Assessing responsive state action in the conflict between disability rights and reproductive choice

产前筛查和选择性残疾堕胎的出现在人权领域是一把双刃剑。虽然可以提出论点说，它们扩大了生殖选择，但它们对残疾人的影响也引起了同样的关注。因此，我的项目考察了残疾人权利与妇女生育选择权之间的冲突，试图在残疾选择性堕胎方面在两者之间取得平衡。它认为，基于脆弱性方法（Fineman, 2008）和相关性（Harding, 2017; Nedelsky, 2011）的分析最适合解决这个问题，通过评估对残疾人和其他关系因素的响应性国家行动影响生殖选择的程度。表现主义观点（Asch, 1999）声称，残疾选择性堕胎表达了对残疾人的歧视态度。残疾人的主要担忧之一是，促进残疾人选择性堕胎可能会加剧围绕他们的耻辱，理由是他们的存在代表着对社会的责任（Steinbach, 2016）。他们也可能增加被歧视的感觉（纳菲尔德生物伦理委员会关于唐氏综合症患者对NIPT的看法的报告，2017）。但是，完全取消产前检查和因基因异常而堕胎的权利将导致剥夺获得安全堕胎的权利，从而抑制生殖选择。这就产生了一个具有挑战性的困境：我们如何保障残疾人的权利，同时确保妇女的生育选择？利用玛莎·费曼的脆弱性理论（费曼，2008），我的项目认为，在残疾选择性堕胎的背景下，权利冲突困境可能与反应性国家的存在有关。虽然“脆弱”一词通常与受害者和依赖性联系在一起，但Fineman认为，这个词实际上可以用来描述人类状况的普遍、不可避免和持久的方面。因此，脆弱性可以作为一种强有力的概念工具，进一步界定国家确保更丰富的平等保障的义务。因此，本项目旨在评估国家对残疾人的反应是否有能力，以及国家是否缺乏对残疾人的支持。它将分析这如何有助于话语终止是唯一可行的选择，当胎儿检测阳性的遗传异常。这种“反应状态”的缺失可能会因此“推动”（Thaler和Sunstein， 2008）怀孕的母亲终止妊娠，这反过来不仅抑制了残疾人的权利，也抑制了妇女的生育选择。我将采用文献和相关法律政策的理论分析相结合，以及定性访谈研究，进一步研究当胎儿基因异常检测呈阳性时，影响终止决定的无数社会、法律和相关因素。通过这种方法，我希望能够充分回答这样一个问题，即如何将解决残疾选择性堕胎所带来的风险的活力与保护生育选择权的需要结合起来。

The emergence of prenatal screening and disability-selective abortions have presented a double-edged sword within the field of human rights. Whilst arguments could be raised that they amplify reproductive choice, parallel concerns have surfaced with regard to their effects on persons with disabilities. Accordingly, my project examines the conflict between the rights of persons with disabilities and women's reproductive choice, attempting to strike a balance between the two in terms of disability-selective abortions. It argues that an analysis based on the vulnerability approach (Fineman, 2008) and relationality (Harding, 2017; Nedelsky, 2011) is best suited to address this issue, by assessing the extent to which responsive state action towards disabled people and other relational factors affect reproductive choice. The expressivist argument (Asch, 1999), claims that disability-selective abortions express discriminatory attitudes about disabled people. One of the primary concerns for disabled people is that the promotion of disability-selective abortions may heighten the stigma surrounding them, on the grounds that their existence represents a liability to society (Steinbach, 2016). They may also increase feelings of being discriminated against (Nuffield Council on Bioethics Report on the Views of People with Down Syndrome on NIPT, 2017). However, complete elimination of prenatal screening and the right to abort on grounds of genetic abnormalities would lead to a deprivation of the right to access safe abortions, thereby inhibiting reproductive choice. This gives rise to a challenging dilemma: how do we safeguard the rights of persons with disabilities, whilst securing reproductive choice for women? Using Martha Fineman's Vulnerability Theory (Fineman, 2008) my project argues that, in the context of disability-selective abortions, the conflict of rights dilemma could be tied to the presence of a responsive state. Whilst the term 'vulnerability' has commonly been associated with victimhood and dependency, Fineman argues that the term can actually be used to describe a universal, inevitable, and enduring aspect of the human condition. Consequently, vulnerability could be used as a powerful conceptual tool to further define an obligation for the state to ensure a richer guarantee of equality. Accordingly, this project seeks to assess whether state responses towards disabled people are ableist, and whether there is a lack of state support for persons with disabilities. It will analyze how this contributes to discourse that termination is the only viable choice when a fetus tests positive for a genetic abnormality. This absence of a 'responsive state' may consequently 'nudge' (Thaler and Sunstein, 2008) pregnant mothers towards termination, which in turn inhibits not only the rights of disabled individuals, but also women's reproductive choice. Adopting a combination of documentary and doctrinal analysis of relevant laws and policies, as well as qualitative interview research, I will further examine the myriad of social, legal, and relational factors that influence a decision to terminate when a fetus tests positive for a genetic abnormality. Through this approach, I hope to adequately answer the question of how to marry the vitality of addressing the risk posed by disability-selective abortions to the disabled community, with the need to protect the right to reproductive choice.