Comment on: Diagnosis of autism, abortion and the ethics of childcare in Yoruba culture

9 Nov

I have an email alert from PubMed for autism. I’ve seen a few very problematic papers go by over the years, but this one really bothers me. The study is from Nigeria, home of much of the Yoruba people. I have not seen the full paper, but from the brief abstract it appears that the Yoruba people have developed moral principles that create an accepting environment for autistic children. They believe in “equality of humans at birth” and “solidarity”. The author of the study appears to take the position that “despite these justifications” there is a need for a “contextual rethinking” which would allow for aborting fetuses deemed to be at high risk for autism.

Note that there is not existing test to determine that a fetus is at high risk for developing autism. And even if there were, really? We need contextual rethinking to allow for abortion of autistics? And this is in a medical journal?

Acceptance, equality and solidarity should not preclude diagnosis and support for autistics, but I wonder if the author is going beyond that in his/her call for these Yoruba principles from prohibiting treatment.

Here is the abstract:

Indian J Med Ethics. 2014 Oct-Dec;11(4):245-8.

Diagnosis of autism, abortion and the ethics of childcare in Yoruba culture.

Fayemi AK.

Author information

Abstract

This paper examines the ethics of childcare in Yoruba culture in the contexts of autism and abortion. The traditional Yoruba moral principles of ibikojuibi (equality of humans at birth) and ajowapo (solidarity) have been theoretically developed to establish the personhood of autistic children and provide a justification for not aborting foetuses with autism. Despite these justifications, this paper argues that there is a need for contextual rethinking, which would allow for: (i) prenatal genetic testing, as well as abortion of foetuses with a high risk of the autism mutation, and (ii) early clinical diagnosis and treatment of autistic children in contemporary Yoruba society.


By Matt Carey

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6 Responses to “Comment on: Diagnosis of autism, abortion and the ethics of childcare in Yoruba culture”

  1. Dr Mitzi Waltz November 9, 2014 at 09:32 #

    Ademola Kazeem Fayemi is a lecturer in philosophy at Lagos State University in Ojo State, Nigeria. His publication record is all over the place. The journal itself is not exactly a “medical journal” but one in which Indian and African doctors burnish their dubious publication records by penning opinion pieces with titles like “Doctors Do Cry.” (We have plenty of analogous journals in the West as well…).
    So what worries me is not potential impact, but that the appearance of this article is another sign of how the devaluation of people with autism in the West is having an impact elsewhere–an impact that, given the even lower level of protection and resources available to disabled people elsewhere, may have a far greater impact on more people fora longer length of time.
    Selective abortion “to prevent autism” is already quite common in India amongst that class that can afford it–never mind that it is also very ineffective, since there is not and likely never will be an accurate prenatal test for such a heterogeneous condition. So are unsupportable and dangerous therapies like stem cell therapy “for autism,” and these reach far beyond the Indian upper class, since medical services are now one of India’s biggest experts, attracting patients from the far east, middle east and Europe to shiny but often deeply dodgy clinics.
    I believe the author of this particular article can be reached at kcaristotle@yahoo.com or kcaristotle@gmail.com. I would like to encourage constructive dialogue–but I would like to read the full piece first, just in case the abstract has misrepresented the content. Does anyone have access to full text?

  2. Dr Mitzi Waltz November 9, 2014 at 09:43 #

    Reblogged this on Dr Mitzi Waltz and commented:
    Commenting on Matt Carey’s post (see reblog link) has reminded me that autism researchers and practitioners need to think about the worldwide impact of the discourses and approaches we promote. Devaluing people with autism is one product of the “autism industry” that I would like to see banned from export.

  3. mike stanton (@convivir) November 9, 2014 at 20:04 #

    http://ijme.in/~ijmein/index.php/ijme/article/viewFile/2140/4611 for the full text. It is only four pages. Meanwhile I think it is clear that the good professor is way out of his depth. There is no single autism mutation. He also mentions an amniocentesis test in relation to autism.

    The substance of his argument is that in the Yoruba culture neurological disorders are regarded as God-given and empathic care rather than therapeutic interventions are the order of the day. He wants a more scientific approach and for the Yoruba to consider abortion as an option. It is, according to him, counter to their philosophy which values all life from conception onwards.

    Thus we have three issues.

    1. Educating the Yoruba about the efficacy of modern health interventions.
    2. Challenging their philosophy to persuade them to countenance abortion in extreme cases of incurable but preventable disease.
    3. Spreading misinformation about autism as being one of these incurable but preventable diseases in order to force his case study about a family affected by autism into the debate.

    Point one is incontrovertible.
    Point two is contentious and requires careful argument and justification. And it is an unnecessary distraction from winning the argument over point one. Arguments about abortion should always be kept entirely separate from arguments about clinical care and provision.
    Point three is just plain wrong. It is irrelevant to point two and can only make winning point one more difficult.

  4. Narad November 9, 2014 at 21:30 #

    And this is in a medical journal?

    The same one that provided such Puliyel classics as this and this.

  5. Saraquill November 10, 2014 at 16:53 #

    Treating children as worthy human beings is an idea to be fought against? That sounds like a good reason not to take this publication seriously.

  6. Moromillas November 16, 2014 at 21:04 #

    It’s always horrifying that I have to repeat over and over, that I’m actually a human being, and not a malady.

    There’s a difference between elective abortion, and selective abortion, and this is just eugenic elimination.

    Using prejudice to justify this is beyond the pale, and it’s certainly not ethical.

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