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Dr. Jeffery Shallit on Eugenic Morality: “Why, exactly, would the world be better off with more Down’s syndrome children?”

Michael Egnor

Dr. Jeffery Shallit has a post on his blog Recursivity that really caught my eye. He comments derisively on an essay by McGill University ethicist Margaret Somerville titled, “Facing up to the dangers of the intolerant university: Bird on an ethics wire.” Somerville argues that universities are increasingly becoming intolerant of viewpoints that fall outside of a narrow leftist-atheist ideology. She notes that healthy democracies depend on respectful sharing of opinions, and university censorship and exclusion of competing opinions — especially opinions on ethical issues that derive from religious traditions — leaves our public discourse dangerously impoverished.
Dr. Shallit agrees with some of her criticism of suppression of speech on campus, but he finds her essay “very shoddily argued.” He mainly objects to her suggestion that religious views be given a place in the public forum and her view that ethical decisions based on religious faith be accorded respect. Dr. Shallit asks:

With respect to religion, why should religious dogma, which maintains ridiculous and unverifiable claims, be treated in the same way as science and rational thinking?

Dr. Shallit’s view on the relationship between religion and rational thinking is notably short on rational thinking. The existence of God is not a “ridiculous and unverifiable claim;” it’s the conclusion reached by the vast majority of human beings living today and who have ever lived, and is a viewpoint held by most of the best philosophers, ethicists and scientists in history. While there are thoughtful arguments that can be made for atheism, the arguments advanced by Shallit and his comrades like Dawkins, Dennett, Harris, Myers, and Hitchens are puerile. For example, the assertion that Christianity is disproven by assertions such as ‘If God created the universe, who made God?’ or ‘some bad things have been done by Christians, therefore Christianity is untrue’ would get a failing grade in any respectable introductory philosophy course. You’ll get more genuine insight from a paragraph of Aristotle or Aquinas than from a library of Dawkins and Dennett.
Subtle arguments about God being the ground for existence and about the role of Christianity in Western politics and culture aren’t “ridiculous and unverifiable;” these arguments are central to philosophy and to any informed understanding of history. New Atheist boilerplate trivializes the profound issues that religious belief raises, and the New Atheist contribution to meaningful discussion of these fundamental issues is …well… nil. For New Atheists, ‘rational thinking’ takes a backseat to ideological spittle.
But that’s not what caught my eye in Shallit’s post. Here’s what did.

Dr. Somerville, in her essay on intolerance and academic freedom, writes:

[W]e need to balance intense individualism with a robust concern for the community, and we need to consider the collective impact of our individual decisions. In our interconnected world, an order unavoidably emerges from thousands of individual decisions. For example, Quebec is proposing to offer all pregnant women screening for Down’s Syndrome. Whether or not, as individuals, we think that is good and ethical, the cumulative effect at the societal level of each woman’s individual decision (including the decisions not to abort when the fetus is “normal”) is to implement a 21st Century form of eugenics. Only the decision not to abort when the fetus has Down’s Syndrome is not a eugenic decision.

Dr. Somerville is exactly right. In the 1950’s, Fredrick Osborn, the president of the American Eugenics Society, advocated a shift away from the more explicit negative eugenics that had been discredited by the Nazi’s uncommonly skillful implementation of eugenic theory. In a 1956 speech, “Galton and Mid-Century Eugenics,” delivered to the Galton Society, Osborn stated:

“The very word eugenics is in disrepute in some quarters … We must ask ourselves, what have we done wrong? I think we have failed to take into account a trait which is almost universal and is very deep in human nature. People simply are not willing to accept the idea that the genetic base on which their character was formed is inferior and should not be repeated in the next generation. We have asked whole groups of people to accept this idea and we have asked individuals to accept it. They have constantly refused and we have all but killed the eugenic movement … they won’t accept the idea that they are in general second rate. We must rely on other motivation. … it is surely possible to build a system of voluntary unconscious selection. But the reasons advanced must be generally acceptable reasons. Let’s stop telling anyone that they have a generally inferior genetic quality, for they will never agree. Let’s base our proposals on the desirability of having children born in homes where they will get affectionate and responsible care, and perhaps our proposals will be accepted.” (1)[emphasis mine]

