The Medico-Legal Authorization of Disability-Selective Pregnancy Termination

Abstract

In this chapter, we provide a comparative analysis of the authorization processes of disability-selective abortion and their socio-historic and political shaping in Austria and Denmark—two European countries that constitute comprehensive welfare states with internationally acknowledged healthcare systems. In both settings, disability-selective abortion is legal and covered by health insurance or state-financed if medically authorized. However, authorization processes differ considerably. These differences form the starting point of our contribution, in which we unfold how national abortion laws and histories in the 20th century, the prenatal testing schemes in place and the contemporary political cultures surrounding selective reproduction in each country have given rise to two distinctive authorization systems. In Austria, where the country’s eugenic past looms large, and where prenatal testing constitutes a private service and abortion a stigmatized criminal offense, a decentralized system has evolved that allows for organizational flexibility and individual moralities. In Denmark, in contrast, the conceptualization of abortion as reproductive right, and a “healthy” family as pervasive social norm, have firmly embedded prenatal testing and abortion in universal health care, requiring a high level of centralization and juridical streamlining. Despite these differences, our comparative analysis shows that being medico-legally responsible for authorizing abortion is a morally loaded matter that calls for collectivity and sharing of the burden.