Is pre-natal genetic testing morally permissible?
A genetic disorder is a consequence of defects in single genes or in whole chromosomes, parts of which may be lost, duplicated, or misplaced. It may also be due to the interaction of multiple genes with external factors in fetal or early post-natal development.
Ongoing research has permitted scientists to identify the genetic basis of many diseases. At the same time, it has allowed the development of tests to detect the presence of the genes associated with those diseases, or predisposing those who inherit the gene for a disease. The overall aim of genetic testing is to diagnose the disease early enough to initiate treatments that will prevent permanent and irreversible damage, even death.
Prenatal testing is performed to determine whether a particular genetic disease is present in the offspring before birth. It is suggested that the information may be used by the parents to plan ahead for raising a child with disabilities. Unfortunately, it usually provides a motive to abort, or, if the parents are using artificial reproductive technologies, to discard gametes or zygotes with the disorder.
The habitual techniques for prenatal testing are amniocentesis and chorionic villi sampling. Both methods imply serious risks for the child. Amniocentesis has a rate of fetal loss of 1 in 200. Chorionic villi sampling poses greater risks, such as limb reduction, malformation and spontaneous abortion, results of its being performed earlier in the pregnancy, that is, at an earlier stage of development.
To discern the moral permissibility of any medical procedure, we must first remember that the complete morality of an act arises from the combined consideration of (1) its object, that is, the end to which the act tends by itself and which is immediately achieved; (2) the circumstances that surround the concrete performance of such an action; and (3) the intention of the agent who performs it. If those three elements are morally good, the action is good. If any of them is morally evil, the action is evil, whatever the goodness of the other elements may be.
Regarding pre-natal testing, the Encyclopedia Britannica states approvingly that “screening of the susceptible population for Tay-Sachs has significantly lowered the number of newborns affected by this lethal disease in the United States.” Translated, this terse “newspeak” means that, following the genetic tests, the prospective parents have chosen either to use contraceptive methods or to abort.
Gilbert Meilaender, a Christian scholar, cuts ruthlessly through the euphemisms: “The day may come when we can treat and cure prenatally or postnatally many genetic diseases; however, for the moment, we can diagnose prenatally far more that we can treat. In the meantime, therefore, we screen and abort. For now, that is essentially the only ‘treatment’ for illness diagnosed prenatally. We know more and more about the child in utero; hence, people…seek and use such knowledge in order to select the babies they desire and abort those they do not want.”
The object of the testing is to acquire information about the health of the unborn child. But knowledge, or information, although in itself morally neutral, cannot be separated from the motive for seeking it. From that motive, the pre-natal genetic test will receive its first moral qualification.
If the knowledge is sought to initiate treatment that may reduce the consequences of the defect, and insofar as excessive anxiety and despair are avoided, the genetic screening might be morally good.
It is very easy to deceive ourselves by asserting that the knowledge is sought to prepare better for the raising of a child with disabilities. Perhaps it is so, but it is imprudent to pursue the acquisition of this information only for this motive—it will taint the parents’ gift of life, creating regrets, a reluctance to accept the child even before he is born.
On the other hand, if the test is performed with the intention of aborting the child if he presents any of the tested for genetic defects, the testing is morally evil—a sin. Nothing justifies direct abortion. As Pius XII said, “Every human being, even a child in the mother’s womb, has a right to life directly from God and not from the parents or from any human society or authority. Hence, there is no man, no human authority, no science, no medical, eugenic, social, economic or moral ‘indication’ that can offer or produce a valid juridical title to a direct deliberate disposal of an innocent human life; that is to say, a disposal that aims at its destruction, whether as an end or as a means to another end, which is, perhaps, in no way unlawful in itself.”
To the basic moral qualification given by the motive, there has to be added the moral evaluation of the concrete circumstances of the testing. As we have said, the most common tests do imply certain risks for the fetus between conception and birth. The desire of the parents “to know” is not proportionate to the danger imposed on the child.
The only possible exception would be that such a test is needed to prevent a definite commensurate risk of life or health, either to the child himself or to the mother. In such a case, the emergent risk for the child may be indirectly permitted—that is, intending the good of life and health to be protected by the testing, and reluctantly accepting the fact that a similar but less imminent danger is incurred. In almost every other case, though, the testing should not be performed—it is sinful to perform it.
What is the “Common Good” of society?
Catholic doctrine defines the end of civil society—the goal that unites all its members and determines the manner of their organization—as the “common good.” What is it?
The natural, and therefore necessary mission of civil society is to facilitate to men, by means of the social cooperation, the attainment of their supreme and definitive good, their happiness. As the human person finds his happiness in God, the ultimate end of society is the glory of God and the perfect happiness of men in the vision and love of God.
This is what may be called the extrinsic Common Good—“extrinsic” because it is external to society, its attainment is beyond the reach of civil society. The definitive union with God is something personal: happiness is attained—or lost—by the individual person, not by the social group as a whole. Social cooperation is simply an aid, creating the more favorable conditions to attain that happiness—but it is the individual who has to attain it.
Therefore, although God is truly the ultimate end of society, He is not its direct and immediate finality. Civil society has its proper “intrinsic” finality, the temporal common good, for which attainment it has all the necessary means. This “common good” is the ensemble of vital and moral means and conditions that every society must provide to its members, to allow them to attain—freely, spontaneously and in the measure of their possibilities—the ends of their lives.
It includes all the goods whose possession will facilitate to man the attainment of his temporal perfection, in view of the eternal. It consists in all those goods that give to men a certain material ease: sufficient food, housing, rest, and all the other means directed to the welfare of the body.
But is also includes honest goods—moral, intellectual and religious—which communicate some perfection and are intermediate ends regarding God, the supreme end of human activity. As all must participate in this kind of goods, the Common Good implies also the practice of justice and of the virtues that regulate the use of material things: temperance, sobriety, liberty, generosity, etc.
Consequently, the common good—the end of civil society—is bene vivere, the virtuous life, and not simply the temporal well-being. Independently of the popular use of the term, the “temporal” common good does not mean simply material goods, or economic development—it includes also the worship of God, the acknowledgment and observance of the order of nature, the preservation of the dignity of marriage and of the family, the promotion and protection of public morality, culture, etc.
The right social order implies the respect of the due hierarchy between these goods, and, concretely, the primacy of the spiritual goods. A social organization is good when it is capable not only of providing its members with the goods necessary for their temporal perfection, but when it procures those goods according to their just hierarchy.
The modern world does not simply reject God, or the dominion of God over the lives of men; it also denies that the increase of human perfection is the end of civil society, and in its place proposes as sole end the preservation of man’s freedom, security and resistance to oppression—thus dissolving the common good into the good of the individual.