This Value-for-Money life.

There is an article on the Daily Mail website today that has left me feeling rather disturbed. For once, it is not the opinions expressed within the article, nor those implicit in the language or phraseology of it that have caused my discomfort (though there were a couple of unfortunate references to ‘Down’s babies’). The article itself is perfectly reasonable, and gives a voice to the families of people with Down’s. What has disturbed me is the fact that it needed to be written. It begins with this headline:
‘You can’t put a price on a Down’s child’s life! Families’ fury as top doctors say lifetime cost of care to NHS justifies new simple blood test for mothers-to-be’
It then continues:
‘Senior doctors sparked fury yesterday for suggesting the NHS should work out the ‘cost effectiveness’ of caring for children with Down’s syndrome.’ 
Who has a crystal ball that can predict how much any single one of us will cost the NHS? 
Many people with Down’s Syndrome enjoy good health (like Freddie, so far).
But there are also many people (who do not have DS) born ostensibly ‘healthy’ and ‘normal’ who are later diagnosed with some chronic condition or illness requiring ongoing treatment; or who meet with a life-changing accident. These people also need care that will place a cost on the NHS. Are we to analyse the cost of caring for them and decide what their life is worth in terms of treatment costs? Are we to weigh the lives of dustman and doctor, barista and barrister, in the scales against each other to decide which one is worth the cost of cancer treatment, or insulin injections, or a heart bypass?
And what about those people who will be born with a disability or condition that is not detectable before birth? Should midwives be equipped with a calculator and a pillow, so that they can tot up the likely cost of these imperfect lives and snuff out the ones that will prove expensive?
No, of course that isn’t going to happen. I’m being melodramatic. But to many of the policy-makers, the power-brokers, getting rid of any potentially problematic people before they’re born makes sense. It’s the perfect solution.
So, first they demonise the condition, or the people who have it; the ‘establishment’, the ‘status quo’ (medical profession, politicians, press, etc) use only nuanced language in describing the condition, it’s effects, and those people who have it. Information given out presents only lists of clinical features, possible complications and worst-case-scenario prognoses; people are reduced to mere syndromes, devoid of their humanity. Positive examples are dismissed as flukes. Thus we are persuaded that these less-than-human lives are not worth living, and that it is our responsibility, our duty, to prevent their suffering,and our own, before it begins, and relieve society of an unwelcome burden. 
In the case of learning disability it is only a short step from advocating abortion to advocating euthanasia – once we have been persuaded that such people are less than human, and lack the capacity to reason, to make informed decisions, to understand (none of these assumptions we are lead to make are true, by the way).
At the moment it is only possible to detect certain conditions before a child is born, not all of which are life-limiting. But the medical profession seems intent on eliminating these – abortions, even beyond the limit that would be legal for a ‘healthy’ foetus, have been performed for conditions such as cleft palate which is treatable by surgery. How long before we can detect other things, like Autism, before birth? How long before we can detect genetic tendencies before birth: the tendency to become obese, for instance, or to become addicted to smoking, or to develop certain cancers, and so on – all of which involve the likelihood of greater than average cost in terms of NHS treatment and/or social care? How many of us would never have seen the light of day if this had been possible when we were foetuses?
How do you measure the cost of a life, the value-for-money of a life? What price would they have put on Freddie’s life at 13 weeks gestation, when a 1:12 chance of his having DS was detected. No doubt they would have factored in the probability of a heart defect, or Hirschprung’s disease, hearing problems, on so on (as though he was going to have all of these at once. But no one does have them all. Some don’t have any). 

But how do you reckon up the value of this:


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