Catholic Medical Quarterly Volume 71(3) August 2021

Thumbs up for persons with Down's

Fr James McTavish, FMVD

Fr McTavishEvery March 21, the World Day for Persons with Down’s Syndrome is celebrated. The 21st day is chosen as persons with Down’s have a triplication of chromosome 21, hence trisomy 21. This year, 2021, the global theme is “We Decide”, inspired by the United Nations Convention on the Rights of Persons with Disabilities (CRPD) which supports effective and meaningful participation as a core human right. There is in fact a growing awareness worldwide of the rights of persons with disabilities. Much laudable progress has been made, and much work still needs to be done. The United Nations has produced an International agreement on the rights of disabled people.[1] The agreement endeavors to ensure disabled persons are treated fairly, with the same rights to be included in society as anybody else.

Catholic Church teaching regarding disability

The Catholic Church also shares in this mission to promote the rights of persons with disabilities, seeing all persons as made in the image and likeness of God. In number 2208 of the Catechism of the Catholic Church we find, “the family should live in such a way that its members learn to care and take responsibility for the young, the old, the sick, the handicapped, and the poor.”[2] The Compendium of the Social Doctrine of the Church states, “Persons with disabilities are fully human subjects, with rights and duties: in spite of the limitations and sufferings affecting their bodies and faculties, they point up more clearly the dignity and greatness of man. Since persons with disabilities are subjects with all their rights, they are to be helped to participate in every dimension of family and social life at every level accessible to them and according to their possibilities.”[3]

Ground E abortions

In this encouraging milieu of positive promotion of persons with disabilities, it is disturbing to know that in 2019, there were 3,183 abortions performed in England and Wales because of fetal abnormality. These are known as “Ground E” abortions and are defined as such where supposedly there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped. They include diagnoses of the following syndromes: Down’s (trisomy 21), Edwards’ (trisomy 18) and Patau’s (trisomy 13).


In 2019, in England and Wales, there were:

656 abortions carried out for Down’s syndrome
221 abortions for Edwards’ syndrome
99 abortions carried out for Patau’s syndrome[4]
It is a concern that there were also 17 abortions performed for cleft lip and cleft palate. [5]


The Government acknowledges abortions carried out for these reasons (ground E) are under­reported, which is rather alarming. This was discovered by comparing statistics given to the Department of Health and Social Care, and those recorded by National Down’s Syndrome Cytogenetic Register (NDSCR). “Results from the matching suggest that a Department of Health and Social Care notification was made for about 54% of NDSCR records and that almost half of Ground E notifications are missing... However, despite some progress being made, it is likely there is still a significant undercount presented in the ground E notification tables in this publication, so overall figures related to ground E notifications should be treated with caution.”[6]

Pre-natal testing

Typically, pre-natal testing was done using amniocentesis and chorionic villus sampling. This allowed for some conditions to be diagnosed in-utero. In recent years, a new blood test became available for pregnant women called Non-Invasive Prenatal Testing (NIPT). It measures DNA levels for chromosomes 21, 18 and 13 which when high can indicate Down’s syndrome (21), Edwards’ syndrome (18) or Patau’s syndrome (13). Unfortunately, the information is often used to decide to abort the baby. This leads to the sad state of affairs that we have now in England and Wales, namely that 90% of all babies with prenatally diagnosed Down’s syndrome are aborted when in the womb.


We began with the good news that the rights of persons with disabilities are being promoted so that they can enjoy equal dignity. We can see this positive move in society, with such events as the celebration of World Down’s Syndrome day, where the joy of having a child with an extra chromosome is heralded. The beautiful animated video song, made by mums and kids with Down’s syndrome, is a heart-warming example. See their performance entitled “50 Mums, 50 Kids, 1 Extra Chromosome”at Such efforts really help consolidate the position of persons with Down’s syndrome in our society, especially of children.