Note Osborn’s invocation of “voluntary unconscious selection,” using explicit Darwinian terminology. Osborn’s recommendation was that the public be encouraged to practice eugenics without calling it such. The phrase Osborn endorsed may be familiar to you:

“Every Child a Wanted Child”

Planned Parenthood, with its deep roots in the eugenics movement, has an enduring fondness for Osborne’s eugenic spin. Not to be outdone, The National Organization for Women sells “Every Child a Wanted Child” bumperstickers and buttons. The “Pro-Choice Resource Project” sells Osborn’s dictum on rubber stamps and refrigerator magnets.
Dr.Somerville is right to point out that voluntary unconscious selection — eugenics — permeates our culture.
Dr.Shallit comments:

…she says “Only the decision not to abort when the fetus has Down’s syndrome is not a eugenic decision”. But here she is begging the question: why are decisions that she labels as “eugenic” necessarily bad? Why, exactly, would the world be better off with more Down’s syndrome children? By her reasoning, positive assortative mating would be considered “eugenic”; yet most of us practice some form of it. [my emphasis]

Shallit channels Osborn, questioning whether the selective abortion of Down’s children is really “eugenic” and really “bad.” He leaves us wondering, “Why, exactly, would the world be better off with more Down’s syndrome children?”
Setting aside Shallit’s characterization of love and marriage as “positive assortative mating” (a poor rhetorical strategy for eligible Darwinists interested in reproductive success), it’s worth noting that Shallit’s second inference (“the world would be better off with fewer Down’s kids”) refutes his first inference (that “selective abortion of Down’s children isn’t eugenics”). He clearly views selective abortion of Down’s syndrome children as eugenic, although he uses sneer quotes around “eugenics.” Whatever the selective killing of unborn children with Down’s syndrome is, he seems to endorse it.
Enough with Shallit’s muddled eugenic sophistry. The selective abortion of children with Down’s syndrome is obviously eugenic. The question that Dr. Somerville asks, and that she believes can only be answered in an open forum in which religious views are given equal voice, is this:

Is the eugenic abortion of children with Down’s syndrome moral?

In the atheist/Darwinian view, eugenics is moral, even virtuous. The Darwinian understanding of man’s origins is that man arose through a struggle for survival. Our highest traits are the result of Natural Selection. The kindness and charity that are inherent to civilization threaten mankind, because it impairs Natural Selection, which is the source of our humanity. In the early 20th century, Harvard biologist Edward East made the Darwinian case for eugenics succinctly:

Nature eliminates the unfit and preserves the fit… Her fool-killing devices were highly efficient in the olden days before civilisation came to thwart her. It is man, not Nature, who has caused all the trouble. He has put his whole soul to saving the unfit, and has timidly failed to do the other half of his duty by preventing them from perpetuating their traits.

Eugenics is the Darwinian remedy for civilization’s impairment of Natural Selection’s “fool-killing devices.” So the question asked by 21st century eugenicists is the same question asked (and answered in the negative) by 20th century eugenicists:

“Why, exactly, would the world be better off with more disabled children?”

