Prenatal Genetic Testing, Abortion, and Disability Justice
Amber Knight, Joshua A. Miller
Abstract
Abstract The routinization of non-invasive prenatal genetic testing (NIPT) raises urgent questions about women’s reproductive autonomy and disability rights. Many supporters defend NIPT on the grounds that prenatal genetic information helps would-be parents make better family planning choices. We challenge that assessment by showing how, under the current regime of ableism and neoliberal reprogenetics, NIPT provides opportunities for intensified control over women’s reproductive decisions. Focusing intently on the case of Down syndrome, the book demonstrates how several factors ensnare prospective mothers in a web of tough choices by stacking the deck against the decision to bring a child with a genetic impairment into the world and parent her with dignity, including: (1) widespread ableist attitudes in medical institutions; (2) neoliberal welfare policies that privatize social services and the provision of care; and (3) oppressive social norms, including ableist and sexist attitudes. Drawing on feminist political theory and critical disabilities scholarship, we advance a conception of relational autonomy premised on perfectionist liberal notions of the state as a vehicle for intersectional social justice. Our goal is to theorize about which political arrangements would better enable prospective mothers to decide more autonomously whether they want to undergo prenatal testing, terminate a pregnancy following a positive result, carry the fetus to term, raise a child with a disability, or choose adoption. Ultimately, our analysis suggests that genuine reproductive autonomy requires both governmental restraint and active governmental support, arguing that restraint and action can work hand in hand to promote reproductive justice and disability rights.