that opportunity for challenge [of raising a child with Down's syndrome] is little more than a lifetime of endless burden. In this light, it is completely legitimate for a woman to look at the circumstances of her life and decide that having a child with Down syndrome (or any child for that matter) is not an obligation that she can accept. After all, the choice to have a child is a profoundly selfish choice; that is, a choice that is an expression of the parent's personal desire to create new life.
Viewing childbearing as "a profoundly selfish choice" tells us nearly everything we need to know about why birth rates in the "advanced" Western world has dropped below replacement rates. After all, how can anyone who simultaneously views children as a "burden" and a "selfish choice" really justify having children at all? That would be an illogical imposition on one's personal autonomy, after all - an unbearable burden.
Further - a point that comes out clearly in Provenzo's argument - the assumption that such a momentous obligation to the future and other human beings represents "a selfish choice" underlies the fundamental eugenicist assumptions at the root of this worldview. When we undertake any choice - including bearing children - for reasons of personal self-satisfaction, then like any consumer choice, we want the nicest fashion accessory possible. If choice dominates our calculus, then reasonably it should extend to exactly the kind of baby that I WANT. It's my selfish choice, after all. Thus, today according to Provenzo it's immoral and obscene to knowingly bear a child with Down's syndrome. Tomorrow it will be immoral and obscene to bear a child who will be short, who will have brown hair, who will not have the finest genetic package that money can buy. Gattaca meets Children of Men. Those with such "imperfections" will at times wish they had been aborted in a world in which they will be only good enough for a thrift store, a "seconds" sale, or the island of misfit toys. Anyone who doubts the return of a new eugenics needs only to read, and understand, the implications of arguments such as this.