t matter what people were doing. Too few to make an impact. It’s the *size* of today’s human population that makes all of our activities destructive. Remember that because of preindustrial fertility and mortality patterns, the human population remained always below a billion. In the West, fertility rates were kept well below the biological maximum by delaying the age of marriage, by limiting marriage to those who could support families, and by virtually no illegitimacy. (Gregory Clark discusses this demographic history at length in “A Farewell to Alms”.) Our ecological crisis is the result of a population explosion (from 1 billion humans in 1800 to 7 billion and growing today) and the massive demand on resources that this unsustainably large population puts on other animals and the resources that support us all.

    Ultimately, I think it’s the moral burden of humanists, especially non-religious humanists, to justify their speciesism. Why is it morally unquestionable to assert the value of the lives of all members of your species above the lives of non-members? Species is just a grouping merely reflecting (mostly) a genealogical similarity: you and I share a last common ancestor more recent than the lca we share with a chimpanzee. I appreciate the necessity of recognizing laws and governments that artificially ascribe rights to citizens, and I would like governments also to recognize certain rights of nonhuman animals (like the right not to suffer needlessly). Human children, whatever their chromosomal status, consume and eat a lot. How many individual animals does an average omnivorous American eat over the course of his life? How many of those animals suffered during their squalid and crowded lives and deaths on factory farms? Is such treatment of sentient animals (if you’re a Darwinist, presumably you believe in the common origin of all species, and our own animal status) morally justifiable?

    • Replies: @Bill P
    If people in advanced Western nations don't have kids they're hurting the environment, because eventually their populations will be replaced by people from cultures that absolutely ruin the environment. China, for example, is a toxic waste dump. It's so bad you'd have to see it to believe it (I've seen it). Africans still live a Malthusian lifestyle, much of Asia is choking under clouds of smog, Mexico is strewn with garbage and the corpses of endangered animals, etc.

    So by all means have a couple kids. But honestly, most environmentalist/progressive types I know (I'm from Seattle, so I know A LOT), put off kids because of the expense and trouble and then retroactively justify the choice based on environmentalism. It isn't exactly good for your career to have a kid, and daycare costs almost two grand a month, not to mention the extra space you'll need. This is why I can understand the impulse to abort a disabled kid, as unfortunate as it may be. Just dealing with one normal kid is much more difficult than it used to be.

    As for Watson saying that environmentalism is heritable, I think that's kind of funny. More likely it's the character trait of self-righteous fanaticism that got passed down in his case. That guy's attacks on the Makah Indians up here were so over-the-top I can't believe he has any credibility left. However, I do think certain traits, such as conscientiousness, do have something to do with conservationism. Some populations appear to be a lot more conscientious than others.

    I justify my speciesism on both religious and psychological grounds (the two are related IMO). Animals are not "conscious" beings with the ability to reflect on the world. They are immune from feelings of guilt and responsibility because they lack the ability to think in terms of analogy and metaphor. When they act, they don't do so out of some consciously articulated choice, but rather unconscious compulsion. Most human actions are the result of unconscious compulsion, too, but not all, and it is those few that are that separate us from the beasts.

    Does this mean that animals deserve to be abused? Of course not. On the contrary: it means we have an obligation to them when we use them for our purposes. This is why I think ritual slaughter, when performed in a humane manner, can be a good thing. It reinforces the idea that to kill is no trifling matter, and reminds us that our prosperity has a cost borne by others.

    Of course, I have a sort of different personal theology. I don't think there is any conflict between science and religion whatsoever, because the religious instinct is integral to what we are as human beings. It's in our biology, in other words, and I think it's inherent to all life due to the irrational "purpose" of life.

    When science and religion collide it's almost always because of mythology, and occasionally due to psychological phenomena that seem to contradict what our conscious minds consider rational. But science contradicts much of what self-declared "secular" people consider self-evident as well. For example, the idea that all people are born with equal capabilities, the fantasy that human populations are fully interchangeable, etc. So who's really secular, anyway?
  25. I had to do a double take when the phrase “widespread adoption” was used at the end of this post, due to the potential alternate reading of “widespread adoption [of babies]” as opposed to “widespread adoption [of prenatal testing]”, until the end of that long sentence when the phrase “early adopters” was used.

  26. @WJ
    Such incredible ignorance and irrationality on this site regarding Down Syndrome. As a parent of a child with DS and who had the option of finding out prior to birth, I can say that many of these commenters know nothing this topic. DS is not a tragedy. They children are not grotesque ogres. They don't inflict suffering on their parents and they don't suffer any more than any other kid.

    To kill these kids because you don't want them suffering is an irrational feeling. I can assure you that every one of your normal children will suffer at some point in their life and as will all of us, they will die. Get over it. If you are too lazy and self centered to have anything other than a boutique child then just simply admit it.

    I respect your choice to carry a Down Syndrome’s child to term. My brother and sister-in-law, for instance, said that if they had conceived a Down Syndrome baby, they would have continued the pregnancy (now a moot point; they’ve both been sterilized). And no, I wasn’t looking for a ’boutique child.’ If, for instance, I was found to be carrying conjoined twins, I would have continued the pregnancy. So I wish you all the best in your parenting, but please don’t disparage those who have taken, or would have taken, a different course of action.

