Selective abortion following a prenatal diagnosis of Down syndrome presents complex ethical and religious challenges, particularly within the context of Qatar. Advances in prenatal screening enable early detection of chromosomal conditions, prompting debates grounded in the principles of autonomy and non-maleficence. While autonomy emphasizes the pregnant individual’s right to make informed reproductive choices, it does not provide sufficient moral justification for terminating a fetus granted moral personhood. Arguments based on anticipated familial burden or altered expectations fail to demonstrate that lives affected by Down syndrome lack value. From the perspective of non-maleficence, abortion constitutes significant harm by depriving the fetus of a “future like ours,” and claims of psychological harm rely on speculative judgments shaped by societal discrimination rather than intrinsic suffering. Islamic bioethics and Qatari law further restrict abortion, permitting it only under specific conditions, such as severe fetal anomalies before ensoulment or maternal health risks. These frameworks affirm the sanctity of life and reject disability-based termination. Ultimately, ethical responses should prioritize inclusion, reduce stigma, and strengthen support systems for families, aligning medical practice with principles of justice and the equal dignity of all human lives.