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Over the last three days, many hundreds (thousands?) of words have been generated by dKos diarists speculating on the parentage of Trig Palin.  But that really isn't the issue.

A few thousand more words have been set forth berating Ms. Palin for taking on the arduousness of campaigning for the Vice-Presidency of the United States while her special-needs son is in early infancy.  But really, that is a decision she, with her family has the right to make — whether they feel it is in the best interest of their family to have Ms. Palin on the campaign trail.

Other words have speculated on why Ms. Palin underwent genetic testing so as to know, before Trig's birth, that he had Down syndrome.  As an ardent anti-abortionist, Ms. Palin wouldn't have been considering terminating the pregnancy if — as happened — a genetic abnormality was found.  But, again, that was a choice the Palin family had the right to make.

Isn't a pity that Palin would deny other families those same rights, and those same choices?

After the age of 35, the probability of genetic abnormality in a pregnant woman's fetus is high enough to make genetic testing routine.  This allows the woman, and her family, to make an informed decision, taking into consideration all aspects of their family, of whether to proceed with the pregnancy, or terminate.  Even if a family is certain that they will not choose to terminate the pregnancy, the information that their child will have a genetic defect such as Down Syndrome allows the family to prepare for the special needs, both intellectual and physical, of their child.

Many decry the estimated 90% abortion rate of Down syndrome fetuses.  It has been blamed on "eugenics", "selfishness" and the "demand for a perfect child".  The decision on whether to carry a Down syndrome fetus to term — just as the decision to carry any pregnancy to term, is unique to each woman and to each family.

The hard and brutal fact of Down syndrome is that it can cause significant physical disabilities and illnesses, as well as "mild to moderate" mental retardation.  The severity of a child's disability will not be known until the child is born.  The children with Down's that we see mainstreamed in our children's classrooms, or participating in the Special Olympics, or working, as adults, as courtesy clerks ("box boys") at the grocery store, are those who are the least physically and mentally challenged by Down syndrome.

For a family without superior medical insurance, above-average financial resources, and a large support system, a child with Down syndrome can have a devastating impact.

Consider: one-half of children with Down syndrome are born with heart defects.  60% have vision impairment, up to 75% have hearing loss.  5% have hyperthyroidism, and up to 7% have gastrointestinal problems.  Children with Down syndrome have double the risk of leukemia.

Additionally, Down syndrome is associated with poor muscle tone and an over-sized tongue.  These physical manifestations likely require prolonged physical and speech therapy; yet most medical insurance plans limit therapy sessions to as few as 10 visits.

We all know what the situation is regarding access to health care in our country: You're On Your Own.  Because of all the medical problems caused by Down syndrome, it may be difficult or impossible for a family to find and maintain affordable insurance.  Even if they are insured, they may quickly reach the lifetime cap of a policy, or find the co-pays to be unaffordable.  If a family has other children, any financial resources they had planned to put towards those other children's educations may be taken up by the medical requirements of the child with Down Syndrome — and still the family may wind up in bankruptcy.

Further, children with disabilities are at higher risk for child abuse.  A disabled child can strain not only the family's financial budget, but its emotional budget as well.

In being a parent, one aims (hopefully) prepare one's children to be responsible, independent adults and able function on their own.  However, for a child with Down syndrome that independence will never come.  Although people with mild mental retardation may be able to live largely independent lives, they always will require some assistance, and will always be at risk for exploitation.  Further, people with Down syndrome have higher incidence, and earlier onset of, Alzheimer's disease.  It is estimated that 25% of people with Down syndrome show signs of Alzheimer's by age 35.

The parents of a child with Down syndrome must plan for the time after their deaths, and have in place a support system for their child.  According to the ARC of the United States an estimated 1,000,000 people with disabilities are living at home with caregivers over 65 years of age.  Nationally, over 285,000 people are on waiting lists to receive public support services.  Once again, you're on your own.

Sarah Palin and her family had every right to decide for themselves whether becoming parents to a disabled child was the right choice for them.  However, Sarah Palin also believes that she has the right to make that same decision for every family, while at the same time denying those families the public support systems that might make that choice more feasible.

That, my friends, is the issue.

Originally posted to Franklin's Tower on Sun Aug 31, 2008 at 07:19 PM PDT.

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