  27. @Uptown Resident
    I understand that it's unusual, when reasoning about the morality of keeping or aborting a DS fetus, to consider the environmental or animal-welfare implications. But it's a low blow to dismiss such reasons out of hand. As a woman, there is nothing I can do to help the environment--a vegan diet, composting, conserving water, recycling, donating to PETA,etc.--that would reduce my ecological impact MORE than NOT having children. Having children simply multiplies your net ecological impact (as does population growth, at a national scale). There are many environmentalists who forego childbearing altogether out of concerns for the environment and other animals (why mainstream environmentalists no longer advocate for population stabilization/moratorium on immigration is a mystery to me). My husband and I deliberated long and hard whether or not to have children. I've always *wanted* to, having a really strong maternal instinct, but feel guilty about it. We considered how dysgenic fertility patterns are today, and figured that as well-educated, happy, affluent and healthy adults it would be better for us to have children than not to. There's also some evidence that environmentalism is heritable (Paul Watson, the Sea Shepherd captain who goes after Japanese whalers talks about this), and so we hope to pass on to our children our advocacy.

    But your suggestion that having a DS baby would be ecologically preferable having a normal baby is interesting. You're right, the DS child will probably have a lower ecological impact--but not for the reasons you mention. Most of our ecological impact comes from the food we eat. The energy and resources expended to make the grain that feeds the cow and get the final product to table. *The DS baby would be ecologically preferable in the longterm if he or she were infertile or did not have children for other reasons.* (Doug Stanhope actually has a comedy routine about this) I would guess that DS children have lower fertility rates than normal children.

    "Advocacy, as practiced in the West, counts for nothing."

    You are absolutely right (and I also have feelings of contempt for mainstream environmentalists). But I would argue that it's precisely because we think of conservation in terms of individual actions --individual carbon footprint, lifestyle choices, etc.--instead of scale. Our environmental crisis is not the result of rich Westerners driving hummers and flying around the globe. If the USA were still the nation of 2 million it was at its founding, it really wouldn't matter what people were doing. Too few to make an impact. It's the *size* of today's human population that makes all of our activities destructive. Remember that because of preindustrial fertility and mortality patterns, the human population remained always below a billion. In the West, fertility rates were kept well below the biological maximum by delaying the age of marriage, by limiting marriage to those who could support families, and by virtually no illegitimacy. (Gregory Clark discusses this demographic history at length in "A Farewell to Alms".) Our ecological crisis is the result of a population explosion (from 1 billion humans in 1800 to 7 billion and growing today) and the massive demand on resources that this unsustainably large population puts on other animals and the resources that support us all.

    Ultimately, I think it's the moral burden of humanists, especially non-religious humanists, to justify their speciesism. Why is it morally unquestionable to assert the value of the lives of all members of your species above the lives of non-members? Species is just a grouping merely reflecting (mostly) a genealogical similarity: you and I share a last common ancestor more recent than the lca we share with a chimpanzee. I appreciate the necessity of recognizing laws and governments that artificially ascribe rights to citizens, and I would like governments also to recognize certain rights of nonhuman animals (like the right not to suffer needlessly). Human children, whatever their chromosomal status, consume and eat a lot. How many individual animals does an average omnivorous American eat over the course of his life? How many of those animals suffered during their squalid and crowded lives and deaths on factory farms? Is such treatment of sentient animals (if you're a Darwinist, presumably you believe in the common origin of all species, and our own animal status) morally justifiable?

    If people in advanced Western nations don’t have kids they’re hurting the environment, because eventually their populations will be replaced by people from cultures that absolutely ruin the environment. China, for example, is a toxic waste dump. It’s so bad you’d have to see it to believe it (I’ve seen it). Africans still live a Malthusian lifestyle, much of Asia is choking under clouds of smog, Mexico is strewn with garbage and the corpses of endangered animals, etc.

    So by all means have a couple kids. But honestly, most environmentalist/progressive types I know (I’m from Seattle, so I know A LOT), put off kids because of the expense and trouble and then retroactively justify the choice based on environmentalism. It isn’t exactly good for your career to have a kid, and daycare costs almost two grand a month, not to mention the extra space you’ll need. This is why I can understand the impulse to abort a disabled kid, as unfortunate as it may be. Just dealing with one normal kid is much more difficult than it used to be.

    As for Watson saying that environmentalism is heritable, I think that’s kind of funny. More likely it’s the character trait of self-righteous fanaticism that got passed down in his case. That guy’s attacks on the Makah Indians up here were so over-the-top I can’t believe he has any credibility left. However, I do think certain traits, such as conscientiousness, do have something to do with conservationism. Some populations appear to be a lot more conscientious than others.

    I justify my speciesism on both religious and psychological grounds (the two are related IMO). Animals are not “conscious” beings with the ability to reflect on the world. They are immune from feelings of guilt and responsibility because they lack the ability to think in terms of analogy and metaphor. When they act, they don’t do so out of some consciously articulated choice, but rather unconscious compulsion. Most human actions are the result of unconscious compulsion, too, but not all, and it is those few that are that separate us from the beasts.

