DOWN’S: DOING THE IMPOSSIBLE

There is nothing worse than a child born with Down’s syndrome. Or so medicine teaches us.

Anyone contemplating or entering parenthood has done so under the shadow of this chromosomal abnormality, singled out as the most intolerable of possible birth defects.That notion has been used as rationale for the development of the entire armament of prenatal tests AFP, chorionic villus sampling and amniocentesis carried out today. It’s also behind the policy of offering indeed, encouraging elective abortions if your amnio or CVS test comes up positive.

In mainly investigating for Down’s syndrome, every prenatal test sends new mothers the message that it is vital to rid the world of these defective genes these defective children.

But suppose you could eradicate most of the Down’s child’s mental and physical abnormalities with a vitamin pill? Increasingly, research demonstrates that Down’s syndrome results in a number of metabolic imbalances which cause the eventual physical characteristics and physical and mental handicaps. A handful of doctors and parents with Down’s syndrome have been experimenting with nutritional supplementation and dietary measures to correct these metabolic imbalances. Their admittedly small evidence has begun to show that if nutritional intervention is early enough, growth rate and cognitive development might be normalized. They even claim that, caught early, their children escape the worse physical characteristics of the syndrome.

If this is so, does it still make sense (if it ever did and, to my mind, it never did) to weed out these children and terminate them?

If these parents and doctors are right, the implications are monumental. It means that the entire rationale for prenatal testing is wrong. If we can correct Down’s syndrome and we know that spina bifida can be prevented with adequate intake of folic acid, is there any good reason to do prenatal testing at all?

If Down’s syndrome isn’t a syndrome at birth, but develops into one because of metabolic disturbances, perhaps we also have to redefine the term “mentally retarded”. Is mental retardation, other than true brain damage, not a static condition that one is born with, but the dynamic result of defective processing say, nutritional deficiency which occurs over time? And what of brain damage? Can we compensate for damage in other ways? Some of the evidence on autism suggests that it, too, can be improved with nutrition. Is any damaged brain in fact hopeless?

Eventually, we have to stop thinking in terms of finite conditions that we are lumbered with, but consider that many diseases like Down’s syndrome or autism are products of our environment and like any other environmental deficiency, might be amenable to fixing.

We also have to do some pretty hard thinking about our policy of terminating these pregnancies.