Dr. Shallit’s implicit answer, like the explicit answer of eugenicists dating back to Darwin, is that the world isn’t better off with people with genetic handicaps. The modern eugenic view is that it is ethical to prevent procreation of people with genetic disabilities, and, in some circumstances, it is ethical to kill them in the womb. Pace Osborn and Shallit, it’s better not to think of eugenics as eugenics. Is selective abortion of handicapped children really “eugenics”? Is it really “bad”? Why is the world better off with more handicapped children? The goal of eugenicists, since Osborn, is to sanitize eugenics by refusing to name it, and to portray it as reasonable and compassionate. In Osborn’s and Shallit’s view, aborting a handicapped child is merely a reasonable, even compassionate, decision, unfettered by unverifiable and irrational religious dogma. Voluntary unconscious selection.
Here’s my view on eugenics. It is a view that Dr. Somerville strives to keep in the public square, and that Dr. Shallit strives to exclude from the public square. I don’t believe that man is the product of purposeless natural selection. I believe that man is created by God, for a purpose, and that each of us is in part the image of God. Our dignity is that we carry that image. We are not mere animals to be bred and culled. Our dignity is not that we are smart, or strong, or that we have prevailed in our struggle for survival. Our dignity is that we are human and carry our Creator’s image, and we retain that full dignity despite the accidents of illness or genetics.
We are each afflicted with disabilities of different sorts. Some are genetic disabilities, and some are moral disabilities. Advocacy of eugenics is a much deeper — and a much more pernicious — disability (of the moral sort) than Down’s syndrome. Yet I believe that the world is better off because of each of us, and that includes children with Down’s syndrome as well as atheist mathematicians who casually endorse killing handicapped children before they’re born.
Why do I find eugenics not merely morally wrong but repellant? I have three reasons. First, as I noted above, I have fairly traditional Christian beliefs, and I find the assertion that people should be bred and culled like farm animals to be repugnant.
Second, eugenics has stained my profession. It’s fair to say that the medical profession’s participation in eugenics is the most shameful aspect of its history. Most prominent eugenicists have been Darwinist scientists, but it is also true that many physicians played (and continue to play) a central role in eugenics. Yet the fundamental tenet of medical ethics is that a physician must always act primarily for the benefit of his patient. The thought of a physician entering an examining room with the thought, “How can I most effectively end this patient’s germ line?” makes me sick. It is a deep violation of trust.
The third reason is personal. I am a pediatric neurosurgeon, and I take care of many children with profound genetic neurological handicaps. My kids are “unfit” in the extreme. Many are paralyzed and many have profound cognitive deficits. My kids are the referents in Dr. Edward East’s description of natural selection as a “fool killing device.” They are the people of whom Dr. Shallit and his eugenic soul mates ask rhetorically

“Why, exactly, would the world be better off with more of these children?”.

To understand the answer to that question, you have to get to know these children and the people who care for them and who love them. Here are three (of the thousands) that I’ve had the privilege to know:
Chelsea (not her real name) is 8 years old, and she has Down’s syndrome. I’ve taken care of her since she was born. She has hydrocephalus (water on the brain), which is unusual for Down’s children, but it’s how I have come to know her. She’s had seven operations, in her eight years, to relieve pressure on her brain. She is very afraid of needles, and doesn’t like hospitals. But she really likes doctors and nurses, and she really likes, well…everyone. When she has to undergo a painful or frightening procedure (blood-drawing or the like), she cries, but does not struggle, and as soon as the procedure is over, she hugs each participant, assuring them that “It’s OK.” She loves people — all people — and she never seems to associate the sometimes unpleasant things that people must do to her with the people themselves.
When she visits the doctor’s office or the hospital, she is the center of attention. Merely the phrase “Chelsea’s here!” brings doctors, nurses, ward clerks, secretaries — anyone who knows her — to stop by for a chat. She’s pretty good with names, and everyone gets a hug. Like most Down’s kids, she is preternaturally happy. Is the world much better off with Chelsea in it? Without question it is. Even a room is much better with Chelsea in it.
David (also not his real name) passed away a few years ago, when he was ten. Like Chelsea, he had Down’s syndrome and hydrocephalus, but he had a much harder time. David never learned to talk or to feed himself or even to sit up. In addition to Down’s syndrome and hydrocephalus, he suffered from a heart disorder, scoliosis, and pulmonary and digestive problems. He too was a happy child, but his disabilities were profound. He suffered much in his life; he had more than a hundred operations, and he passed away several years ago from his heart problems.
He spent quite a bit of his life in the hospital. His parents and three older brother and sisters intensely devoted to him. Neighbors and people in her home town held fundraisers to help, and extended family and friends volunteered to stay with him in the hospital (he was never alone) when his mom and dad needed a break.
I attended his funeral. I found a standing-room only crowd, a couple of hundred people, spilling out into the hallway. I was surprised how many of the people I knew — other doctors and nurses, clerks and administrative people from the hospital who had come to know his family well, as well as neighbors and extended family who I had met many times over the years. The eulogy was given by the medical center’s Lutheran pastor, who had become very close to David and his family. He gave the most moving eulogy I have heard. He recounted the death of his own daughter from a congenital heart disorder several years ago, and what he had come to know, in a very personal way, about grief over the loss of a child. Then he said (I paraphrase):