    Does this mean that animals deserve to be abused? Of course not. On the contrary: it means we have an obligation to them when we use them for our purposes. This is why I think ritual slaughter, when performed in a humane manner, can be a good thing. It reinforces the idea that to kill is no trifling matter, and reminds us that our prosperity has a cost borne by others.

    Of course, I have a sort of different personal theology. I don’t think there is any conflict between science and religion whatsoever, because the religious instinct is integral to what we are as human beings. It’s in our biology, in other words, and I think it’s inherent to all life due to the irrational “purpose” of life.

    When science and religion collide it’s almost always because of mythology, and occasionally due to psychological phenomena that seem to contradict what our conscious minds consider rational. But science contradicts much of what self-declared “secular” people consider self-evident as well. For example, the idea that all people are born with equal capabilities, the fantasy that human populations are fully interchangeable, etc. So who’s really secular, anyway?

  28. The results are interesting enough that I reviewed the full report. The false negative and false positive rates for standard screening is very much worse than the new test.

    The AUC for trisomy 21 was 0.999 for cfDNA testing and 0.958 for standard screening (P=0.001) . . .

    Primary Outcome for Trisomy 21 Screening.

    Of the 38 participants with trisomy 21 with a result on cfDNA testing, cfDNA identified all 38 cases, for a sensitivity of 100% (95% confidence interval [CI], 90.7 to 100). Standard screening identified 30 of 38 cases as positive, a sensitivity of 78.9% (95% CI, 62.7 to 90.4; P=0.008). There were 9 false positives among the 15,803 women in the cfDNA-testing group without trisomy 21, for a false positive rate of 0.06% (95% CI, 0.03 to 0.11). There were 854 false positive results for trisomy 21 on standard screening, for a false positive rate of 5.4% (95% CI, 5.1 to 5.8; P<0.001). The positive predictive value was 80.9% (95% CI, 66.7 to 90.9) for cfDNA testing and 3.4% (95% CI, 2.3 to 4.8) for standard screening (P<0.001) . . . .

    Secondary Analyses

    Trisomy 21

    Among the 11,994 women with low-risk pregnancies on the basis of a maternal age under 35 years, cfDNA testing identified 19 of 19 women with trisomy 21, with 6 false positive results. Among the 14,957 women for whom standard screening showed a risk of less than 1 in 270, cfDNA testing identified 8 of 8 women with trisomy 21, with 8 false positive results. The positive predictive value for cfDNA testing was 76.0% (95% CI, 54.9 to 90.6) for women under the age of 35 years and 50.0% (95% CI, 24.7 to 75.3) for those with a negative result on standard screening.

    Thus, the new screening test had 19 true positives and 6 false positives and no false negatives for low risk women, and 19 true positives, 3 false positives and no false negatives for high risk women.

  29. @Razib Khan
    most of the time i hear it explained as "we don't want our child to live like that." of course that's somewhat self-serving. i think it's a complicated issue in terms of the ultimate motivations. though in practice the outcomes are pretty straightforward; 50 to 90 percent terminate on positive test.

    “50 to 90 percent” is an extremely wide range. Have any more precise studies been done?

  30. @jtgw
    I notice that the moral argument in favor of aborting pre-screened DS babies is based on the emotional comfort of the parents, as if that were the most important thing.

    In this case, the parents’ emotional response to the suffering of their child is an excellent proxy for their distress at the evolutionary damage caused by a Downs child, who’ll consume substantial resources, without providing any long term genetic propagation.

    I think it quite obvious that emotional responses and social concepts like morality have evolved to fulfill evolutionary purposes, and in this context, the evolutionarily correct path is abortion.

    I would go so far as to say that parents should be legally able to euthanize, with suitable regulation, already born offspring with severe genetic defects that were undetected during pregnancy, who are likely to be massive drains on their parents and siblings’ wellbeing.

    Of course, emotional hardwiring can become obsolete and even counterproductive, such as the high rates of obesity owing to the instinct for overeating and calorie storage as fat.

    • Replies: @Sandgroper
    Agree.
    , @jtgw
    Your reasoning seems to be based on a naturalistic fallacy: we've evolved to feel certain urges and therefore we are morally obligated to obey those urges. I don't buy that kind of reasoning.
  31. I’m entertained by the thought that I have a “boutique child”.

    In an era when this is becoming increasingly possible, I don’t see why not.

    She’s not exactly how I would have designed her – I would have preferred that she had less pale, more Chinese skin. And no freckles. But that’s about it.

    She will make more of a positive contribution to humanity and alleviate more human suffering than a very high proportion of others. That’s nothing to jeer at.

  32. @Tarkmargi
    @jtgw:

    In this case, the parents' emotional response to the suffering of their child is an excellent proxy for their distress at the evolutionary damage caused by a Downs child, who'll consume substantial resources, without providing any long term genetic propagation.

    I think it quite obvious that emotional responses and social concepts like morality have evolved to fulfill evolutionary purposes, and in this context, the evolutionarily correct path is abortion.

    I would go so far as to say that parents should be legally able to euthanize, with suitable regulation, already born offspring with severe genetic defects that were undetected during pregnancy, who are likely to be massive drains on their parents and siblings' wellbeing.

