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. 2000 Mar 25;320(7238):873.

Eugenics debate

Eugenics principles are there

Rupert Suckling 1
PMCID: PMC1127214  PMID: 10731195

Editor—Eugenics is defined in the Oxford English Dictionary as the science of improving the (especially human) population by controlled breeding for desirable inheritable characteristics. Stated in this way there is no doubt that the coercion of controlling breeding together with the subjectivity of desirable characteristics makes eugenics morally difficult to defend.

Caplan is really putting the case for gene manipulation.1 Manipulation of somatic cells has been considered to pose no new ethical challenges, but manipulation of germ cells raises ethical issues as an alteration in the germ cell line affects future generations. The same criticisms can be levelled against manipulation of germ cell genes as were made against eugenics. Coercion is still a problem. Although we hope that parents can take decisions in the best interests of their child, this cannot be guaranteed and is similar to the problem with society coercing individuals to make inappropriate choices. The child has the right to be treated as an autonomous individual.

The social dimension of the subjectivity of perfection should not be forgotten. If society decides that a particular trait is beneficial this does not mean that it is morally right—for example, colour of skin. Admittedly, however, some traits may be globally regarded as beneficial.

Can equality be guaranteed by a programme of social initiatives to compensate for differences in biological endowment? It is always possible that rich people will purchase the technology. The other problem is that if people do not use the technology or do not use it well enough they may be ostracised by society. There seem to be moral uncertainties when examining these individual principles. If we consider what the business of health is we might get a better idea. Seedhouse defines the business of health as the removal of obstacles.2 Modifying genes is a spectrum, from interventions that definitely remove obstacles to those that do not remove obstacles but may improve an individual's genetic make up towards a subjective ideal.

Perhaps clinical trials are needed to ascertain whether or not modifying genes is beneficial. Until then, can we condone the possible use of resources on “designer children” as opposed to using the resources to treat illness? Perhaps the principles of beneficence, non-maleficence, and justice can guide us through this maze.

References

  • 1.Caplan AL, McGee G, Magnus D. What is immoral about eugenics? BMJ. 1999;319:1284–1285. doi: 10.1136/bmj.319.7220.1284. . (13 November.) [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Seedhouse D. Health. The foundations for achievement. Chichester: John Wiley; 1986. [Google Scholar]
BMJ. 2000 Mar 25;320(7238):873.

Other slippery slopes become apparent

Susan Root 1

Editor—I am writing with reference to Caplan et al's editorial on eugenics.1-1 Eugenics has been vilified because of its abuses during the early 20th century, particularly Germany's choice to murder people with perceived disabilities. But the origin of eugenics was simply a desire to increase the odds that a child would be born healthy. Today we consider such measures as prenatal care, eating sensibly during pregnancy, avoiding use of alcohol or other drugs, and choosing your partner carefully to be the minimum that the pregnant woman should do and that the healthcare system should offer. Yet these practices are the very basis of “eugenics.”

If we decry genetic engineering because of its potential to lead us down a slippery slope to potential force or compulsion, the imposition of arbitrary standards, or inequities that might result, we must also decry medical care in general. It leads to making people who cannot obtain it second class citizens with shorter, more unpleasant lives. It provides unfair advantages to those with the money and power to get more of it. The antibiotics that save one person's life may lead to antibiotic resistance that will harm others. Are we ready to say that medical care should be banned on these grounds? What other human endeavours would be banned if these standards were applied?

Our own version of eugenics today includes offering pregnancy termination to a woman carrying a fetus that seems to have a condition producing disability, such as Down's syndrome. Just the offer of a triple screen to a pregnant woman has implications for what she “should” do if an abnormality is found. This “standard of care” practice in obstetrics today is remarkably similar to Germany's rationale for murders in the name of eugenics. Widespread use of the triple screen implies that it is moral to murder your child if it is defective. Surely it must also be moral to improve the health of your child using genetic engineering?

Genetic engineering offers the potential to dramatically reduce the burden of disease and disability. Stem cell technology may produce cures for Alzheimer's disease; vascular growth factors may enable the body to produce its own cardiac bypasses; and the elimination of metabolic derangements may cure phenylketonuria and diabetes. My hope is that we will use science and technology to continue improving lives and health rather than regressing into Luddite technophobia.

References

BMJ. 2000 Mar 25;320(7238):873.

What is immoral about the eugenics article?

Pablo Millares-Martin 1

Editor—Reading Caplan et al's article about eugenics2-1 I can understand the fear and the threat that genetic engineering is to many people. The article is centred on the belief that parents have the right to choose the best for their offspring, and if a decision is made without coercion it should be accepted by society.

I understand medicine as the art of healing, and genetic engineering is a potentially wonderful tool to eradicate genetic illnesses that mankind, because of its supremacy over the environment, carries around without any option for natural selection.

I do not understand how choosing to increase any other attribute of a human being can benefit our society. Firstly, if there is a gap between rich and poor, with the former being able to improve the odds of their children by investing not only in better education but in “better” genetic material, this gap can only increase further, leading to a society where the weak will have no chance to improve their social status. Secondly, if parents look for the best genoma, pressure will be increased to raise the standards that could be achieved, leading eventually to a different subspecies of human beings, perhaps more “perfect” but by no means stronger, as nobody can predict the ultimate consequences and possible mutations and DNA ageing that can happen if DNA changes are pursued to the limit. Thirdly, diversity will be lost as more people are created to have similar attributes, and the chance of natural improvement by aleatory combination of varied genes with or without spontaneous mutations will be lost as any cell with unknown genes would be eliminated before it can manifest itself.

Parents should not be allowed to favour a specific sex (as already happens nowadays) or attribute in their children. Parents are looking for the best not for their children but for themselves. They want their offspring to have what they would like to have themselves, and they want their offspring to succeed where they didn't. Life is about living, not about setting goals to achieve. Life is about chances, not about rigid protocols. Life is diversity and spontaneity, and it should not be spoiled by grandiose ideas.

References

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