The Alfie Evans Case Highlights the Dangers of Defending Selective Abortion

A message supporting Alfie Evans outside Goodison Park, Liverpool, England. (Lee Smith/Reuters)
If we accept that life has no intrinsic value, it becomes easier to justify killing or withholding treatment from those who experience suffering.

In the United Kingdom, a young boy is fighting for his life. Alfie Evans’s doctors have deemed him unable to survive his terminal illness, and the state has forbidden his parents from removing him to Italy for further care, despite the fact that the Italian government has granted him citizenship and Italian doctors have agreed to treat him.

This situation is a barbaric display of what can happen when judges have the authority to arbitrarily prevent parents from seeking treatment for their own child, even treatment outside the state’s purview. According to this judge, and the doctors he echoes, Alfie Evans must die, and he must die now.

But this case is also an example of what can happen when our culture of death embraces the idea that human life, most especially the lives of suffering children, has no intrinsic value. (This belief is evident, too, in the growing debate over end-of-life care, physician-assisted suicide, and euthanasia.)

Alfie Evans has been denied care on medical grounds, because his doctors have determined that he cannot survive without external assistance and therefore that his life should not be prolonged through the use of technology. His doctors, in fact, have been proven at least partially wrong already; Alfie has now survived for a full day without the assistance of technology, despite assurances that he’d live only another few minutes, an hour at most once his oxygen supply was removed.

Setting aside the specific medical and legal details of Alfie’s case, this choice to withhold medical treatment from him is clearly based on the assumption that some lives — those afflicted by certain types of suffering — are not worth living. And once you claim that human life has no inherent moral worth, the question becomes, “Who decides?” If Alfie hasn’t earned the right to live simply by being human, then his parents, his doctors, and the state suddenly must grapple for control over the decision of whether he lives or dies.

This type of subjective judgment about the value of life is nowhere more evident than in the abortion debate, most especially when it comes to selective abortion, as pro-choice advocates insist that parents must be free to terminate pregnancies when prenatal tests reveal “life-limiting” abnormalities.

Take the example of aborting children prenatally diagnosed with Down syndrome, a debate over which has been revived in recent months. Last summer, CBS News reported that Iceland is leading the world in “eradicating Down syndrome births.” But Iceland isn’t eradicating the chromosomal disorder; the country’s residents are using an aggressive combination of prenatal testing and selective abortion to identify and exterminate children afflicted with it. This is hailed as moral and medical progress.

This heinous attitude is spreading to the U.S. as well, where two out of every three pregnant women who receive a prenatal diagnosis of Down syndrome for their unborn child choose to abort. Just last month, Washington Post columnist Ruth Marcus wrote two consecutive columns defending the abortion of such children, and several others followed, agreeing with her.

“To be a parent is to . . . love your child for who she is,” Marcus wrote in the first of her pieces. But that love apparently goes only so far:

Accepting that essential truth is different from compelling a woman to give birth to a child whose intellectual capacity will be impaired, whose life choices will be limited, whose health may be compromised. Most children with Down syndrome have mild to moderate cognitive impairment, meaning an IQ between 55 and 70 (mild) or between 35 and 55 (moderate). This means limited capacity for independent living and financial security; Down syndrome is life-altering for the entire family.

This argument has an obvious eugenic tinge, but in both columns, Marcus included just one, throwaway line addressing her position’s dangerous implications: “There are creepy, eugenic aspects of the new [prenatal-testing] technology that call for vigorous public debate.” But she did nothing to address them. In fact, it is incredibly difficult to find a pro-choice defender of Down syndrome abortion willing to follow his argument to its logical conclusion.

Instead, advocates cloak their support for selective abortion in the rhetoric of the all-encompassing “right to choose.” But does that right include the right to choose abortion for a fetus revealed to be a girl, if her parents want a boy? Does it include the right to abort one’s child if he or she will have blue eyes instead of brown, or brown eyes instead of blue? What if his genetic profile suggests he won’t grow up to be particularly tall or athletic? These questions go unanswered.

Interestingly, much of the pro–Down syndrome abortion argument is premised on the idea that parents should be free to decide that a certain type of suffering renders a human life unworthy of living — that, in fact, it is compassionate to kill particular unborn children because they will experience a certain type of suffering.

Consider the possibility that, in the future, prenatal genetic profiling will be able to reveal the likelihood of disease. What if a fetus’s genes reveal a higher risk of breast cancer or multiple sclerosis or heart disease? Perhaps abortion is the compassionate choice in such cases, too. What if medicine someday locates a “gay gene” — will the potential bullying or harassment the child might face justify a “compassionate” abortion? The list could go on.

And here is where the argument for selective abortion intersects with Alfie Evans — a living toddler — who has been deemed unworthy of life because someday, probably sooner rather than later, he will succumb to a terminal illness. This is why the refusal of Marcus and others to address the logical implications of defending aborting those with Down syndrome is so dangerous. It legitimizes a culture that grounds the value of human life not in intrinsic dignity and worth, but in a sliding scale of suffering and a twisted view of compassion, wherein death is better than a certain type of life.

Abortion-rights activists — especially those who vigorously defend selective abortion of genetically abnormal fetuses — must address these imperative questions. Not to do so is to leave room for the growth of the very same culture that has condemned Alfie Evans to death.


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