by Laura Burden
It shouldn’t be surprising that there were three news
stories featuring people who have Down’s syndrome during the summer. It is,
after all, one of the most common disabilities, occurring at the rate of one
per 1,000 births globally. It is even less surprising that the features
concentrated upon the young.
One heart-warming story was of the actor Daniel Laurie
becoming the first person with Down’s syndrome to be accepted for the summer
course for the Royal Central School of Speech and Drama. Acting is an area in
which those with the condition have traditionally met with success: a glance at
Wikipedia’s page “Notable Individuals with Down Syndrome” (sic) suggests that
many have enjoyed positive careers in theatre. Daniel Laurie, a teenager,
interviewed on BBC Radio 4’s Saturday
Live on 9th August. He was articulate, funny, and evidently
excited about his achievement.
The second story is a sad one and it provoked international
outrage. A Thai mother reported that she had entered into a surrogacy
arrangement with an Australian couple and had given birth to twins – one
healthy girl and one boy with Down’s syndrome and an attendant heart condition.
She claimed that the Australian couple had abandoned their disabled child and
that she would struggle to care for the little boy, who she had named Gammy.
Within a week, an online fundraising campaign titled “Hope for Gammy” had
raised £88,000. The biological parents made counter (and, at times,
contradictory) claims that their surrogate had threatened to abort both children
and had wanted to keep the male child, but the revelation that Gammy’s natural
father had prior convictions for sexual offences against children did little to
strengthen their case. The story subsided from global media attention with the
Australian government moving towards banning international surrogacy: Gammy, a
classically adorable baby with blue eyes, presumably remains in Thailand.
And where would we be without Richard Dawkins to reduce
every moral issue to 140 characters? A twitter user, InYourFaceNewYorker,
tweeted, “I honestly don’t know what I would do if I were pregnant with a kid
with Down syndrome. Real ethical dilemma.” Dawkins’ response was swift and
succinct: “Abort it and try again. It would be immoral to bring it into the
world if you have the choice.” In the ensuing furore, which evangelical
Christians, disability rights activists, and trolls happily pitched into, a few
themes emerged from the online postings. One was that Dawkins is a figure who
provokes strong responses, with several posters hysterically equating atheism
with neo-Nazi eugenics. The second is that few engaged with the idea of a
Down’s syndrome foetus as a person – all references were to a child. A user of
The Guardian website, darkflowering, ended her post with the following
comment: “A child dancing, whatever
their genetic vulnerabilities, is closer to life and its meaning than an aging
scientific arrogance that condemns the very source of their intellect, the
body, to an inferior place in the scheme of things.”
For me, the key consideration is the final word of Dawkins’
original tweet: choice. Abortion always involves a choice and I am a firm
supporter of a woman’s right to choose. Even the Down’s Syndrome Association,
the UK’s premier charity that supports those with the condition, takes great
care to promote the truth that those with Down’s syndrome can lead a “full
life” but acknowledges that each family must make its own decision. Many, of
course, view abortion as being wrong in all circumstances. In my view, the choice
to abort a foetus with Down’s syndrome can, indeed, be a moral one.
A reasonably common misconception is that those born with
Down’s syndrome die young. They don’t. Before the Second World War this was
probably the case, but it was largely down to the fact that, at the time,
medical science had not advanced to the extent that the congenital heart
diseases that around 40% of them are born with (Gammy is an example of this)
could be treated successfully. Childhood mortality was high. These days, in
Europe or the United States, the average life expectancy of a person who has
Down’s syndrome is between 50 and 60.
This increased life expectancy has raised new issues.
Increased genetic material from chromosome 21 results in an enhanced chance of
dementia. The Alzheimer’s society estimates that elderly people with Down’s
syndrome are six times more likely to develop Alzheimer’s than the general
population. As they face this difficult ending to life, many are supported by
friends and family. But many are not. Down’s syndrome people are – possibly
owing to the increased prevalence of the condition in older mothers – often the
youngest of a family or the only child. By the time they reach their sixties,
their loving parents, who wanted them so badly whatever their condition, may
well be dead. Some, of course, will have been given up for adoption at birth
and their stay in a home for patients with dementia will merely be the final
phase of a life spent in the care system. Some will have developed other
complications – I know two people with the condition who have never been able
to speak or to become continent owing to the extremity of their condition and
complications following severe seizures (which also seem to be linked to an
additional chromosome 21 and increase with age).
There is also the issue of care itself. Most residential or
supported living environments for those with learning disabilities are
delightful places with dedicated staff. Anyone who saw the Panorama exposure of the horrific abuse at Winterbourne View will
know that there are some grave exceptions to this rule. Even the best places
cannot always provide continuity of care – many have licences to house
residents below the age of sixty, meaning that some have to seek alternative
accommodation in their old age. As time has passed, individuals may be facing
these challenges and adjustments alone (and, hopefully, with the support of a
good social worker if they have no family to fight their battles).
No two individuals with Down’s syndrome are identical (and,
certainly, they do not all have “really loving personalities” any more than
those with the usual complement of chromosomes do). Some excel in a particular
field. Some are not only literate but gain GCSEs and other qualifications. Some
hold down paid work. Some marry. At the other extremity, some never move on
from nappies and never learn to speak. My brother is somewhere in between –
healthy, happy and greatly loved but unable to read and write, or to live
independently. When he is sixty, I will be sixty-six and, sadly, if my parents
are still living, they will be in their nineties.
So, returning to the recent portrayals of Down’s syndrome in
the media, I would like to see less of a focus on individuals with the
condition who are children. Gammy’s wide blue eyes provoked outrage and
compassion from around the globe but I suspect that an adult (probably
struggling to shave and manage their weight – the average height of an adult
male with Down’s syndrome is 5’1’’) would not pull at heartstrings in the same
way, irrespective of the pathos of their particular situation. Richard Dawkins
presented terminating a foetus with the condition as a necessary moral choice
and anyone who looked at a picture of Gammy or listened to Daniel Laurie could
easily abhor this view. The choice resides with the family concerned. A foetus
who has Down’s syndrome, however, is not a baby, nor a toddler, nor a child. He
or she is a person who, like everyone else, must face the process of ageing.
It’s not merely the duration of a childhood that is under consideration, but
the span of a life.
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