    Of course, emotional hardwiring can become obsolete and even counterproductive, such as the high rates of obesity owing to the instinct for overeating and calorie storage as fat.

    Agree.

  33. I don’t see any necessity for moral reasoning to be grounded in emotion unless one insists that the ultimate premise or premises of one’s argument are by definition emotional because they are not empirically or scientifically ascertainable or verifiable. No doubt one’s temperament or the emotional impact of one’s life experience will help determine one’s choice of moral premises but it does not follow that one’s personal emotion *has to be* a determining element in the moral rules one subscribes to – though it may well be if one holds inconsistent positions simultaneously.

    My confident assertions can be tested against my totally godless moral reasoning which starts with the proposition that a viable human community must be able to rely on most (nearly all) people expecting that most people will honour some reasonably well defined rules. So there must be rules unless – and here you can accuse me of emotionalism if you like – one is willing to accept a Hobbesian war of all against all as a version of the human condition. So what rules will work? Clearly real world facts could make a considerable difference if only in the emphasis that one would put on one rule or situation or another. Effective pain control is one such factual input of major if not unambiguous import. But how do we live together so as to cause as little pain or strife as may be practicable, with the further condition, express or implicit, that we allow for the maximum self-determination by informed consenting persons? As far as possible we refrain from coercion while we engage in discussion of possible rules and decisions to achieve some kind of Pareto optimum solution. The “discussion” can be the unemotional moral reasoning in one’s own head. N’est-ce pas, Razib?

    None of this, it scarcely needs saying, leaves much scope for those with a special line to a bossy deity who cares or who have personal visceral love of foetuses to lay down rules against abortion which are enforceable by any kind of legsl or social punishment. Nonetheless, I don’t think I would have a problem criticising a healthy married woman for having an abortion who did it without any financial or career pressure or any psychiatric or medical reason pertaining to herself or the foetus at all if she did it without telling her husband or against his wishes and there was a likelihood that she couldn’t become pregnant again with her husband. But it certainly has no public interest element in it to justify making it a criminal legal issue.

  34. @Tarkmargi
    @jtgw:

    In this case, the parents' emotional response to the suffering of their child is an excellent proxy for their distress at the evolutionary damage caused by a Downs child, who'll consume substantial resources, without providing any long term genetic propagation.

    I think it quite obvious that emotional responses and social concepts like morality have evolved to fulfill evolutionary purposes, and in this context, the evolutionarily correct path is abortion.

    I would go so far as to say that parents should be legally able to euthanize, with suitable regulation, already born offspring with severe genetic defects that were undetected during pregnancy, who are likely to be massive drains on their parents and siblings' wellbeing.

    Of course, emotional hardwiring can become obsolete and even counterproductive, such as the high rates of obesity owing to the instinct for overeating and calorie storage as fat.

    Your reasoning seems to be based on a naturalistic fallacy: we’ve evolved to feel certain urges and therefore we are morally obligated to obey those urges. I don’t buy that kind of reasoning.

    • Replies: @Tarkmargi
    I'm the last person to suggest following urges just because the exist. As I mentioned above, in this particular case, the emotion seems to be consonant with the evolutionarily correct path, hence it should be followed.

    As I mentioned in my last paragraph, emotions and urges can become obsolete or counterproductive due to rapid environmental change. So I would strongly suggest that obese people reject their urge to over consume.

    To give another example, the instinct of empathy, in my view, has evolved to compel one to part with scarce resources and help out fellow citizens in times of need, who can then return the favor, thus improving group fitness. However, now that far fewer people are in dire need compared to when the instinct evolved, it seems to be leaking out to animals who cannot reciprocate our help, and are therefore not viable candidates for this emotion. Thus the animals rights movement, or the whale worship evident in Western society today.

    May I suggest that perhaps your defence of the unborn Down's fetus is also a result of a similarly misplaced empathy?

    All this is of course, my interpretation and I remain open to changing it when faced with better analysis or new information.
  35. @jtgw
    Your reasoning seems to be based on a naturalistic fallacy: we've evolved to feel certain urges and therefore we are morally obligated to obey those urges. I don't buy that kind of reasoning.

    I’m the last person to suggest following urges just because the exist. As I mentioned above, in this particular case, the emotion seems to be consonant with the evolutionarily correct path, hence it should be followed.

    As I mentioned in my last paragraph, emotions and urges can become obsolete or counterproductive due to rapid environmental change. So I would strongly suggest that obese people reject their urge to over consume.

    To give another example, the instinct of empathy, in my view, has evolved to compel one to part with scarce resources and help out fellow citizens in times of need, who can then return the favor, thus improving group fitness. However, now that far fewer people are in dire need compared to when the instinct evolved, it seems to be leaking out to animals who cannot reciprocate our help, and are therefore not viable candidates for this emotion. Thus the animals rights movement, or the whale worship evident in Western society today.

    May I suggest that perhaps your defence of the unborn Down’s fetus is also a result of a similarly misplaced empathy?

    All this is of course, my interpretation and I remain open to changing it when faced with better analysis or new information.

