Prenatal Diagnosis and Selective Abortion by Harry Harris (review)

Abstract

through on his promise that "every particular statement made rests directly on some piece of ancient evidence which will be found in the Notes." In conclusion, this is a worthwhile book suitable for a large audience wishing to acquire a good start in the history of Greek medicine ... it is less for the professional or serious amateur than for the beginning student in the history of medicine. Melvyn Keiner Mercy College Dobbs Ferry, New York 08884 Prenatal Diagnosis and Selective Abortion. By Harry Harris. Cambridge, Mass.: Harvard University Press, 1975. Pp. 101. $6.00. The first two-thirds of this book deal with current knowledge of the subject of prenatal diagnosis. The summary is clear, comprehensive, and as up-to-date as one could reasonably expect in a rapidly changing field. The author emphasizes two main points, first, that the scope of prenatal diagnosis will expand considerably , and second, that the application of present knowledge could have only a very small effect on the incidence of inherited disease. More interesting is the last third of the book which deals with questions of ethics. Superficially, as the author points out, the issue of selective abortion would appear to be of less concern in countries which now accept abortion. However, the moral issue remains, since to those who believe that abortion is wrong it is wrong whether the fetus is defective or not. Several real problems remain, although the author does not list them explicitly. Not only parents but medical personnel and even the state are involved. Should abortion be performed when prenatal diagnostic studies indicate that a much wanted child will or may have a congenital anomaly or genetic abnormality? Is it appropriate for a couple to choose the sex or even the characteristics of their offspring by selective abortion? Is the physician in a position to play God by recommending abortion on the basis of prenatal tests? Does the state have a duty to reduce its future financial burden by requiring selective abortion when a defective child is likely to be born? Should the state encourage the output of selected individuals by abortion or, eventually, perhaps, by extrauterine gestation? The situation would be much clearer if the methods of detecting disease in utero were 100 percent reliable. However, this limitation does not relieve the involved parties of the responsibility of making a decision on the basis ofcurrent information. Perhaps some guidelines may be helpful for present thinking: 1.There should be reasonably good scientific evidence of the validity and reliability of the tests used and a reasonably accurate forecast should be possible before any decision can be made. 2.The professionals involved, whether physicians or others, should be responsible for providing the parents with unbiased knowledgeable opinions on the results of the diagnostic tests and the possibility of an abnormal fetus. 3.Neither the compulsory nor even the advisory power of the city, county, state, or federal government should be involved in any way in the decision. Perspectives in Biology and Medicine · Summer 1976 | 597 4.The issue for or against abortion, in a given case, lies with the parents when they have received such advice as is available. 5.The parents are entitled to understanding and support from family, medical attendants, and the state, whatever their decision. Harris's book raises many ethical questions for the future. They are worth remembering, and their solution is not easy. Michael Newton, M.D. Department of Obstetrics and Gynecology University of Chicago Sociobiology: The New Synthesis. By Edward O. Wilson. Cambridge, Mass.: Belknap/Harvard University Press, 1975. Pp. 697. $20.00. This is a beautiful book with an immodest title and a grandiose mission. Most writers would stumble over this self-imposed environmental load, but Professor Wilson carries it off magnificently. It could well become the most influential book written for biological scientists in this decade. Its potential importance may be likened to that achieved by John Peter's and Donald Van Syke's Quantitative Clinical Chemistry, which established a beachhead, set a style, and served as an articulate authoritative reference over a quarter of a century ago. For biologists or physicians, Sociobiology is a book which ought to be easily available...