Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-08T05:23:42.012Z Has data issue: false hasContentIssue false

The Case of the Missing Hand: Gender, Disability, and Bodily Norms in Selective Termination

Published online by Cambridge University Press:  08 December 2014

Abstract

The practice of terminating a pregnancy following the diagnosis of a fetal abnormality raises questions about notions of bodily normality and the ways these shape ethical decision‐making. This is particularly the case with terminations done on the basis of ostensibly minor morphological anomalies, such as cleft lip and isolated malformations of the limbs or digits. In this paper, I examine a recent case of selective termination after a morphology ultrasound scan revealed the fetus to be missing a hand (acheiria). Using the work of Georges Canguilhem, I show that a person with acheiria could be considered normal. Further, I show that this case reveals a kind of “undecidability” in the significance of fetal sex/gender and disability in termination. From this, I consider the conceptual interaction of disability with sex/gender, to argue that the ethics of disability termination are not as distinct from those of sex/gender selection as is commonly supposed.

Type
Articles
Copyright
Copyright © 2015 by Hypatia, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

I would like to thank Robert Sparrow for insightful comments on drafts of this paper. I am also grateful for comments from audiences at workshops and seminars where I presented early versions of the paper, as well as from anonymous Hypatia reviewers.

References

Amundson, Ron. 2000. Against normal function. Studies in the History and Philosophy of Biology and Biomedical Sciences 31 (1): 3353.CrossRefGoogle Scholar
Arendt, Hannah. 1998. The human condition, 2nd edition. Chicago: University of Chicago Press.CrossRefGoogle Scholar
Asplin, N., Wessel, H., Marions, L., and Ohman, S. G. 2013. Pregnant women's perspectives on decision‐making when a fetal malformation is detected by ultrasound examination. Sexual & Reproductive Healthcare 4 (2): 7984.CrossRefGoogle ScholarPubMed
Boorse, Christopher. 1977. Health as a theoretical concept. Philosophy of Science 44 (4): 542–73.CrossRefGoogle Scholar
Boorse, Christopher. 1987. Concepts of health. In Health care ethics: An introduction, ed. VanDe Veer, Donald and Regan, Tom. Philadelphia: Temple University Press.Google Scholar
Boorse, Christopher. 2010. Disability and medical theory. In Philosophical reflections on disability, ed. Christoper Ralston, D. and Ho, Justin. Dordrecht: Springer.Google Scholar
Butler, Judith. 1993. Bodies that matter: On the discursive limits of “sex”. New York: Routledge.Google Scholar
Canguilhem, Georges. 1991. The normal and the pathological. Translated by Carolyn, Fawcett. New York: Zone Books.Google Scholar
Canguilhem, Georges. 2008a. The living and its milieu. In Knowledge of life, ed. Marrati, Paola and Meyers, Todd. Translated by Stefanos Geroulanos and Daniela Ginsburg. New York: Fordham University Press.Google Scholar
Canguilhem, Georges. 2008b. The normal and the pathological. In Knowledge of life, ed. Marrati, Paola and Meyers, Todd. Translated by Stefanos Geroulanos and Daniela Ginsburg. New York: Fordham University Press.Google Scholar
Davis, Lennard J. 2013. Introduction: Normality, power, and culture. In The disability studies reader, ed. Davis, Lennard J. Hoboken, N.J.: Taylor and Francis.CrossRefGoogle Scholar
De Crespigny, L., and Savulescu, J. 2004. Abortion: Time to clarify Australia's confusing laws. Medical Journal of Australia 181 (4): 201–03.CrossRefGoogle ScholarPubMed
Derrida, Jacques. 2002. Force of law: The “mystical foundation of authority”. In Acts of religion, ed. Anidjar, Gil. New York: Routledge.Google Scholar
