from the December 07, 2001 edition -
http://www.csmonitor.com/2001/1207/p1s3-woeu.html
France debates right not to be bornA Paris court ruled last week that disabled children can sue doctors over not having aborted them.By Nanette van der Laan | Special to the Christian Science Monitor PARIS
The first thing doctors asked Willemijn Forest, after she gave birth
last year to a baby boy diagnosed with Down syndrome, was whether she
wanted to keep her child. "After the delivery, they took him away immediately, assuming I did not
want to see him anymore," says the Dutch woman who lives in Marseilles,
the country's second-largest city. "I said of course I want to keep him. I
was so appalled by their attitude." These days, Forest, like many other parents here who have children
diagnosed with mental disabilities, is no longer shocked. Last week France's highest appeals court ruled that children with Down
syndrome have a legal right never to have been born and could sue doctors
that attended the pregnancy. For parents like Forest, the ruling demonstrates a view, which she says
is widespread in French society, that a disabled life is not worth
living. The judgment, which confirmed a previous ruling in a similar case, has
caused a furor in France, sparking a national debate on a whole host of
ethical issues. In their Nov. 28 ruling, three judges said that a doctor had
negligently failed to warn an expectant mother that pre-natal scans showed
that her baby had the symptoms of Down syndrome. The baby, who was only
identified as Lionel, was born in 1995. His mother argued that she would
have aborted if she had been given a correct pre-natal diagnosis. Although most in France agree that the parents should receive financial
aid for Lionel's specialized care, many are offended by the nature of the
mother's grievance: that her son had been allowed to be born. The judges in Lionel's case decided that the doctor was "100 percent"
liable for the cost of the care needed for the child, since the diagnostic
error meant that the mother was not given the chance to abort. The court
had already awarded damages of around $100,000, five years earlier. Last
week's ruling ordered the sum to be substantially increased. The exact
amount is to be announced at the end of January. Parents of mentally disabled children who gathered outside the
courthouse to hear the verdict, said they were outraged by the ruling. "Certain judges still believe that it is better to be dead than to be
handicapped," says Xavier Mirabel, spokesman for the Collective Against
Handiphobia, a group that fights for rights for the disabled. Mr. Mirabel says the most worrying aspect is that the ruling confirmed
a similar decision by the same court last year. In November 2000, the
court ruled that Nicolas Perruche - born severely disabled - should
receive damages from his mother's doctor, who had failed to warn her of
the dangers of rubella (also known as German measles) during pregnancy.
That case immediately caused widespread consternation, but many thought
the ruling was an exception. Mirabel's Collective Against Handiphobia has since brought its own
case, charging that the Perruche case amounted to a dysfunction of the
justice system. Though 54 percent of the French consider themselves Catholic, a
nationwide poll last year by SOFRES, a leading independent polling agency,
showed most respondents viewing abortion as justifiable. Legal abortion
was introduced in 1975, with termination now allowed up to 12 weeks of
pregnancy - and later, if there is a grave risk to the mother's health or
if the fetus is diagnosed as suffering from a condition such as Down
syndrome. Roger Bessis, president of the French College of Echography (ultrasound
scanning), says that new national statistics, due out shortly, will show
that France carries out fewer abortions when genetic abnormalities are
detected - because in France, unlike in other countries, there is no
strict time limit for abortions. "Doctors are not under pressure to terminate pregnancies when there is
only slight doubt," he says. "We don't need to rush, so we can do more
tests, and therefore have one of the most accurate rates of detection in
the world." Dr. Bessis says that, in Paris last year, 90 percent of prenatal
genetic abnormalities were detected. In those cases, 8 percent of the
mothers decided against abortion. The Handiphobia Collective's Mirabel says he is concerned that the
attention to the recent court cases has eclipsed other, more pressing
issues. He says that, in northern France, 85 percent of parents with
mentally handicapped children are sending them to specialized schools in
Belgium, because the French system cannot accommodate them. The cases have also alarmed doctors, who fear a growing number of
lawsuits. Bessis says many specialists have already stopped carrying out
prenatal scans and some are calling for a nationwide strike beginning Jan.
1. "All of a sudden, the courts are deciding what is law. How can we
accept this in a democracy?" he says. "The courts said the doctor was 100
percent liable, but everyone knows that medicine can never be 100 percent
accurate. We do the best we can." The French Roman Catholic church has called the rulings an insult to
all families with disabled children. The bishop of Tours, André
Vingt-Trois, president of the church's family committee said: "I think
with great sadness of all families who have welcomed Down syndrome
children, who have showered them with love and received great love in
return. This ruling amounts to a declaration that such love was
worthless." The French government, which has kept mainly on the sidelines to date,
is due to hold a parliamentary debate next week on the ethical and moral
issues involved. Some politicians say the court hearings raised the
question of eugenics (controlled breeding), while others maintain that the
court awards had been made in recognition of a right to dignity. On Wednesday, Bernard Kouchner, the health minister, said the case had
left him "perplexed" and "ill at ease." Stressing the "value of every
life," he said that a "handicapped life is not a pitiful one." But he
added: "Nobody should question a doctor's medical responsibilities towards
a mother, any harm done to her as a result of medical negligence, or
challenge her right to have an abortion." The minister for families, Ségolène Royal, sees the ruling as
acknowledging the right to justice for people with disabilities. But she
says she fears it could be seized on by pressure groups opposed to
abortion. Full HTML version of this story
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