    • Replies: @jtgw
    You're still relying on a naturalistic fallacy. What's "evolutionarily correct" is not necessarily what's morally correct.
  36. @Tarkmargi
    I'm the last person to suggest following urges just because the exist. As I mentioned above, in this particular case, the emotion seems to be consonant with the evolutionarily correct path, hence it should be followed.

    As I mentioned in my last paragraph, emotions and urges can become obsolete or counterproductive due to rapid environmental change. So I would strongly suggest that obese people reject their urge to over consume.

    To give another example, the instinct of empathy, in my view, has evolved to compel one to part with scarce resources and help out fellow citizens in times of need, who can then return the favor, thus improving group fitness. However, now that far fewer people are in dire need compared to when the instinct evolved, it seems to be leaking out to animals who cannot reciprocate our help, and are therefore not viable candidates for this emotion. Thus the animals rights movement, or the whale worship evident in Western society today.

    May I suggest that perhaps your defence of the unborn Down's fetus is also a result of a similarly misplaced empathy?

    All this is of course, my interpretation and I remain open to changing it when faced with better analysis or new information.

    You’re still relying on a naturalistic fallacy. What’s “evolutionarily correct” is not necessarily what’s morally correct.

    • Replies: @Tarkmargi
    My hypothesis, as I mentioned in my first post, is that morality and instinct are social and individual level behavior traits which have evolved to achieve evolutionary aims.

    For instance, the universal prohibition of theft or murder or dishonesty, ties in quite well with the obvious detrimental impact of these actions on social fitness.

    A very convincing example is that of incest. Incest, when between mutually consenting adults, does not involve force or fraud, yet is still illegal and socially prohibited almost everywhere. Is it merely a coincidence that widely separated societies have all evolved to ban this practice independently?In my view, if a pattern recurs repeatedly and persists, there is likely a macroscopic reason for it.

    With the advent of genetics, it has become clear that incest greatly increases the risk of homogenous recessive genetic disorders. Thus we see that multiple societies have independently evolved norms that are quite convincingly evolutionary in nature.

    On the basis of this kind of reasoning, I have reached the conclusion that "morality" is a set of group level behaviors evolved to fulfill evolutionary purposes. The same applies to individual level instincts like pursuit of pleasure (food, sex etc which improve evolutionary fitness) or avoidance of pain (a proxy for injury or social rejection which diminish evolutionary fitness).

    Thus it seems quite clear that morality/instincts are a means of mediating evolutionary goals and is not independent of it.

    In cases where these norms/instincts conflict with explicitly stated evolutionary goals, such as the in the example of obesity caused by the obsolete instinct to over consume, I think it more rational to ignore the instinct or social norm in favor of evolutionary fitness.
  37. @jtgw
    You're still relying on a naturalistic fallacy. What's "evolutionarily correct" is not necessarily what's morally correct.

    My hypothesis, as I mentioned in my first post, is that morality and instinct are social and individual level behavior traits which have evolved to achieve evolutionary aims.

    For instance, the universal prohibition of theft or murder or dishonesty, ties in quite well with the obvious detrimental impact of these actions on social fitness.

    A very convincing example is that of incest. Incest, when between mutually consenting adults, does not involve force or fraud, yet is still illegal and socially prohibited almost everywhere. Is it merely a coincidence that widely separated societies have all evolved to ban this practice independently?In my view, if a pattern recurs repeatedly and persists, there is likely a macroscopic reason for it.

    With the advent of genetics, it has become clear that incest greatly increases the risk of homogenous recessive genetic disorders. Thus we see that multiple societies have independently evolved norms that are quite convincingly evolutionary in nature.

    On the basis of this kind of reasoning, I have reached the conclusion that “morality” is a set of group level behaviors evolved to fulfill evolutionary purposes. The same applies to individual level instincts like pursuit of pleasure (food, sex etc which improve evolutionary fitness) or avoidance of pain (a proxy for injury or social rejection which diminish evolutionary fitness).

    Thus it seems quite clear that morality/instincts are a means of mediating evolutionary goals and is not independent of it.

    In cases where these norms/instincts conflict with explicitly stated evolutionary goals, such as the in the example of obesity caused by the obsolete instinct to over consume, I think it more rational to ignore the instinct or social norm in favor of evolutionary fitness.

    • Replies: @jtgw
    Prohibitions against theft, murder and dishonesty are not universal. Read Peter Frost's columns here.

    However, I believe that theft, murder and dishonesty are universally immoral, despite the fact that not all cultures prohibit them absolutely in the way modern Western culture (mostly) does. More often, cultures treat in-groups and out-groups, or kin and non-kin, differently: you may be free to kill strangers, but not members of your family, for instance. Your notion that all humans have the same evolved instinct to avoid murder is parochial and false. But I believe your moral intuitions in this instance happen to be correct. It just goes to show that what's moral and what our instincts tell us to do are not necessarily the same (which isn't news to Christians, at any rate).
  38. @Jim W
    I expect a massive decrease in Down Syndrome incidence.

    This is the biggest issue that makes me pro-choice. I wonder why this topic never comes up in the abortion debate. When I became a parent, I was extremely grateful for the opportunity to do pre-screening for problems like these, with the option available for abortion.

    This is the biggest issue that makes me pro-choice. I wonder why this topic never comes up in the abortion debate.

