Early last week a great swell of public indignation rose up against a couple who had decided to abort their baby because they had discovered it had a cleft palate. The verdict of an outraged media seemed to be that this was self-evidently wrong. I cannot agree.
I believe that morality, just like the devil, lies in the detail, and there is no reason to imagine we know the true details of this case, no matter how much publicity it gets. It does not seem at all self-evident to me that these parents were wrong. What is wrong, I believe, is the uncritical and unfeeling censoriousness that is heaped upon such painful decisions. People talk about eugenics, but what I think of is parental protectiveness.
Personally, I hate the thought of late abortions, and this case involved one. However, if there is reason enough, the butchery of a late abortion sometimes may be justified.
The argument in this case was that a cleft palate was not reason enough for abortion at all. It was accompanied by the usual cries
of slippery slope. But all of life, surely, is a slippery slope, slithering from birth through decades of compromise and mistakes, and finally between forcibly inserted tubes and Do Not Resuscitate notices. Where are the high cliffs of certainty that people seem to imagine when they warn against the slithery slope? Their moral topography is faulty.
A cleft palate is not necessarily a matter of relatively minor surgery, though it can be and often is. Nor is it just a divided lip. The phrase cleft palate covers a wide spectrum of deformities and disfigurement, including some that are not minor and which need highly skilled repair and treatment with perhaps many operations and related difficulties.
To compare it with something different, the same is true of Down’s syndrome. Down’s is now known to be a wide spectrum of conditions. At one end there are people of normal intelligence, with only a suggestion of the physical signs of the syndrome. At the other are those with profound intellectual disabilities and serious health problems as well as marked signs of the characteristic appearance.
To talk about people with Down’s as if they were all similar is a serious mistake. Equally, it’s a mistake to talk about babies with cleft palates as if their disabilities were much of a muchness. These conditions themselves are arranged on, if not a slippery slope, then at least a steep and alarming gradient of difficulty. A prenatal diagnosis cannot tell you exactly where on that gradient your baby will be.
As between degrees of disability, deformity and disfigurement, who is to say what is too much? And too much for whom? Too much for the child? Or the mother? Or the entire family? Or for a society that is not prepared to help or is too poor to, as in most of the world? If you accept the idea of abortion at all, surely the best judge of all these things must be the pregnant mother. Most mothers in a rich society would feel that something that can probably, with any luck, be fixed in early childhood by good doctors is hardly a reason to abort an otherwise healthy baby. That’s my feeling, too, but even so I have a great deal of sympathy with people who think otherwise.
The painful truth is that even in the world’s richest and most humane countries, even the slightest disfigurement can be a torment. It is a well-documented fact that millions of girls of normal shape are obsessed with their weight and consumed with self-loathing. Our daughters cry bitter tears about imperceptible new millimetres of flesh on their thighs. If they can afford to they will cut and burn it off.
And it’s not only people in pursuit of beauty who demand treatment. Millions of women (and now men) think of ageing as a disfigurement and spend vast sums of money on dangerous treatments to disguise it. For years it has been possible to have a nose job or a boob job on the NHS, because we recognise the genuine psychological suffering that can be caused by perfectly normal noses and breasts that their owners consider substandard.
Only last week a surgeon announced that he would now be able to perform a human face transplant. He has a method of lifting a face from a corpse and grafting it on to a patient with a serious facial disfigurement.
Short of these extremes, the message everywhere is that how you look is hugely important. To call our civilisation “lookist” would be a feeble understatement. There are countless papers, magazines, videos, films and television shows dedicated to teaching us how to look newer, better, different, wider-eyed, fuller-lipped, straighter-haired, or whatever. The result must be misery since whatever we do we will continue to look much the same, and will never have a bottom like Kylie Minogue’s or legs like Victoria Beckham’s.
This mass obsession, and mass failure, is miserable enough for people who look more or less normal. What it must do to people who do not look quite normal, to people who do have some obvious disfigurement, is painful to imagine. I spend a lot of time with someone dear to me who does not look quite normal. She seems unaware of the constant rebuffs we meet. But I notice. And I understand why some parents of Down’s children arrange cosmetic surgery for them, to correct their overlarge tongues and change the characteristic shape of their eyes. Who can blame them? The disability lobby blames them, I am sorry to say. Its activists say society should change. Disability and disfigurement, they argue, lie in the eye of the beholder, and the beholders must change. On a radio programme last week about our images of people who look different, a woman activist with an unusual type of genetic disfigurement spoke of having “beauty with a different spin”. I admire her courage but I think it is a tragic error to imagine we can wish away disfigurement and disability purely with the power of fellow feeling.
There are some harsh evolutionary reasons behind our tendency to turn away from disfigurement. They are the same as the harsh reasons underlying our obsession with beauty. Beauty is an extreme expression of good health, youth and fertility — normality is a lesser expression of the same things. And in the dark evolutionary recesses of our brains we remain obsessed with reproduction, with finding the healthiest, strongest and most fertile mate to help us pass on our genes. Disfigurement gives out — however incorrectly — subliminal signals of low fertility, of poor resistance to illness, and of weakness. People instinctively react against it, against their own better feelings.
This is inexpressibly sad. But it is a tragic mistake to argue that because people ought to be blind to such appearances, they therefore can be and will be. I would not want to take a chance on that assumption and perform such a social experiment on any baby of mine by bringing it into an unwelcoming world. The road to hell is paved with good intentions for other people; the 20th century was disgraced not only by eugenics but also by the doom-laden good intentions of socialism.
minette.marrin@sunday-times.co.uk
