Foetal reduction is the dark side of the moon of fertility treatment. All too often women who become pregnant have twins or triplets. Since this involves medical and social risks, one or more of the foetuses are "reduced", ie, aborted. It is a procedure which few outside the industry are aware of. Freelance journalist Ruth Padawer has just written a feature in the New York Times Magazine shedding light on its bioethical dilemmas.
About 5-20% of pregnancies from fertility drugs are twins or higher, according to the American Society for Reproductive Medicine, and half of babies conceived using through IVF are part of a multiple pregnancy.
About 5-20% of pregnancies from fertility drugs are twins or higher, according to the American Society for Reproductive Medicine, and half of babies conceived using through IVF are part of a multiple pregnancy.
"For all its successes," writes Padawer, "reproductive medicine has produced a paradox: in creating life where none seemed possible, doctors often generate more fetuses than they intend. In the mid-1980s, they devised an escape hatch to deal with these mega-pregnancies, terminating all but two or three fetuses to lower the risks to women and the babies they took home."
But now foetal reduction is being offered for social reasons -- as an option for women who could not stand the stress of having twins.
But now foetal reduction is being offered for social reasons -- as an option for women who could not stand the stress of having twins.
Columnist Ross Douthat complained that the growing acceptance of "foetal reduction", or the abortion of one or more foetuses in a multiple birth, illustrated the failure of "liberal" thinkers to say No to anything. The column has been whizzing around the blogosphere, creating much comment.
Douthat points out that the leading advocate of foetal reduction, Dr Mark Evans, changed his mind between 1988 and 2004. At first he declared that most reductions below twins was unethical. Doctors should not be "technicians to our patients' desires." But 20 years later, Evans endorsed the abortion of a twin because older women find twin too difficult.
Douthat concludes:
From embryo experimentation to selective reduction to the eugenic uses of abortion, liberals always promise to draw lines and then never actually manage to draw them. Like Dr. Evans, they find reasons to embrace each new technological leap while promising to resist the next one -- and then time passes, science marches on, and they find reasons why the next moral compromise, too, must be accepted for the greater good, or at least tolerated in the name of privacy and choice. You can always count on them to worry, often perceptively, about hypothetical evils, potential slips down the bioethical slope. But they're either ineffectual or accommodating once an evil actually arrives. Tomorrow, they always say -- tomorrow, we'll draw the line. But tomorrow never comes.
Related reading: The Two-Minus-One Pregnancy; The Failure of Liberal Ethics
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