It would be natural now to think of David’s life as wasted, as having fallen short of what he might have accomplished had he been born physically and intellectually whole. But that would be a misunderstanding. His accomplishments are many. He brought his family closer, and helped them learn about love and sacrifice in a deeply and at times painfully personal way. He catalyzed friendships [here he pointed to the hundreds of people filling and spilling out of the room], and he brought people together who might never have met. He taught us much about love and about life through his own life. Now of course he is whole, with God, who knows much about the expression of love through suffering. Any one of us would be counted fortunate to have lived a life that moved so many people to love and compassion as he has. It’s a much better world because David has been in it.

Emma (also not her real name) is 22 years old. I’ve taken care of her for 17 years. She was born with spina bifida, a genetic disorder; her spinal cord was exposed on her back. She’s paralyzed below the waist, and her legs are shrunken and deformed. She has never had any control of her bladder or bowels. She’s had surgery to graft a piece of her intestine to her bladder so she’s incontinent several times a day rather than several times an hour. She has hydrocephalus, which is the continuous accumulation of water in her brain, and she’s had more than 20 operations to repair the plastic tube that drains the water from her brain into her abdomen. She has had major surgery to remove pressure from the bones at the base of her brain, and she has metal rods in her spine so she can sit up.
She’s a fairly cheerful person, but she’s very afraid of surgery, and she cries each time I tell her that she needs another operation. Lately her greatest concern, aside from her visceral fear of the operating room, is that surgery will set her back. She has a lot to do.
She tries to schedule her surgery — even relatively urgent surgery — around her responsibilities. She takes her responsibilities to her fiancée and to her family very seriously. She works full time as an administrative assistant at a local hospital. In the evenings and on the weekends she attends college, and she’s close to getting her undergraduate degree. She plans to get her masters’ degree, and then a doctorate. During an office visit a few months ago, I told her that she would need another operation to relieve pressure that was gradually building on her brain. After we took a few minutes to deal with the emotions that such a recommendation evokes in her, I asked her what she was studying in college. Her spirits brightened.
“I’m studying medical administration. My dream is to be a hospital administrator and to run a hospital.” she said. Then she smiled. “I’m going to be your boss someday.”
The world is made better by every person.
1) From “Galton and Mid Century Eugenics” by Frederick Osborn, Galton Lecture 1956, in Eugenics Review, vol. 48, 1, 1956

Michael Egnor

Senior Fellow, Center for Natural & Artificial Intelligence
Michael R. Egnor, MD, is a Professor of Neurosurgery and Pediatrics at State University of New York, Stony Brook, has served as the Director of Pediatric Neurosurgery, and award-winning brain surgeon. He was named one of New York’s best doctors by the New York Magazine in 2005. He received his medical education at Columbia University College of Physicians and Surgeons and completed his residency at Jackson Memorial Hospital. His research on hydrocephalus has been published in journals including Journal of Neurosurgery, Pediatrics, and Cerebrospinal Fluid Research. He is on the Scientific Advisory Board of the Hydrocephalus Association in the United States and has lectured extensively throughout the United States and Europe.