Bioethics battleground Down syndrome: Verdict in Howard case is sound, but genetics debate rages.

October 24, 1997

THE SPEEDY VERDICT by a Howard Circuit Court that cleared a doctor in the "wrongful birth" of a child with Down syndrome settles the legal question.

The verdict was sound. The ethical and moral quandaries raised by this case are far from settled, however.

A Hagerstown couple had sued Dr. Swati M. Saraiya and her Columbia medical practice. They alleged that the gynecologist had failed to tell the pregnant woman that she had a high probability of bearing a mentally handicapped child. Joyce Shull testified that she would have terminated the pregnancy had she known of the risk.

Evidence in the week-long trial showed that although the medical practice initially misread results of a blood test in 1993, Dr. Saraiya quickly corrected the mistake. The doctor told Dan and Joyce Shull that their baby had a one in 24 chance of having Down syndrome. The child, Elliott, was born with the congenital disorder. The jury deliberated only 1 1/2 hours before rejecting the couple's claim, finding that doctors had informed the couple of the medical risk.

Still unsettled, however, is how the courts will deal with these bioethical issues as advances in prenatal technology unravel the mysteries of human development. Wrongful birth cases such as the one in Judge Diane O. Leasure's courtroom this week were virtually nonexistent a generation ago. With genetic tests making increasingly accurate predictions for embryos, parents want to know more. Doctors who fail to make information available can leave families unprepared to care for disabled children. Parents who claim they would have terminated a pregnancy seek money to pay the costs of raising children with special needs.

Medicine and law are wrestling with the question of what qualifies as a genetic defect.

Is it severe physical or mental retardation or does it extend to the mildly retarded, such as Elliott? How about a fetus predisposed to Alzheimer's disease? Short stature?

Although parents always have sought perfect children, technology enables them to learn more about qualities they view as imperfect. Imperfect, however, does not mean inferior. Many parents armed with knowledge will opt to raise children like Elliott, who is here and, therefore, entitled to equal standing among us.

Pub Date: 10/24/97

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