Any
allusion to present day biomedical practices as being eugenic usually
leads to quite hysterical denials and the accusation that one sees
everything one disagrees with as being painted with the inappropriate
Nazi brush.

I’ve heard all the arguments, so please spare me: The
only people who were Nazis were the Nazis. The only things that are
eugenic are what the Nazis did in the interests of breeding a more
superior race. Genetic research in this day and age is an absolutely
cutting edge, wonderful, and very necessary ethical endeavor.

The
howling eugenics deniers will even concede that eugenics didn’t
originate in Nazi Germany (the US and the UK have that distinction),
and, if pressed, that some prominent historical figures supported
eugenics (Margaret Sanger and Winston Churchill among them). But that’s
as far as it goes. The prevailing zeitgeist holds that eugenics was a
terrible thing in a time gone by. It doesn’t happen any more. We
learned from our collective social mistakes.

The
thinking behind eugenics isn’t very difficult to understand. People are
different in many ways. Some of these differences are socially and
medically acceptable, others are not. We need more people with socially
acceptable traits, fewer people with undesirable traits. There are two
ways to do this. One, we passively encourage people with undesirable
traits not to reproduce, but this takes a long time to reduce the
undesirable population. Two, we actively take steps to eliminate those
with undesirable traits by whatever means we can. Historically, that
has meant sterilization, abortion, laws banning people with undesirable
traits from marrying or reproducing, and the killing of so-called defectives.

Which brings us to an AP story that surfaced recently.

Essentially,
the article makes the case that advances in genetic screening are
reducing the incidence of children born with a wide range of genetic
anomalies, so much so that several genetically-induced disabilities are
close to being completely eliminated. However, the AP is,
unintentionally but clearly, an exemplar of the spin that has morphed
eugenics from a reprehensible horror to a heroic and loving social
responsibility with predictable results. Eugenics is now called
preventive medicine.

As
increasing numbers of women undergo prenatal testing at the behest of
their physicians, genetic counselors, and medical organizations, more
and more unborn children with genetic anomalies are being detected. The
result? A genetic sorting that makes some unborn children (and human
embryos) second-class citizens fit only for death.

What
you think of this state of affairs depends on your views about the
exceptional nature of human life. However, there are two undeniable
certainties. One, unborn children with genetic anomalies are now much
more likely to be aborted than their more perfect peers. Two, abortion
cures genetic anomalies 100% of the time.

I
have no argument with parents who are genetically tested and decide not
to take the risk of reproducing children who might have some form of
genetic disability. This is preventive genetic screening used
appropriately and ethically. The turning point emerges when a human
life is created and decisions are then made that some should live
because they are more genetically perfect while others are destroyed
because they are genetically less perfect. This genetic discrimination
is already a matter of policy of several major medical associations,
including the American College of Obstetricians and Gynecologists.
ACOG, for example, strongly recommends that all white women be
genetically tested for cystic fibrosis and that in-utero testing for
Down syndrome be extended to all pregnant females, not only older women
who are most at risk.

While
lip-service is often paid to presenting the pregnant women whose
fetuses are genetically disabled with all possible options, including
giving birth, there is evidence suggesting that in the real world of
the doctor’s or geneticist’s office the pressure is much more likely to
be for abortion than anything else. Most commonly, health professionals
convince parents that their child will have a lower quality of life, be
subject to expensive and possibly painful medical procedures, and that
the child will have a limited lifespan.

The
AP piece reports the inevitable results. For example, in Massachusetts
the instances of live births with cystic fibrosis dropped from a
relatively high of 29 in 2000 to 10 in 2003 as mothers opted for
abortion over delivering a genetically disabled infant.

There
are similar trends in California where in 2006-2008 Kaiser Permanente
offered genetic screening for cystic fibrosis. Of the 87 volunteer
pregnant couples genetically predisposed to producing offspring with
the anomaly, 64 fetuses were anomaly-free, while 23 were found to have
cystic fibrosis. 16 of the 17 who were more severely afflicted were
aborted. Of the 6 with milder forms of the disease, four were aborted.

Easy
math: 23 unborn children singled out only and exclusively because they
were genetically disabled, 21 disposed of. The other 64 genetically
nondisabled unborn children were allowed to live – only because they
were of purer genetic makeup.

How is this not eugenics?


Professor Mark Mostert teaches at Regent University School of Education, in Virginia. He is a director of the Institute for the Study of Disability and Bioethics and runs a blog, Disability Matters