Facts and values in the history of spina bifida

Abstract

Over the past two decades, maternal–fetal surgery has become a clinical reality for some pregnant women carrying a fetus diagnosed with spina bifida. Since its conception, maternal–fetal surgery has been the focus of ethical deliberation, because expected health benefits for the fetus come at the cost of potential health risks for the pregnant woman. Zachary's view was that disability was not the result of the physical or mental impairments per se, but of society's response to such impairments, thereby vocalising the prevalent social criticism of the time related to disability rights. [...]Zachary also rejected Lorber's criteria “from a strictly scientific point of view”, arguing that, in his studies, Lorber had given the inaccurate impression that children not selected for treatment would die spontaneously without exception. According to Zachary, many of these patients would have survived, had they not been “pushed into death” by excessive amounts of analgesic drugs that suppressed their demand for food. [...]of various factors including the introduction of folic acid supplementation, the implementation of prenatal screening, and the option for the termination of a pregnancy when a fetus is diagnosed with spina bifida, the incidence of newborns with spina bifida has declined in high-income countries.