    Probably because anyone who would entertain the idea of abortion as a way to reduce birth defects would have to be pro-choice to start with? Arguing for abortion because of its material benefits would only be effective against an opponent who does not feel that abortion is the killing of a person, which rules out the vast majority of people you would be having the debate with.

    To the ears of someone who believes abortion is murder, bringing up kids with birth defects as an argument for abortion would be like arguing for legalizing the euthanasia of special ed kids.

    So bringing the issue up in a debate would imply one of two accusations: either the pro-lifers would be willing to euthanize special ed children, or that they are lying about what they believe about abortion.

    • Replies: @Jim W
    I don't think everyone is firmly ensconced on one side of the debate or other. There are many who will change their views based on arguments (I think this is true of almost all issues, by the way). Personally, some common pro-choice arguments seem facile and morally abhorrent to me (eg, women have the right to do what they want with their bodies, which implies that they also have no responsibility for the health of a fetus they bring to term).

    With women having babies at later ages, and with better screening technologies, it's just hard to imagine people would ever allow the state to demand they carry a fetus to term that has serious problems such as Down's Syndrome. You are correct, though, that one needs to come up with a logical argument justifying abortion in these cases while also not condoning euthanasia for babies with serious defects, and thereby coming across as monstrous to the majority population. Personally, I do think a policy like this would be a good idea, like some of the previous commentators, but it is a step way too far with respect to popular opinion.
  39. @Tarkmargi
    My hypothesis, as I mentioned in my first post, is that morality and instinct are social and individual level behavior traits which have evolved to achieve evolutionary aims.

    For instance, the universal prohibition of theft or murder or dishonesty, ties in quite well with the obvious detrimental impact of these actions on social fitness.

    A very convincing example is that of incest. Incest, when between mutually consenting adults, does not involve force or fraud, yet is still illegal and socially prohibited almost everywhere. Is it merely a coincidence that widely separated societies have all evolved to ban this practice independently?In my view, if a pattern recurs repeatedly and persists, there is likely a macroscopic reason for it.

    With the advent of genetics, it has become clear that incest greatly increases the risk of homogenous recessive genetic disorders. Thus we see that multiple societies have independently evolved norms that are quite convincingly evolutionary in nature.

    On the basis of this kind of reasoning, I have reached the conclusion that "morality" is a set of group level behaviors evolved to fulfill evolutionary purposes. The same applies to individual level instincts like pursuit of pleasure (food, sex etc which improve evolutionary fitness) or avoidance of pain (a proxy for injury or social rejection which diminish evolutionary fitness).

    Thus it seems quite clear that morality/instincts are a means of mediating evolutionary goals and is not independent of it.

    In cases where these norms/instincts conflict with explicitly stated evolutionary goals, such as the in the example of obesity caused by the obsolete instinct to over consume, I think it more rational to ignore the instinct or social norm in favor of evolutionary fitness.

    Prohibitions against theft, murder and dishonesty are not universal. Read Peter Frost’s columns here.

    However, I believe that theft, murder and dishonesty are universally immoral, despite the fact that not all cultures prohibit them absolutely in the way modern Western culture (mostly) does. More often, cultures treat in-groups and out-groups, or kin and non-kin, differently: you may be free to kill strangers, but not members of your family, for instance. Your notion that all humans have the same evolved instinct to avoid murder is parochial and false. But I believe your moral intuitions in this instance happen to be correct. It just goes to show that what’s moral and what our instincts tell us to do are not necessarily the same (which isn’t news to Christians, at any rate).

    • Replies: @Tarkmargi
    I believe you misunderstand. As I mentioned above, contrary to what you seem to believe, I'm actually a strong opponent of drifting along with emotional impulses to reach decisions. Hence, as I pointed out earlier, I oppose animal rights and support parents' rights to euthanize irremediably severely genetically diseased offspring. These decisions run against my natural empathy, but I disregard that instinct in favor of a more rational long term evolution based decision process because, as I mention above, morality is best understood as a system evolved to further evolutionary aims.

    In cases where traditional moral norms or instincts become counterproductive due to rapid social change, I would disregard them in favor of a more clear headed evolution friendly decision.

    While it is true that there is a variation in in-group/out-group application of prohibitions against murder etc, the best explanation seems to be the variable evolutionary histories behind the different groups. It seems that those populations which have a long history of socialization and experience of centralized states have much more expansive prohibitions against murder irrespective of whether they are Christians or not (just ask the secular Eurpoeans or secular humanists of Amnesty or Human rights watch), whereas populations that are less socialized are more Hobbesian about this.

    It is worth mentioning that Christian conquistadors used Christian justifications to massacre the natives, among numerous examples of Christian disregard for out-group suffering.

    Given the empirically unsupported mythology in which various religions, including Christianity, are embedded and the widely divergent interpretations they enable, they are unreliable moral compasses, in my view, as are hardwired instincts.

    Hence my emphasis of rational consideration of evolutionary purposes, to fulfill which, it seems to me, traditional religions or instincts have evolved. Both these may however, end up on occasion becoming obsolete, so only a rational process is absolutely reliable.
  40. @Glaivester
    This is the biggest issue that makes me pro-choice. I wonder why this topic never comes up in the abortion debate.

