Autism, abortion and prenatal screening
The news that scientists may soon be able to develop a prenatal test for autism, which would allow us to terminate pregnancies where there is evidence of autism spectrum disorders, must lead to a public debate about the ethical and unethical use of that new knowledge. We can expect inevitable and mostly inaccurate comparisons with Nazi eugenics programmes, and the hasty deployment of the phrase "playing God". But this subject requires a calm head and a careful analysis.
The director of the Cambridge University autism research team, Simon Baron-Cohen, is right to call for an ethical debate ahead of a viable prenatal test. Autism is a condition that sometimes blesses the human population with mathematical geniuses and brilliant artists; but in many other cases the condition produces extreme learning difficulties. Professor Baron-Cohen helpfully lays out some of the issues at stake in a public debate here.
Coincidentally, this research is being published just as a new biography of the Nobel Prize-winning physicist Paul Dirac suggests that the man sometimes described as "Britain's Einstein" gave evidence of undiagnosed autism. Earlier this year, Michael Fitzgerald, a professor of psychiatry at Trinity College, Dublin, argued that Isaac Newton, Immanuel Kant, Albert Einstein, George Orwell, H G Wells and Ludwig Wittgenstein all showed signs of autism, as did Beethoven, Mozart, Hans Christian Andersen. Professor Fitzgerald believes that "genes for autism/Asperger's, and creativity are essentially the same".
One thing is clear: the test itself is not the issue. A prenatal screening test would not only offer parents the opportunity to terminate a pregnancy, it could also provide an early warning system enabling parents to prepare for the arrival of an autistic child. At present, children often reach the age of two or three before a diagnosis of autism is considered. (A side-note: when I suggest that the test itself is not the issue, I accept, of course, that prenatal testing is always freighted with ethical questions, to the extent that all testing can pose risks for the developing foetus.)
Another thing is clear: the analogy sometimes drawn between autism and Down's Syndrome is mostly unhelpful. These conditions, though sometimes diagnosed together, are different conditions and they affect children and adults differently. The moral argument for termination in the case of Down's Syndrome cannot be simply extended, mutatis mutandis, to autism spectrum disorders. The moral case for termination in the case of autism needs to be made independently. The simplest form of that case would be an argument based on the likely negative impact of this condition on the child's life and the burden the condition could place on the shoulders of the child's parents. But the argument would have to also consider the likely impact on society, as a whole, of removing some extremely creative people from our future. It would also have to consider that as many as one in 150 children could be diagnosed at some point on the autism spectrum, as opposed to one in 800 in the case of Down's Syndrome.
(Note about picture: This blackboard features the handwriting of Albert Einstein, who is thought by some experts to have been autistic. Typically, when autism is covered in the press, the image of a child with a learning disability is often used to illustrate the story. Both images are fair illustrations, but the one I've chosen challenges some common misapprehensions.)