An introduction

When my children were in middle school, they participated in a schoolwide effort called the “Worthwhile Life Project.” The students were assigned to take stock of their lives and their dreams, and to write an essay in which they explained how they planned to use their talents for the benefit of society.

Margaret’s essay was both elegant and direct. She wrote that she had Down syndrome, explained that it is a genetic condition that causes her to learn more slowly than other students, and said she did not think it would stop her from having a worthwhile life. When Margaret presented her essay to the class, she caused a sensation. Some students wept. She was invited to present her work in several other classrooms around the school, with much the same result.

The reporter in me wondered at the time why Margaret’s presentation seemed to elicit so much emotion. In retrospect, I think now that she was challenging the subliminal messages that her classmates were picking up elsewhere. A worthwhile life? How could a person with an intellectual disability have a worthwhile life? And yet there was Margaret advocating for herself and talking about her dreams just like everybody else. It was a powerful statement.

A few years have passed since then, but the need for those powerful statements hasn’t gone away. This spring, the American College of Obstetricians and Gynecologists recommended that all pregnant women regardless of age be offered prenatal screening and testing for Down syndrome.

This recommendation, which is perhaps the perverse unintended consequence of concerns about “wrongful birth” lawsuits and high malpractice insurance rates, seems to me to fuel public fears of disability. It sends an implicit message that people with Down syndrome aren’t capable, don’t have worthwhile lives, and aren’t welcome members of loving families.

In my experience, that’s not an accurate assessment. Thanks to changes in federal law that have opened doors to education and healthcare, people with DS are increasingly finishing high school, working in the community, and enjoying more independence than ever before.

Anybody who has had the pleasure of spending time with Margaret knows that young adults with DS are not heroes or victims but real people trying to live ordinary lives under slightly extraordinary circumstances. Margaret’s got friends, a part-time job, an exercise class, a can-do attitude and a smile that can light up a room. I asked her recently what she thought people need to know about Down syndrome. Here’s her answer: “Tell them it’s not so bad.”

While raising my children, I’ve used my journalistic training in an effort to understand the ways in which our society treats people with disabilities. I've been encouraged by improved access to education and health care; I also know firsthand the frustrations of trying to exercise those legally protected rights.

At the same time, I've been struck by the paradox posed by the new reproductive technologies. While they hold the promise of great medical progress, it must also be said that they will further marginalize a class of people who have historically faced discrimination, social ostracism, stigma and abuse.

With neither a coherent public discussion nor a concerted effort to obtain true informed consent, we seem to be sleepwalking toward a collective intolerance for genetic diversity. Absent as well is a public conversation about the vast sums that will be spent on prenatally diagnosing DS, as compared with the relatively meager amounts currently dedicated to research into medical treatments for people with DS.

Margaret’s girlfriends from elementary and middle school are child-bearing age now. I try to picture them in an obstetrician's examining room, listening to a well-meaning doctor offering a gloomy and outdated vision of the life of a person with DS. What will they think? Will they remember the cute blond girl who shared sandwiches with them at lunch, who dusted them off when they fell on the playground, who loved them? Will they remember her “Worthwhile Life” project?

My husband likes to say that Margaret asks nothing of us except that we change the world. I invite the readers of this blog to contribute to my ongoing exploration, which recognizes the essential contributions of people with disabilities and searches for ways to assure that they are respected and valued.