Hacking, Ian. 1990. The taming of chance. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Joshi, Sneha, and Uppal, Talat. 2010. Absent foetal hand: A case report. Australasian Journal of Ultrasound in Medicine 13 (2): 2426.CrossRefGoogle Scholar
Kafer, Alison. 2013. Feminist, queer, crip. Bloomington: Indiana University Press.Google Scholar
Karpin, Isabel, and Savell, Kristin. 2012. Perfecting pregnancy: Law, disability, and the future of reproduction. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Kittay, Eva Feder. 2006. Thoughts on the desire for normality. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore: Johns Hopkins University Press.Google Scholar
Mansfield, Caroline, Hopfer, Suellen, and Marteau, Theresa. 1999. Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: A systematic literature review. Prenatal Diagnosis 19 (9): 808–12.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Margree, Victoria. 2003. Normal and abnormal: Georges Canguilhem and the question of mental pathology. Philosophy, Psychiatry, and Psychology 9 (4): 299312.CrossRefGoogle Scholar
Mills, Catherine. 2011. Futures of reproduction: Bioethics and biopolitics. Dordrecht: Springer.CrossRefGoogle Scholar
Natoli, J. L., Ackerman, D. L., McDermott, S., and Edwards, J. G. 2012. Prenatal diagnosis of Down syndrome: a systematic review of termination rates (1995–2011). Prenatal Diagnosis 32 (2): 142–53.CrossRefGoogle Scholar
Petersen, Kerry. 2006. Classifying abortion as a health matter: The case for de‐criminalizing abortion laws in Australia. In First do no harm: Law, ethics and healthcare, ed. McLean, Sheila A. M. Aldershot, UK: Ashgate.Google Scholar
Press, Nancy, Browner, Carole H., Tran, Diem, Morton, Christine, and Le Master, Barbara. 1998. Provisional normalcy and “perfect babies”: Pregnant women's attitudes toward disability in a context of prenatal testing. In Reproducing reproduction: Kinship, power, and technological innovation, ed. Franklin, Sarah and Ragone, Helene. Philadelphia: University of Pennsylvania Press.Google Scholar
Pryde, Peter G., Isada, Nelson B., Hallak, Mordechai, Johnson, Mark P., Odgers, Amy E., and Evans, Mark I. 1992. Determinants of parental decision to abort or continue after non‐aneuploid ultrasound‐detected fetal abnormalities. Obstetrics and Gyneacology 80 (1): 5256.Google ScholarPubMed
Savell, Kristen, and Karpin, Isabel. 2008. The meaning of “serious disability” in the legal regulation of prenatal and neonatal decision‐making. Journal of Law and Medicine 16 (2): 233–45.Google ScholarPubMed
Schechtman, Kenneth B., Gray, Diana L., Baty, Jack D., and Rothman, Steven M. 2002. Decision‐making for termination of pregnancies with fetal anomalies: Analysis of 53,000 pregnancies. Obstetrics and Gynaecology 99 (2): 216–22.Google ScholarPubMed
Shaffer, Brian L., Caughey, Aaron B., and Norton, Mary E. 2006. Variation in the decision to terminate pregnancy in the setting of fetal aneuploidy. Prenatal Diagnosis 26 (8): 667–71.CrossRefGoogle ScholarPubMed
Shildrick, Margrit. 2009. Dangerous discourses of disability, subjectivity and sexuality. Houndsmill, UK: Palgrave Macmillan.CrossRefGoogle Scholar
Snyder, Sharon L., and Mitchell, David T. 2001. Re‐engaging the body: Disability studies and the resistance to embodiment. Public Culture 13 (3): 367–86.CrossRefGoogle Scholar
Tremain, Shelley. 2001. On the government of disability. Social Theory and Practice 27 (4): 617–36.CrossRefGoogle Scholar
Tremain, Shelley. 2006. Reproductive freedom, self‐regulation, and the government of impairment in utero. Hypatia 21 (1): 3553.CrossRefGoogle ScholarPubMed
Williams, Jeremy. 2012. Sex‐selective abortion: A matter of choice. Law and Philosophy 31 (2): 125–59.CrossRefGoogle Scholar
Wong, S. 2002. At home with Down syndrome and gender. Hypatia 17 (3): 89117.CrossRefGoogle ScholarPubMed