By Dr Gillian Wright

"IT’s not fair!" is one of the cries from our earliest years. The sense that things ought to be fair seems to be innate. Yet deciding what is fair is not always easy, as grumbling toddlers find to their peril. Must things be equal to be fair? Should individuals be treated differently when their needs or circumstances are different? The UK Government ratified the UN Convention on the Rights of Persons with Disabilities (2009) and passed the Equality Act (2010) to require equal treatment of those with disabilities.

It is an interesting (or concerning) paradox of our age that we uphold diversity and promote inclusion but have a programme to allow elimination of those with disability before they are born. There is a national screening programme to identify babies with Down Syndrome, a common cause of learning disability, caused by an extra chromosome 21. In a study from the US, UK, New Zealand, France and Singapore, 92 per cent of pregnancies diagnosed with Down Syndrome were terminated.

Hans Reinders, Professor of Intellectual Disabilities in the Netherlands, has called this a “new eugenics” with lives of perceived poor quality terminated to prevent possible suffering.

In the UK, abortion is permitted up to 24 weeks for a normal pregnancy, but up to birth when there is significant risk of serious disability. Heidi Crowter, a young woman with Down Syndrome, is campaigning for the UK Government to change the law. Although late terminations are rare, she wants equal treatment of babies after 24 weeks for non-fatal disability. She is quoted by the disability charity Dimensions: “We are all equally valuable and should be all equally valued.”

What is the significance of 24 weeks? It refers to viability, which is the time that it is likely that the baby will be born alive; 24 weeks represents the point at which the current law recognises that there are foetal interests that outweigh maternal interests. However, a distinction for disability throws a spanner in the works. Either the foetus deserves protection at 24 weeks or it does not. It should not be dependent on disability status.

If abortion is justified in the interests of the mother’s physical or mental health, it is possible to do so under a different section of the Act. The presence of the disability section makes the statement that society gives the right to choose not to have a disabled child. Laws send social messages.

In a 2017 Com Res poll, 53 per cent of Scots supported an equal time limit for disability abortions of 24 weeks. If the law changed, how would we respond with compassion at these difficult times for families? The BBC journalist Victoria Derbyshire asked Heidi Crowter who replied: “Get to know someone like me. There is a person behind the chromosome.”

How could we do this? Perhaps more learning disability liaison nurses to support families at diagnosis and to train those involved in the screening programme. Adoption could be considered more when counselling families. Increased funding for education for those with additional needs, and for support for families.

Society has come far since the Abortion Act was framed in 1967. Disability rights are enshrined in international law. However, with abortion for Down Syndrome, we are making a deliberate choice on grounds of disability, rather than affirming the innate worth of a person. In our quest to eliminate disability, people with disability, a little like Heidi, are being trampled along the way.

Dr Gillian Wright is Senior Researcher, Scottish Council of Human Bioethics