    Probably because anyone who would entertain the idea of abortion as a way to reduce birth defects would have to be pro-choice to start with? Arguing for abortion because of its material benefits would only be effective against an opponent who does not feel that abortion is the killing of a person, which rules out the vast majority of people you would be having the debate with.

    To the ears of someone who believes abortion is murder, bringing up kids with birth defects as an argument for abortion would be like arguing for legalizing the euthanasia of special ed kids.

    So bringing the issue up in a debate would imply one of two accusations: either the pro-lifers would be willing to euthanize special ed children, or that they are lying about what they believe about abortion.

    I don’t think everyone is firmly ensconced on one side of the debate or other. There are many who will change their views based on arguments (I think this is true of almost all issues, by the way). Personally, some common pro-choice arguments seem facile and morally abhorrent to me (eg, women have the right to do what they want with their bodies, which implies that they also have no responsibility for the health of a fetus they bring to term).

    With women having babies at later ages, and with better screening technologies, it’s just hard to imagine people would ever allow the state to demand they carry a fetus to term that has serious problems such as Down’s Syndrome. You are correct, though, that one needs to come up with a logical argument justifying abortion in these cases while also not condoning euthanasia for babies with serious defects, and thereby coming across as monstrous to the majority population. Personally, I do think a policy like this would be a good idea, like some of the previous commentators, but it is a step way too far with respect to popular opinion.

  41. @jtgw
    Prohibitions against theft, murder and dishonesty are not universal. Read Peter Frost's columns here.

    However, I believe that theft, murder and dishonesty are universally immoral, despite the fact that not all cultures prohibit them absolutely in the way modern Western culture (mostly) does. More often, cultures treat in-groups and out-groups, or kin and non-kin, differently: you may be free to kill strangers, but not members of your family, for instance. Your notion that all humans have the same evolved instinct to avoid murder is parochial and false. But I believe your moral intuitions in this instance happen to be correct. It just goes to show that what's moral and what our instincts tell us to do are not necessarily the same (which isn't news to Christians, at any rate).

    I believe you misunderstand. As I mentioned above, contrary to what you seem to believe, I’m actually a strong opponent of drifting along with emotional impulses to reach decisions. Hence, as I pointed out earlier, I oppose animal rights and support parents’ rights to euthanize irremediably severely genetically diseased offspring. These decisions run against my natural empathy, but I disregard that instinct in favor of a more rational long term evolution based decision process because, as I mention above, morality is best understood as a system evolved to further evolutionary aims.

    In cases where traditional moral norms or instincts become counterproductive due to rapid social change, I would disregard them in favor of a more clear headed evolution friendly decision.

    While it is true that there is a variation in in-group/out-group application of prohibitions against murder etc, the best explanation seems to be the variable evolutionary histories behind the different groups. It seems that those populations which have a long history of socialization and experience of centralized states have much more expansive prohibitions against murder irrespective of whether they are Christians or not (just ask the secular Eurpoeans or secular humanists of Amnesty or Human rights watch), whereas populations that are less socialized are more Hobbesian about this.

    It is worth mentioning that Christian conquistadors used Christian justifications to massacre the natives, among numerous examples of Christian disregard for out-group suffering.

    Given the empirically unsupported mythology in which various religions, including Christianity, are embedded and the widely divergent interpretations they enable, they are unreliable moral compasses, in my view, as are hardwired instincts.

    Hence my emphasis of rational consideration of evolutionary purposes, to fulfill which, it seems to me, traditional religions or instincts have evolved. Both these may however, end up on occasion becoming obsolete, so only a rational process is absolutely reliable.

    • Replies: @jtgw
    If you're disregarding your natural empathy, then you're not relying on your emotions.

    Anyway, you can't logically get from is to ought, as Hume demonstrated a long time ago. Your Social Darwinism just takes as axiomatic that what is evolutionarily ideal is also what is moral. I don't accept that axiom.
  42. @Tarkmargi
    I believe you misunderstand. As I mentioned above, contrary to what you seem to believe, I'm actually a strong opponent of drifting along with emotional impulses to reach decisions. Hence, as I pointed out earlier, I oppose animal rights and support parents' rights to euthanize irremediably severely genetically diseased offspring. These decisions run against my natural empathy, but I disregard that instinct in favor of a more rational long term evolution based decision process because, as I mention above, morality is best understood as a system evolved to further evolutionary aims.

    In cases where traditional moral norms or instincts become counterproductive due to rapid social change, I would disregard them in favor of a more clear headed evolution friendly decision.

    While it is true that there is a variation in in-group/out-group application of prohibitions against murder etc, the best explanation seems to be the variable evolutionary histories behind the different groups. It seems that those populations which have a long history of socialization and experience of centralized states have much more expansive prohibitions against murder irrespective of whether they are Christians or not (just ask the secular Eurpoeans or secular humanists of Amnesty or Human rights watch), whereas populations that are less socialized are more Hobbesian about this.

    It is worth mentioning that Christian conquistadors used Christian justifications to massacre the natives, among numerous examples of Christian disregard for out-group suffering.

