Sentimentality is not enough

To bear Siamese twins is an enormous responsibility. But did anyone counsel the alternative?; There are times when hope is treacherous and self-deluding
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The Independent Online
Few stories are as fascinatingly horrible as strange births, so when real Siamese twins are about to be born this month, it is hardly surprising that the Daily Mail buys up the story, certain that the world will eagerly await the first pictures. The gawp factor is thinly papered over with a stirring tale of parental love and fortitude.

The female twins are, according to the scans, joined from chest to navel and share a liver; the doctors give no odds on their survival as there may be further complications. The parents, Melanie and Brian Astbury, are in their mid-twenties with a three-year-old son. With the condition diagnosed at 18 weeks, they could have chosen abortion. With serious deformity, there is no upper time limit for abortions. They could change their minds up tothe very last moment.

"Our love for Siamese twins" blazoned the front-page headline of the Mail on Monday; the couple have already named them Nicole and Chloe. It is a story of human bravery in the face of calamity, since ahead may lie a life of extreme pain and suffering, for themselves, for the twins and for their other child. Admirable in some ways, but so unnecessary and misguided.

The Astburys say they responded to the news of the impending birth with certainty. "We never seriously discussed termination. We each know what the other is thinking and we knew we were going to go through with it. We had the briefest of chats at home and rang the hospital next morning to tell them of our decision. They were delighted."

Those few chilling sentences raise serious concerns. If they didn't talk about it thoroughly together, have they truly faced the reality with anyone? Did they meet parents of other severely disabled children who could describe the future? And why, strangest of all, were the doctors "delighted"? The tone of the Mail's reportage congratulated the Astburys for eschewing abortion, as if their love for the twins overwhelmed all argument, self- justifying and final.

They are not as articulate as Dominic Lawson, editor of the Spectator, who recently wrote a moving description of the love and grief he felt at the birth of his Down's syndrome daughter. Mr Lawson and his wife, a devout Catholic, considered genetic testing. People cope with personal tragedy in their own way and he chose to turn their private decision into a general condemnation of "half-baked eugenics" which allowed the "state- sponsored annihilation of viable sentient foetuses". He compared abortion of the handicapped to Chinese and Nazi extermination of the retarded.

Since then little Domenica Lawson has become a cause celebre, with Princess Diana as her godmother, a symbol of the value of human life.

The intellectual confusion at the heart of the matter concerns the personhood or otherwise of foetuses, the key point in debates on abortion law and in vitro embryos. For some, especially Catholics, the matter is simple. I have interviewed Mother Teresa and heard her argue against both abortion and contraception, because every extra starving baby born to die on a Calcutta street is another welcome creature in God's universe. There is at least consistency in this view, but that depends on belief in the immortal soul, which need not concern those not of the faith.

For the rest of us, the question is whether the unborn child is a person. In my view, it is not. It is mere sentimentality to equate a potential person with an actual person. It is a logical error to look at any child, whole or handicapped, and ask: "Would you be without it?" Of course not. But if we all thought that way, logically every woman should have every baby she possibly could from puberty to menopause, for fear of denying life to someone she will certainly not wish dead once it is born.

The law is no guide, as it is a fudged compromise that makes little sense. But in essence, it declares foetuses not to be people. Mr Lawson argues that allowing the handicapped to be aborted far later than the healthy foetus is a sign of evil eugenics, giving the disabled lesser right to life. Fair enough, if you think all abortion is murder anyway. But if a foetus is not a person, then fussing about precise dates is just a matter of queasiness and a legal illogicality.

Following the Lawson article, many parents of Down's and other disabled children wrote heartbreaking articles about how their lives had been destroyed, and how little they had realised what it would do to them. At least Domenica Lawson will have the money to ensure she is well cared for after her parents' deaths. But to lay this peculiar moral burden on other expectant parents seems to me irresponsible.

The Astburys' "love" for their Siamese twins is a phantasm born of emotive imagining. To claim to love people who do not exist diminishes the concept of "love". But there is a sentimentality about foetuses that leads a great many women on to disaster, with countless young teenagers falling under its spell. Kill a baby? Oh I couldn't, they say, and nobody challenges their hazy thinking sufficiently to urge them on to termination. Has anyone at least put the argument forcefully to the Astburys? This is not a time for mincing words, but for testing that their convictions are robust enough to sustain them through what may be a lifetime of suffering.

I spoke to their obstetrician, Dr Michael Marrish, who was somewhat stricken when he read their story in the Mail. "They do seem too optimistic," he said. "They seem to think the prognosis is good. But the risks are enormous for both children, as there could be so many abnormalities not defined in ultrasound, such as shared gut or other abdominal abnormalities."

I asked if they had had extensive independent counselling, and he seemed rather taken aback by the question. "They had already made up their minds when they came to us, but they did see a midwife after the ultrasound. Certainly I reminded them they had the option to terminate at any time."

Open and forthcoming, he seemed to contemplate the issue of abortion counselling as if for the first time, even though he sees one serious foetal abnormality a day. Is it possible doctors are embarrassed and reluctant to advocate termination strongly enough to couples who seem decided? Do they think it improper to stress the darkness of the days ahead? "I suppose we are trained to look on the bright side," Dr Marrish said thoughtfully. If his wife was pregnant with conjoined twins, what would he have wanted? "Oh, I would have to say termination," he said. Has he said that to the Astburys? No.

When I talked to the midwife who had counselled the Astburys, she said she was very cautious about giving advice either way. But she personally would take the other view, she would probably never opt for abortion, and would have gone ahead in Melanie Astbury's position.

Most people are bad at calculating probability: we all live in hope. But there are times when hope is treacherous and self-deluding. Abortion feels like murder to most pregnant women, but it is the duty of professionals to help them to shed the confused guilt and imaginary love that leads them to carry through calamitous births.