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Thoughts about Eugenics

A)

Eugenics is not associated with a cell, a zygote, an embryo, a fetus, a person, or a human being. Eugenics is associated with a characteristic of a cell, a zygote, an embryo, a fetus, a human being. The underlying issue in eugenics is that someone decides , based on stated or unstated values which characteristics are worthy enough to be part of society and which are not (Discrimination). This selection process is not based solely on genetic composition. For example, elimination of a fetus believed to be exposed to thalidomide is based on a phenotype. Discrimination is not associated with a cell, a zygote, an embryo, a fetus, a person, or a human being. Discrimination is associated with a characteristic of a cell, a zygote, an embryo, a fetus, a human being.

A)

A)

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D) There are many ways to select or deselect the genotype/phenotype of ones offspring or of living members of society through Prefertilisation diagnostics vPreimplantation diagnostics vPrenatal testing vpost natal testing vIn-vitro fertilization vAbortion vSperm banking vEgg banking vCloning vInfanticide vFertilization vAdoption or mate selection
v

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E) Eugenics occurs around the world because we discriminate against and eliminate unwanted characteristics (whether they are inherited or not), all the time. We continually make choices in favor of a characteristic or against a characteristic. The only difference is that the nature and extent of the characteristics we can choose to eliminate or selectively nurture is now increasing with advancements in genetic knowledge and procedures. F) Many procedures are not intrinsically eugenic but can be used for eugenic purposes. For example, abortion per se is not eugenic, but can be used in an eugenic fashion.

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The key question is how a society (social eugenics) or a person (personal eugenics) decides which characteristics are permissible in an offspring/offspring to be. Can a society influence or regulate the decisions of social/personal eugenics? Is there a rational way to distinguish between e.g. Tay-Sachs, beta-Thalassemia, sickle cell anemia, thalidomide, Alzheimer, PKU, gender, sexual orientation (if a way were ever found to predict it), mental illness, cystic fibrosis, cerebral palsy, spina bifida, achondroplasia (dwarfism), hemophilia, Down Syndrome, coronary heart disease, osteoporosis, and obesity? The first step in distinguishing among these characteristics would be to see whether the genotype/phenotype ensures a certain death after birth.

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Eugenic measures can work on two different levels:

(a)

(b)

on the level of the potential offspring (in different stages of development) which would lead to selective reimplantation, selective abortion or infanticide, on the level of the gene carrier through testing of parents, prevention of marriage and prevention of conception.

Which level will be used depends on the cultural, societal, moral, and religious background of the group.

Tay-Sachs
Tay-Sachs is often used as an example to justify eugenic measures because most people will not want to condemn a human being to a slow, painful death. In Western countries the procedure is mostly on the level of the offspring; but there are groups where it works on the level of the carrier (e.g., the Dor Yeshorim program started in Brooklyn NY among Ashkenazi Jews). But unlike Tay-Sachs, none of the other characteristics listed above result in certain death if treated. 5/22/12

Beta-Thalassemia
In some countries, notably Sardinia (part of Italy) and Cyprus, premarital blood tests for beta-thalassemia (a blood disorder leading to death in early adolescence unless treated intensively) are widely applied in Cyprus they are mandatory. Thalassemia is treatable, but the procedure is very costly and has threatened to bankrupt the entire health care system in both areas. Although "unfavorable" test results showing that both partners are carriers does not prevent them from marrying each other, people will nearly all follow an eugenic follow-up procedure: 25% on the level of the carrier and 75% on the level of the offspring . Beta-Thalassemia, although treatable, still leads to eugenic decisions (social and personal eugenics) because of the reality in many countries that the health care system can't afford to provide treatment. The availability of affordable treatment can play a role in the eugenic decision regarding many genotypes/phenotypes (e.g. cystic fibrosis, hemophilia, insulindependent diabetes and many others). All of these conditions are deadly if treatment is not provided.
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Down Syndrome
Down Syndrome is one of the all time favorite targets for eugenic elimination (between 80-95% of people who learn that their baby might have Down Syndrome abort). Many of the eugenic practices are justified by using the example of preventing Down Syndrome. In 1967 the American Medical Association passed a resolution endorsing abortion in cases in which "an infant may be born with incapacitated physical deformities or mental deficiency" . A number of states approved this use of abortion years before Roe v. Wade followed suit with laws allowing abortion for the purpose of eliminating children with mental defects, including Down Syndrome.

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In 1995, the American College of Obstetricians and Gynecologists officially recommended Down Syndrome screening for all pregnant women ( 4). Prenatal screening is now in effect mandatory. What are the reasons used to justify the eugenic practices regarding Down
Syndrome? Down Syndrome is not a terminal disorder. It does not need necessarily costly medical treatment. Most reasons that lead to an eugenic decision are not in fact medical reasons, but instead are societal, educational, perceptual, and conceptual reasons. In most countries, including Western countries, Down Syndrome is viewed as being a burden to society and to the family. It is also believed that having Down Syndrome ensures a low quality of life for the individual with Down Syndrome and his/her family.

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Western Societies use these low quality of life and burden arguments for many medicalized characteristics to justify their eugenic decisions. Interestingly women in India use these same arguments to justify their eugenic decision related to gender. It seems that as soon as we allow the use of quality of life/burden arguments that no line can be drawn anymore at any characteristic. And indeed at a conference in Melbourne, Australia on February 13, 1998, Bob Williamson, director of the Murdoch Institute for Research into Birth Defects in Melbourne, and Professor of Medical Genetics University of Melbourne, said
"We have to realize that most people in my experience have fairly clear views on what level of disability appears to them to be consistent with a worthwhile outcome to themselves. I am actually irritated if people say, everyone thinks that condition is so bad that we should have prenatal diagnosis and termination of pregnancy but condition y (e.g., cleft palate) isn't bad enough. The truth is you can't say that in terms of a condition, you can only say it in terms of a woman, of her family, her perceptions, her social context, her economic context and everything else. For some people cleft palate will be something they will be at ease with, but for other people it will not be. The same is true for Down syndrome. We must avoid categorizing diseases as severe or not severe. This can only be seen in the context of the overall holistic situation of a family and individuals.

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Now, if we use Bob Williamson's logic, hemophilia, juvenile diabetes, dwarfism, and any other characteristics, traits (e.g. sexual orientation and gender) have to be included as the acceptance of every characteristic is based on the above mentioned circumstances. The Philosopher Philip Kitcher, in his book "The Lives to Come", (New York: Simon & Schuster, 1996), argues like Williamson in favor of a voluntary, "laissezfaire eugenics", in which families make their own decisions about what kinds of children they wish to bear and rear. This suggests that parents have autonomy and free choice.

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