It is with much dismay then to see their same rights denied to children with Down’s syndrome while they are still in the womb. Babies in the womb at risk of Down’s are being identified with pre-natal testing. Pope John Paul II stated, “Prenatal diagnosis, which presents no moral objections if carried out in order to identify the medical treatment which may be needed by the child in the womb, all too often becomes an opportunity for proposing and procuring and an abortion. This is eugenic abortion, ... on the basis of a mentality ... which accepts life only under certain conditions and rejects it when it is affected by any limitation, handicap or illness.”[7] Pre-implantation genetic diagnosis (PGD) can also be used to selectively screen IVF embryos for Down’s syndrome. In this way, PGD is “an expression of a eugenic mentality that legitimizes selective abortion to prevent the birth of babies afflicted with various illnesses.”[8]

Pope Francis, another strong critic of abortion, adds his voice in his encyclicals. In Laudato Si’ (n. 117), his encyclical on the care for creation, the Pope reminds us of the littlest amongst the created – to not forget to “fail to acknowledge as part of reality the worth of a poor person, a human embryo, a person with disabilities.”[9] To these prophetic voices we can add that of Mother Teresa, another great defender of life. In her acceptance speech having received the Nobel Peace Prize in 1979, she made the following remarks.

In the newspapers you read numbers of this one and that one being killed, this being destroyed, but nobody speaks of the millions of little ones who have been conceived to the same life as you and I, to the life of God, and we say nothing, we allow it.To me the nations who have legalized abortion, they are the poorest nations.They are afraid of the little one, they are afraid of the unborn child, and the child must die because they don’t want to feed one more child, to educate one more child, the child must die.[10]

May we be inspired too by the life and teachings of St Alphonsus Liguori, the Patron of moral theology in the Catholic Church. This week, Pope Francis in a message on the occasion of the 150th anniversary of the proclamation of Saint Alphonsus Maria de’ Liguori as Doctor of the Church, described St Alphonsus as “Advocate of the least, the frail and those discarded by the society of his time, he defended the rights of all, especially the most abandoned and the poor.”[11] St Alphonsus, pray for us!

The prophetic task of the Church continues today through Catholic Healthcare Workers, and all persons of goodwill. In various countries, it is becoming increasingly common to abort babies with Down’s syndrome. Tragically, in places like Iceland, Down’s syndrome has been virtually eradicated with only one or two children now born with trisomy 21 each year. As Patricia Heaton commented, “Iceland isn’t eliminating Down syndrome - they are just killing everyone who has it.”[12] For this reason, the new Vatican charter for Healthcare workers reminds us that “the Church raises her voice in defence of life, in particular life that is defenceless and ignored, such as embryonic and fetal life. The Church, therefore, calls health care workers to professional integrity, which tolerates no action that destroys life.”[13]

So, while many may be giving the thumbs down to Down’s babies in the womb, we must all, and especially healthcare workers, fight strongly to give all persons with Down’s syndrome a big thumb up.


  1. United Nations. “International agreement on the rights of disabled people.” Easy read version.
  2. Catechism of the Catholic Church. See
  3. Pontifical Council for Justice and Peace, Compendium of the Social Doctrine of the Church. 2005. Available at mpendio-dott-soc_en.html
  4. National Statistics for UK Government. “Abortion statistics 2019: data tables.” Table 9a. Available at See also CBR UK. “Latest UK Abortion Statistics 2019.” Available at
  5. Modern techniques of plastic and reconstructive surgery can ensure good outcomes for babies with cleft lip and cleft palate. It is difficult to understand how these treatable conditions could be considered as serious handicaps necessitating an abortion.
  6. Department of Health & Social Care. “Abortion Statistics, England and Wales: 2019.” No. 26, p. 9. Available at: 891337/guide-to-abortion-statistics-2019.pdf. No. 26, p. 9.
  7. Pope John Paul II. 1995. Evangelium vitae, n. 14. Available at
  8. Pontifical Council for Pastoral Assistance to Health Care Workers, 2017. New Charter for Health Care Workers. National Catholic Bioethics Center, Philadelphia, USA, n. 36. Viewable at­New-Charter-for-Health-Care­Workers#fullscreen&from_ embed
  9. Pope Francis. 2015. Laudato si’. Available at­laudato-si.html
  10. Mother Teresa. 1979. “Acceptance Speech Having Received the Nobel Peace Prize.” University of Oslo, Norway, December 10.
  11. Pope Francis. 2021. “Message of the Holy Father Francis on the occasion of the 150th anniversary of the proclamation of Saint Alphonsus Maria de’ Liguori as Doctor of the Church.” 23rd March. Available at
  12. Patricia Heaton. America Magazine. “Patricia Heaton: ‘Iceland isn’t eliminating Down syndrome­ they are just killing everyone who has it.’” 4 December 2017. Available at
  13. Pontifical Council for Pastoral Assistance to Health Care Workers’ New Charter for Healthcare Workers. Pub The National Catholic Bioethics Center August 2018..., n. 52.