Prenatal testing for disability followed by selective abortion is controversial within the disability rights community (Goering, 2014). Disability rights theorists have argued against this practice using the expressivist argument, claiming that it expresses to already-existing disabled people that, for example, it is better not to exist than to exist the way you are, and that we should avoid creating people like you (Saxton 2000, Wendell 1996). However, the use of in-vitro fertilization (IVF), the same artificial reproductive technology (ART) that allows selection against embryos that are deemed to be deformed or disabled, also allows selection for those embryos.

In response to the ethics of selection for disability—whether by, for example, seeking out sperm donors with known congenital deafness, or using biomedical technologies like IVF—there have been two thematic lines of argumentation. One camp argues that it is perhaps obligatory, but at the very least permissible, to select against disability. The other argues that it is impermissible to select against disability and perhaps permissible to select in favor of it.

Below I discuss three issues in the debate over selection for disability: the main contrasting ethical views regarding the issue of selection for disability, and some often-cited reasons why families select for disability; family and culture; and diversity of human kinds.

Bad-difference, Mere-difference
Mainstream opinion, most vividly displayed on social media outlets, reflects the moral condemnation toward the very idea of selecting for disability. However, these views universally assume a “bad-difference” view of disability. The “bad-difference” view argues that disability is an aspect of a person that automatically makes her worse off, harmed, or existing in otherwise suboptimal conditions. Further, directly rejecting the social model of disability, the bad-difference view argues that these aspects would remain even if social conditions were accommodating of people with all kinds of abilities (Barnes 2014). Those who hold bad-difference views of disability usually think it is wrong to select for disability, no matter the circumstance. This view turns on the assumption that disability is a harmed condition, and insofar as this is true, then it is wrong to cause disability when it can otherwise be avoided.

Some have argued that the idea of disability as a harmed condition is problematized by what philosophers call “the non-identity problem”, first articulated by Derek Parfit (1986). Due to the contemporary constraints of reproductive technologies, selecting an embryo is an identity-forming decision. That is, there is no possible way for the child that is selected to be genetically altered without also changing its genetic identity. Because of this constraint, it is incoherent to say that the parents who chose to bring about a disabled child have harmed her, assuming that her life is worth living and therefore presumably better than not existing at all.

One solution to the non-identity problem posits that the harm committed within cases of “wrongful handicaps” is captured by “non-person affecting” harms, rather than “person-affecting” harms. Framing the problem in this way allows us to say that a harm is committed without requiring an individual victim of harm within the case (Brock 1995).

In contrast to the bad-difference view is the “mere-difference” view or “disability-positive” view of disability, which distinguishes itself from the bad-difference view by maintaining that disabled conditions are not harmed conditions, but a diversity of human embodiment, akin to race and sex (Barnes 2014). As such, to choose a world without disability is a morally indifferent choice; we are merely expressing amoral preferences when saying a world without disability is better (Bennett 2014). In line with the social model of disability, these views maintain that “having a disability makes you nonstandard or different, but it doesn’t—by itself—make you worse off” (Barnes 2014).

Family and Culture
A highly publicized and perhaps exemplary case of selection for disability is the case of an American couple, Sharon Duchesneau and Candy McCullough, both of whom are deaf. The couple sought out a friend’s sperm, knowing he had five generations of deafness in his family, as deafness was a condition that disqualified donors at the sperm banks they visited.

The couple reports that a determining reason they sought out a deaf child was that they would be better parents to a deaf child, being able to relate to the developmental stages of his life. Closely related to this concern is that Candy and Sharon emphasized the rich, supportive culture their child would grow up within. They had in mind more than just the benefits of Deaf culture as an abstract community; the couple lived in close proximity to Gallaudet University in Washington, the first liberal arts college in the US opened expressly for the deaf (Parker 2007, Mundy 2002).

Diversity Concerns
Another consideration that disability rights theories have long championed is that disabled people offer invaluable contributions to what JS Mill has called “the marketplace of ideas”; further, their presence is not only epistemically valuable, but intrinsically morally valuable. A recent argument has been advanced along these lines: We have an obligation to promote human diversity when its instrumental value is nontrivial. Disability is diversity of human kind within which members of the group recognize one another as “agents deserving of equal respect and moral standing” (Woodcock 2009), and as such, we ought to think twice about selection against it. After all, the aggregate effects of such actions could literally mean the elimination of human kinds marked by disability.

The argument from diversity seems to be formulated in two, albeit similar, ways. One comes in the form of a proscription: the claim that it is morally wrong to reduce the diversity of humans who recognize one another as being a part of the same moral community. The second formulation comes in the form of an obligation: the claim that we are obligated to maintain the diversity of moral agents within this same group.

Conclusion
Families who select for disability have a “mere-difference” view of disability and do so because they consider themselves to be part of a rich culture. Further considerations that owe to the issue of selection for disability are the epistemic and moral value disabled peoples add to the human community. The disabled community stresses that what is expressed by prenatal selection against disability, selective abortion of fetuses with disabilities, and those who think selection for disability is unjustified is that disabled people should not exist.

-Clarissa Becerra

• Barnes, Elizabeth (2014). Valuing Disability, Causing Disability. Ethics, 125 (1), 88-113.

• Bennett, R. (2014). There Can Be No Moral Obligation to Eradicate All Disability. Cambridge Quarterly of Healthcare Ethics, 30-40.

• Brock, Dan. (1995). The Non-Identity Problem And Genetic Harms – The Case Of Wrongful Handicaps. Bioethics, 9(3/4), 269-275.

• Goering, Sara. (2014). "Eugenics", The Stanford Encyclopedia of Philosophy (Fall 2014 Edition), Edward N. Zalta (ed.), URL = .

• Mundy, L. (2002). A world of their own, Washington Post.31 March, 2002:W22.

• Parfit, Derek. (1986) “The Non-Identity Problem." Reasons and Persons. Oxford: Clarendon, 1984. 351-65.

• Parker, Michael. (2007). The Best Possible Child. Journal of Medical Ethics, 33(5), 279-283.

• Saxton, Marsha, 2000, “Why Members of the Disability Community Oppose Prenatal Diagnosis and Selective Abortion”, in Parens and Asch 2000: 147–164.

• Wendell, Susan, 1996, The Rejected Body: Feminist Philosophical Reflections on Disability, New York: Routledge.

• Wasserman, D. (2005). The Nonidentity Problem, Disability, and the Role Morality of Prospective Parents. Ethics, 116(1), 132-152.

• Woodcock, S. (2009). Disability, Diversity, and the Elimination of Human Kinds. Social Theory and Practice, 35(2), 251-278.