"What kind of quality of life would a person, child or no, have if they were unwanted, starved, neglected? We live such privledged lives in the West we very oftem forget that for most people life is a series of tragic trade-offs. I do not condemn or envy the people (who are just as emotional cogent as you or I) who are placed in such impossible positions. But many are."
I don't think people in truly extreme situations can be judged in the same moral terms, no, because the struggle to survive can be overwhelming. But Singer is definitely not only talking about people in such situations, so that's beside the point he's making. He's specifically discussing complex diagnostic tests to identify disabilities that may not be immediately apparent, or identifiable in utero, and such tests are not available in the conditions you describe. So his terms of reference are those with access to sophisticated medical care:
"Regarding newborn infants as replaceable, as we now regard fetuses, would have considerable advantages over prenatal diagnosis followed by abortion. Prenatal diagnosis still cannot detect all major disabilities. Some disabilities, in fact, are not present before birth; they may be the result of extremely pre- mature birth, or of something going wrong in the birth process itself. At present parents can choose to keep or destroy their disabled offspring only if the disability happens to be detected during pregnancy. There is no logical basis for restricting parents' choice to these particular disabilities. If disabled newborn infants were not regarded as having a right to life until, say, a week or a month after birth it would allow parents, in consultation with their doctors, to choose on the basis of far greater knowledge of the infant's condition than is possible before birth."
And actually he does advocate it if it's what the parents want. He regards it as morally neutral at worst under his value system. I quote:
"the issue of ending life for disabled newborn infants is not without complications, which we do not have the space to discuss adequately. Nevertheless the main point is clear: killing a disabled infant is not morally equivalent to killing a person. Very often it is not wrong at all."
Sorry, but I find the reasoning he's employing disturbing, because he's reducing infant human beings to commodities, of value only inasmuch as they benefit adults. And he's arguing that a life with difficulties is inherently less worthwhile, and invoking thalidomide compensation in illustration: arguing that the compensation proves life without thalidomide damage is preferable. Well, of course it is - for that person. He seems to miss the salient point that what is on offer is not a life without such damage. It's no life at all. The benefits of continued existence for the baby in question don't bother him - as he says, he sees people as interchangeable, and the corollary of that is, expendable.
Finally, if he genuinely thinks people who terminate for severe disability think their baby is "replaceable" then he hasn't met the ones I have. He's reducing an extremely complex decision to one akin to shopping around for the best deal. Again, he's reducing people to commodities, or agents of happiness, rather than individuals.