    Given the empirically unsupported mythology in which various religions, including Christianity, are embedded and the widely divergent interpretations they enable, they are unreliable moral compasses, in my view, as are hardwired instincts.

    Hence my emphasis of rational consideration of evolutionary purposes, to fulfill which, it seems to me, traditional religions or instincts have evolved. Both these may however, end up on occasion becoming obsolete, so only a rational process is absolutely reliable.

    If you’re disregarding your natural empathy, then you’re not relying on your emotions.

    Anyway, you can’t logically get from is to ought, as Hume demonstrated a long time ago. Your Social Darwinism just takes as axiomatic that what is evolutionarily ideal is also what is moral. I don’t accept that axiom.

    • Replies: @Tarkmargi
    I only follow emotions/traditional norms when they make evolutionary sense, given the clear correlation between emotions/morality and evolutionary purposes; and the fact these emotions/moral norms can become obsolete with rapid social changes.

    Can I request you to elaborate on what logical basis you use to determine what is moral?
  43. @jtgw
    If you're disregarding your natural empathy, then you're not relying on your emotions.

    Anyway, you can't logically get from is to ought, as Hume demonstrated a long time ago. Your Social Darwinism just takes as axiomatic that what is evolutionarily ideal is also what is moral. I don't accept that axiom.

    I only follow emotions/traditional norms when they make evolutionary sense, given the clear correlation between emotions/morality and evolutionary purposes; and the fact these emotions/moral norms can become obsolete with rapid social changes.

    Can I request you to elaborate on what logical basis you use to determine what is moral?

    • Replies: @jtgw
    I'm an Orthodox Christian and base my morals in the traditional teachings of my church. I don't see this as any less rational than your Darwinism-based morality. I don't believe that maximizing the fitness of my offspring/race/species is the ultimate purpose of my life, so your insistence that morality conform to evolutionary needs falls flat. It doesn't sound like we can do more than agree to disagree on this subject.
  44. @Tarkmargi
    I only follow emotions/traditional norms when they make evolutionary sense, given the clear correlation between emotions/morality and evolutionary purposes; and the fact these emotions/moral norms can become obsolete with rapid social changes.

    Can I request you to elaborate on what logical basis you use to determine what is moral?

    I’m an Orthodox Christian and base my morals in the traditional teachings of my church. I don’t see this as any less rational than your Darwinism-based morality. I don’t believe that maximizing the fitness of my offspring/race/species is the ultimate purpose of my life, so your insistence that morality conform to evolutionary needs falls flat. It doesn’t sound like we can do more than agree to disagree on this subject.

    • Replies: @Tarkmargi
    I note that you give no particular empirical reason for following your preferred set of axioms. Based on this and prior experience, I'm left to conclude that mere acculturation since childhood has left you so attached to the beliefs that were taught to you that you care not to wonder and wander beyond. Much the same is true of practically all traditional religions.

    Nonetheless, I agree that further discussion is not worthwhile for both of us. I wish you well and thank you for your time and decorum.
  45. @jtgw
    I'm an Orthodox Christian and base my morals in the traditional teachings of my church. I don't see this as any less rational than your Darwinism-based morality. I don't believe that maximizing the fitness of my offspring/race/species is the ultimate purpose of my life, so your insistence that morality conform to evolutionary needs falls flat. It doesn't sound like we can do more than agree to disagree on this subject.

    I note that you give no particular empirical reason for following your preferred set of axioms. Based on this and prior experience, I’m left to conclude that mere acculturation since childhood has left you so attached to the beliefs that were taught to you that you care not to wonder and wander beyond. Much the same is true of practically all traditional religions.

    Nonetheless, I agree that further discussion is not worthwhile for both of us. I wish you well and thank you for your time and decorum.

    • Replies: @jtgw
    I'm sorry but I really feel I have to respond to your ad hominem. I was not raised Orthodox and I was an atheist for several years. And I don't believe that you can derive morals through inductive, empirical inquiry; that's what I meant when I cited Hume on the impossibility of logically deriving ought-statements from is-statements. That's one reason I abandoned atheism: as far as I can see, moral axioms cannot be derived by reason or observation alone.

    I think this is an interesting conversation but we'd best take it off this comments thread. I've linked to my Google+ account if you want to get in touch.
  46. jtgw says: • Website
    @Tarkmargi
    I note that you give no particular empirical reason for following your preferred set of axioms. Based on this and prior experience, I'm left to conclude that mere acculturation since childhood has left you so attached to the beliefs that were taught to you that you care not to wonder and wander beyond. Much the same is true of practically all traditional religions.

    Nonetheless, I agree that further discussion is not worthwhile for both of us. I wish you well and thank you for your time and decorum.

    I’m sorry but I really feel I have to respond to your ad hominem. I was not raised Orthodox and I was an atheist for several years. And I don’t believe that you can derive morals through inductive, empirical inquiry; that’s what I meant when I cited Hume on the impossibility of logically deriving ought-statements from is-statements. That’s one reason I abandoned atheism: as far as I can see, moral axioms cannot be derived by reason or observation alone.

    I think this is an interesting conversation but we’d best take it off this comments thread. I’ve linked to my Google+ account if you want to get in touch.

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