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Thursday, March 24, 2016

An Indiana Abortion Law, Disability, and Autism

Chelsea Schneider, Tony Cook and Shari Rudavsky report at The Indianapolis Star that Indiana Governor Mike Pence has just signed an expansion of the state’s abortion restrictions.
Pence, a social conservative with a long track record of opposing abortion, described the new restrictions as a “comprehensive pro-life measure that affirms the value of all human life.”
The measure, House Enrolled Act 1337, would make Indiana only the second state to prohibit a woman from seeking an abortion because her fetus was diagnosed with a disability such as Down syndrome. It also would prohibit abortions when they are sought based on the gender or race of a fetus, and would require the remains of miscarried or aborted fetuses to be interred or cremated.
Last week, Sandhya Somashekhar reported at The Washington Post:
The fetal anomaly provision is particularly troublesome, said Patti Stauffer, vice president of public policy for Planned Parenthood of Indiana and Kentucky. It prohibits a provider from knowingly performing an abortion sought because of “a diagnosis or potential diagnosis of the fetus having Down syndrome or any other disability,” according to the bill digest.

Clinics would need to ask women why they want an abortion. It is unclear, Stauffer said, whether the woman would be compelled to provide an answer. The bill digest says doctors could face “disciplinary sanctions and civil liability for wrongful death” if they knowingly abort a fetus because of the diagnosis of a fetal disability.

Supporters of the fetal disability provision say it is critical to prevent discriminatory selective abortions, especially in light of new tests that can tell with a high degree of certainty if a fetus is at risk of developing Down syndrome or another disorder.
What does any of this have to do with autism?  In The Politics of Autism, I explain:
When a pregnancy is under way, doctors can detect certain kinds of disorders, but neither amniocentesis nor any other prenatal test can currently tell us whether a fetus will become autistic. Suppose that such a test did exist. “The best case use of a prenatal test at the moment would be if you could say to a parent, your child has got an 80 percent likelihood of autism and so once the baby's born, we would like to keep a close eye on that child in case they need extra support like speech therapy or social skills training or some sort of behavioral approach,” says leading autism scientist Simon Baron-Cohen. But would the “best case use” be the most common? When amniocentesis indicates Down Syndrome, most mothers choose abortion. A study of autism parents in Taiwan found that just over half would abort if a prenatal test indicated that their next child would be autistic. We cannot be sure what the figures would be if such tests were available in the United States, but it seems likely that a large share of autism pregnancies would end in abortion.

The politics of the issue would be complicated, to say the least. For decades, the broader disability-rights movement has had an uneasy relationship with the movement to curb abortion. On the one hand, selective abortion angers disability rights activists, with some using terms such as “eugenics” and “genocide.” On the other hand, many of these activists also believe that the right to control one’s own body is a thread that connects disability rights and abortion rights. The growing ranks of identified autistic adults could be as conflicted as their elders in the disability rights movement. But it is also possible that they could change the issue’s political landscape by coming down heavily on one side or the other. Expect pro-life and pro-choice groups to vie for their support.