NEW YORK TIMES OP/ED PAGE Charlie's Ghost By BILL KELLER Two years ago this summer, my wife and I lost a baby. I say "lost," as if we had misplaced it. There is nothing like abortion to make you appreciate the solace of euphemism. Lord knows the zealots who have occupied the field and mined it with moral explosives have left little room for comfort. Let's begin with what happened. At 17 weeks, we went to Mount Sinai Hospital in New York City to view ultrasound pictures of our future child and have amniotic fluid drawn for testing. The ultrasound image showed that the fetus was not growing as fast as expected, and before long we had a couple of specialists puzzling over the pictures. Why was there so little fluid? Why was the placenta so large? Was there a defective chromosome? Were the kidneys missing? They rushed the tests, but the chromosomes revealed nothing more about our stunted fetus, except — except that he was male. This is the double- edged scalpel of reproductive science. The technology that informs you your future baby is mysteriously endangered also makes him real, a boy- like creature swimming in utero. (And this was before the new, hyper- realistic sonography that, judging by General Electric's TV commercials, portrays your fetus as a mesmerizing little 3-D merman.) Yes, I know how shamelessly the anti-abortion lobby has exploited this illusion to give tadpole-sized fetuses the poster appeal of full-grown infants. But no amount of reasoning about the status of this creature can quite counteract the portrait that begins to form in your heart with the poetry of the first heartbeats. Sentimental fools, we gave him a name, Charlie, maybe imagining it would help him put up a fight. For the next five weeks Emma was examined by the best minds at one of the best hospitals. She was screened for viruses, blood disorders, hereditary indicators — all normal. She had weekly sonograms by virtuosos of the machine. There were momentary highs (kidneys were functioning after all; a dissenting sonogram reader even thought the amniotic fluid was on the rise) and dispiriting lows (bad blood flow to the fetus, which meant organs were probably not developing properly), but no definite answers. Something was clearly, badly wrong. The doctors assumed that, of course, we would want to abort, as soon as possible. "We know you can get pregnant easily," Emma's obstetrician said. "Why risk an unhappy outcome?" She urged us to schedule quickly, because it would be difficult to line up a surgeon around the July 4 holiday. Appalled by the rush, Emma changed doctors, but we never quite escaped the feeling that by holding out, week after week, hoping for better odds, we were being more than a little eccentric. My wife clings more firmly to her faith than I, so she called the hospital's Catholic chaplain for counseling and left tear-choked voicemails explaining the predicament. He never called back. She found some consolation outside official channels, from a nun she's known since school. "Think about what God would want, not what the church would want," the nun advised, with a wisdom that would surely disqualify her from Vatican office. "They are not always necessarily the same thing." As we approached 24 weeks, the legal deadline for abortions in New York, the most explicit prognosis we could wheedle from the experts was that chances were high — one was willing to say over 90 percent — that the baby would be born dead or in a vegetative state. And carrying the child to term would pose some danger to Emma's health. Facing the prospect of a greater heartbreak, watching a child die or suffer inconsolably, or exhausting the emotional resources needed for two other children, we decided to end it. The last thing Emma was aware of before surrendering to the anesthetic was Charlie kicking madly. Two years later, past the mourning and the guilt and into the precarious hope of a new pregnancy, our experience at the intersection of science and parenthood haunts my thinking in ways I did not anticipate. Among other things it has deepened my suspicion of moral clarity, and also of disembodied rationalism, both of which seem to offer a kind of ethics without human beings. The ideologues on both sides, those who view abortion as an absolute wrong and those who view it as an inalienable right, too often treat these decisions as if they were clear-cut and pain-free. If you'd asked me before that summer, I'd have told you reflexively that I was pro-choice. As a matter of law and politics, that is still my position, for this is not a decision I would entrust to courts and legislatures, even given that some parents will make choices I would find repugnant. But like a lot of parents who have lived through it, I have come to see "choice" as a mixed blessing. I've often wondered what we'd have done if the decision had been less stark — if the doctor had said 50-50, or if the gamble had been on something known, on Down syndrome or one of the severe crippling diseases. Would we have had the strength to ride it out? The fact that I think of this as something to aspire to is itself a change of heart. Science is rapidly chipping away at biological uncertainty. In addition to the growing sophistication of pregnancy testing — amnio and chorionic villus sampling and sonograms and specialized blood screens — some fertile couples now spend the money for in vitro fertilization, accompanied by genetic analysis before the embryo is implanted, to screen for abnormalities that may not kick in for 20 years. It is already possible to check embryos for a gene that will show a predisposition for Alzheimer's. Scientists anticipate tests that will predict whether your child is likely to be homosexual, or unusually aggressive. There is astonishingly little good research on what parents do with this proliferating prenatal information (the subject of abortion is too much of a political minefield to get the research funded), but it is fair to say that the reproductive industrial complex grinds in favor of "perfection." For some parents, the abortion threshold is multiple sclerosis. For some, it's a cleft palate. Counselors who specialize in this say there are prospective parents who end pregnancies because they had their hearts set on the other gender. "You get questionable news and you make the abortion decision," said Adrienne Asch, a Wellesley bioethicist who argues that prenatal screening and selective abortion have become too routine. "Anything else you do is viewed as stupid by your educated friends, by your doctors, by your genetic counsel- ors." No one mandates prenatal testing, although it is such an automatic part of the regimen that many expectant mothers believe it is obligatory, and few fight it. My wife is a testing skeptic. She is convinced that if we had just let nature take its course, without sonograms and amniocentesis, "we would have lost that baby, but we would not have killed that baby." All the same, the next time around we tested. Emma says she didn't have the energy to defend her "right to be ignorant" — to doctors, friends and a husband who can't bear not knowing. It seems to me a plausible fear that eventually these decisions will slip more and more from our hands. In a world of market-driven health care, I can imagine insurers refusing to cover a costly childhood disability that could have been detected in advance and "prevented" by aborting. Wouldn't that be an infringement of choice as surely as outlawing abortion? This is not a subject with much of a middle ground, but one reasonable alternative to reducing parents' choices is to make their choices more educated. Adrienne Asch, for example, advocates better counseling of prospective parents at the time of testing, including some informed discussion of what life is like for children born disabled — to present that as a choice rather than an unthinkable horror. Glenn McGee, a University of Pennsylvania ethicist who is more sympathetic to prenatal screening, agrees with her that the system offers too little support for parents who might want to keep an "imperfect" baby. Most parents who reach the second trimester, when the most intensive testing takes place, have already made a place in their hearts for a child. But the counseling they get when something wrong shows up is cursory, not covered by insurance and geared to avoiding the burden of abnormality. Perhaps Planned Parenthood would like to live up to its name by taking this on. As for our story, it has, if not a happy ending, at least a happy new beginning: Our daughter Alice was born 11 days ago. L'Chaim! _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx