Eugenics (Stanford Encyclopedia of Philosophy)

Although philosophers have contemplated the meaning and value of eugenics at least since Plato recommended a state-run program of mating intended to strengthen the guardian class in his Republic, the modern version of eugenics had its start with the 19th century cousin of Charles Darwin, British scientist Francis Galton (1883). Galton was interested in improving human stock through scientific management of mating; his explicit goal was to create better humans. His ideas were taken up widely in the early part of the 20th century by seemingly well-intended scientists and policy makers, particularly in the United States, Britain, and the Scandinavian countries. Notable eugenicists included Alexander Graham Bell and Margaret Sanger. (For an excellent history of eugenics, see Kevles 1985.)

Eugenicists had two-fold aims: to encourage people of good health to reproduce together to create good births (what is known as positive eugenics), and to end certain diseases and disabilities by discouraging or preventing others from reproducing (what is known as negative eugenics). In the United States, programs to encourage positive eugenics involved the creation of Fitter Family Fairs in which families competed for prizes at local county fairs, much in the way that livestock is judged for conformation and physical dexterity (Stern 2002). Negative eugenics took the form of encouraged or forced sterilizations of men and women deemed unfit to reproduce (in the language of the day, this included individuals who were poor, mentally insane, feeble-minded, idiots, drunken and more). At the time, many eugenicists seemed to assume that social and behavioral conditions, such as poverty, vagrancy or prostitution, would be passed from parent to child, inherited as traits rather than shared as common social situations. (For an interesting discussion of the relevant social moral epistemology, see Buchanan 2007.)

Racist, sexist, and classist assumptions pervaded the discourse. Alarm calls were raised about the lower birth rates among white Protestant Americans compared to the large immigrant Catholic populations of Italian and Irish descent. German scientists and policymakers visited the United States to learn from their methods, and when the Nazis came to power in Germany, they began eugenic policies of their own. Early German policies called for involuntary euthanasia of people in institutions whose physical or mental illnesses were considered incurable. Such individuals were considered to have lives unworthy of life (lebensunwertes Leben). The Nazis also encouraged selective breeding for Aryan traits (e.g., athletic, blond and blue-eyed). This policy quickly expanded to include bans on marriage between particular groups, forced sterilization, and then internment in concentration camps for individuals belonging to groups deemed inferior (i.e., people who were disabled, homosexual, diagnosed with psychiatric conditions, communists, considered to be Roma/gypsies, and/or Jewish). The purported aim was to promote the health of the German population by controlling those who were unhealthy. Prisoners faced extremely hard labor, medical experimentation that was torturous and designed to test the limits of the human body (Lifton 1986) and daily degradation and abuse. Eventually, Nazis escalated their eugenic program to the final solution of death camps, ultimately killing more than six million Jewish people in the name of promoting Germany's health.

Following the end of WWII, the term eugenic was so closely associated with the horrific programs of Nazi Germany that eugenics societies across the world changed their names (e.g., the American Eugenics Society became the Society for the Study of Social Biology) and tempered their aims. Yet many of the same practices and beliefs continued under a different guise. Involuntary eugenic sterilizations of feeble-minded women in a variety of states didn't officially end until the 1970s, and may continue covertly in some state institutions. California had the highest rate of involuntary sterilizations, which were widely performed on prison inmates, people in mental institutions, and women considered to be bad mothers. Such sterilizations were motivated by both perceived individual and social goods, but had deep-seated prejudice as well as scientific inaccuracies built into their assumptions (Stern 2005). Concepts of feeble-mindedness were historically entangled in deeply problematic ways with ideas of race, class and gender (Stubblefield 2007).

Later, attempts to promote positive eugenics were renewed with the creation of the Repository for Germinal Choice, a sperm bank created in 1978 with the idea of collecting sperm from Nobel laureates, others deemed geniuses and Olympic level athletes. Given the availability of in vitro fertilization, women could now choose to reproduce with men presumed to have high-quality genes, without needing to form relationships with them. Although most Nobel prizewinners proved reluctant to donate to the sperm bank, the general idea took off. Even today, print and online ads in college newspapers regularly request sperm or eggs from donors who meet certain qualifications for health, intelligence, athleticism and/or attractiveness. Individuals or couples who require gamete donation to reproduce can shop around for a donor who meets their criteria.

The widespread practice of prenatal genetic testing (traditionally through chorionic villus sampling or amniocentesis in the second trimester of pregnancy, but now more routinely done through non-invasive blood tests in the first trimester, at least as a first screen), similarly presents the opportunity for individuals or couples to identify genes or genetic markers for traits they prefer for their fetuses not to have. If prenatal testing identifies an undesired gene, prospective parents may choose to continue the pregnancy, or to abort the fetus, often with the plan to later attempt a new pregnancy. Studies suggest that in the United States, 90% of positive diagnoses from prenatal testing result in abortion (Rothschild 2005). With the advent of pre-implantation genetic diagnosis, prospective parents can choose to use in vitro fertilization, and then test early cells of the created embryos to identify embryos with genes they prefer, or prefer to avoid. In this way, they avoid the potential need for abortion by choosing to implant only embryos that contain the desired genes. The aim of this practice certainly appears eugenic, though without an obviously coercive structure, and for the benefit of the individual family. The profession of genetic counseling, started in the 1990s, provides prospective parents with detailed information about the meaning of the tests, and the opportunity for discussion of test results. In part due to concerns about eugenic overtones, genetic counseling is built on a policy of non-directiveness to ensure that the reproductive autonomy of prospective parents is respected. That tenet of genetic counseling has been challenged by scholars who argue that we ought to balance parental autonomy with the child's future autonomy (see, e.g., Davis 2010).

Finally, advances in genetic technology suggest the possibility that our ability to test for (if not manipulate directly) a much larger array of genes and genetic markers related to a wide variety of diseases and traits may be on the near horizon. Prenatal testing panels currently include attention to conditions such as Trisomy 13, Trisomy 18, Trisomy 21 (Down Syndrome), Tay-Sachs, and more. Yet we allow adults to be tested for genetic markers linked to late onset disorders such as breast cancer, Huntington's disease, and Alzheimer's disease. Should such genetic tests be available on prenatal testing panels if parents request them? Or for all prospective parents who request prenatal testing? What about other additions that might be of interest to particular parents, even if the genetic linkages to the particular traits are less direct or even only mildly predictive: diabetes, obesity, homosexuality, or psychiatric conditions such as bipolar disorder or schizophrenia? (Informative discussions of the expansion of genetic testing can be found in Davis 2010 and Botkin 2003.) Deciding how to deal with the vast array of potentially genetically-linked markersas a society, and potentially as individual prospective parentsis a monumental task that requires clarity about the benefits and drawbacks of testing, and requires us to revisit the meaning of eugenics, and the problems associated with it.

A much simpler and more clearly linked trait of interest is chromosomal sex. In the United States, parents can choose to find out their fetus's chromosomal sex via amniocentesis, or through an increasing number of early first trimester blood tests. In the U.K., by contrast, parents typically do not learn the sex of their fetus until birth, a policy put in place by the Human Fertility and Embryology Authority (HFEA) with the aim of avoiding sex discrimination and shoring up the line between genetic intervention for disease and non-disease traits. One of the concerns raised by critics of sex selection is what Mary Ann Warren deemed gendercide, in her book of the same name (Warren 1985). Indeed, evidence from around the world suggests a relatively strong bias in favor of male children (South Korea is now an exception), or at least male children first (Davis 2010). China and India, countries where cultural norms and practices still decidedly favor men, are facing significant sex ratio imbalances as a result of the use of technologies (and non-technical practices such as infanticide) to select against girls (for a discussion, see Davis 2010: Chapter 5). In response to concerns about sex ratios and underlying sexism, the American Congress of Obstetricians and Gynecologists (ACOG) has recommended a policy of only allowing sex selective interventions to be used to avoid sex-linked diseases, or for family balancing purposes (e.g., only for the second child in a family)(ACOG 2007). Concerns about the uses of sex selective technologies against a background of unjust sexism (see Bayles 1984; Rogers et al. 2007) illustrate the difficulties of arguing straightforwardly for unfettered reproductive choice about the traits of children.

As this short history should make clear, past, state-run, involuntary eugenic endeavors have been unjust and socially disastrous. Yet certain practices that have eugenic features continue today, albeit framed differently. Prenatal testing and preimplantation genetic diagnosis, for instance, are understood to enhance patient choice and expand prenatal knowledge, even as they are clearly used by prospective parents to determine which individuals should come into existence. Should they be considered eugenic practices? Is that necessarily morally troubling? As technological advances push us to figure out how many more, if any, kinds of genes and genetic markers we ought to be able to test for or choose prenatally, we may need to reassess our current practices to explore their justifications, and sort through the ways in which they are eugenic and potentially morally troubling.

Advocates of liberal eugenics intend to distinguish it from troubling historical predecessors by highlighting four main differences. First, it is individual in nature rather than state-sponsored. The intended benefit of any eugenic intervention is individual/private welfare (that of the child-to-be, or of the family), rather than the welfare of the state as a whole. Second, it is premised on individual liberty, the freedom of parents to choose according to their own values and conceptions of the good life. The state does not mandate contraception, sterilization, prenatal testing, abortion, or any other form of eugenic intervention (note: there are potential exceptions in which judges or states have offered long-term contraception such as Norplant as a condition of probation related to a criminal offense or for the continued provision of welfare, see e.g., Dresser 1996). Rather, it allows individuals to choose among a range of alternatives. Third, it presumes value pluralism, recognizing that individual parents will often desire different things for their offspring. This means allowing others to choose in ways that we ourselves would not, in the interest of preserving a liberal society that is neutral about particular conceptions of the good. The aim of a liberal eugenic program is to expand reproductive choices for individuals, in contrast to the historical eugenic programs that clearly cut off reproductive options for many. (That said, even liberal eugenics advocates typically presume that some limits would need to be in place, to ensure that prospective parents could not act in ways clearly contrary to the interests of their future children, or in ways that seem clearly vicious; how and where those limits would be set are intensely controversial, as will be discussed below.) Finally, advocates of liberal eugenics highlight the difference between the kind and quality of the science underlying the reproductive policies. Past eugenic programs relied on views of race, intelligence, and genetics that were, from our current perspective, hopelessly wrong (Agar 2004: 7). A cursory summary of these kinds of distinctions between old and new eugenics can be found in Caplan 2004, and the same collection of distinctions underlies most liberal or new eugenic arguments.

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Eugenics (Stanford Encyclopedia of Philosophy)

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