The Human Genome Project

What is immoral about eugenics?

BMJ 1999; 319 doi: http://dx.doi.org/10.1136/bmj.319.7220.1284 (Published 13 November 1999) Cite this as: BMJ 1999;319:1284
  1. Arthur L Caplan, director (caplan{at}mail.med.upenn.edu),
  2. Glenn McGee, associate professor,
  3. David Magnus, associate professor
  1. Center for Bioethics, University of Pennsylvania Health System, Philadelphia, PA 19104, USA
  1. Correspondence to: A Caplan

    It is a “given” in discussions of genetic engineering that no sensible person can be in favour of eugenics. The main reason for this presumption is that so much horror, misery, and mayhem have been carried out in the name of eugenics in the 20th century that no person with any moral sense could think otherwise.13 In fact, the abysmal history of murder and sterilisation undertaken in the name of race hygiene and the “improvement” of the human species again and again in this century is so overpowering that the risk of reoccurrence, sliding down what has proved time and time again to be an extremely slick, slippery slope, does seem enough to bring all ethical argument in favour of eugenics to an end.

    However, before dismissing any favourable stance towards eugenics it is important to distinguish what has happened in the past under the banner of eugenics and what might happen in the future. It is important to distinguish between genetic changes undertaken with respect to improving a group or population and genetic change that takes a single individual as its focus.

    Summary points

    The horrible abuses committed in the name of eugenics through coercive policies imposed by governments have obscured the fact that eugenic goals can be the subject of choice as well as coercion

    In the rush to map the human genome and reap the benefits of new genetic knowledge it has become commonplace to argue that eugenic goals will play no part in how new genetic knowledge is used

    The moral case against voluntary choices to advance eugenic goals by individuals or couples has not been persuasively made

    Given the power and authority granted to parents to seek to improve or better their children by environmental interventions, at least some forms of genetic selection or alteration seem equally ethically defensible if they are undertaken freely and do not disempower or disadvantage children

    Efforts to change the genetic makeup of a group or population almost always require third parties to be involved in the personal reproductive choices of individuals and couples. Someone besides the individuals making children has to set a policy and a standard. In our century these efforts have almost always incorporated force or coercion since individuals may not agree with the policy or third parties may seek to force their vision of improvement on an unwilling population.

    It is, however, a different matter for couples to undertake their own efforts to use genetic technologies and knowledge to improve the potential of their offspring. Eugenics has not, until the advent of genetic engineering, offered this option. Efforts to change the inherited genetic makeup of a particular person may be the result of third party involvement, but it is far more likely that such efforts will be the result of individual reproductive choice.4 To put the point another way, population eugenics involves commanding people to produce desired genotypic or phenotypic traits. This sort of eugenics is not the same as allowing an individual or couple voluntarily to choose a heritable trait in their sperm, egg, embryo, or fetus, motivated by their view of what is good or desirable.

    The most common arguments against any attempt to either avoid a trait through germline genetic engineering or to create more children with desired traits fall into three categories: worries about the presence of force or compulsion, the imposition of arbitrary standards of perfection,4 or inequities that might arise from allowing the practice of eugenic choice.5 The first worry is not one that seems insurmountable as an objection to allowing individual choice about germline changes. The latter two may also not discount eugenic choices.

    Coercion

    Certainly it is morally objectionable for governments or institutions or any third party to compel or coerce anyone's reproductive behaviour. 1 3 The right to reproduce without interference from third parties is one of the fundamental freedoms recognised by international law and moral theories from a host of ethical traditions. However, the goals of obtaining perfection, avoiding disease, or pursuing health with respect to individuals need not involve coercion or force

    A couple may wish to have a baby who has no risk of inheriting Tay-Sachs disease or transmitting sickle cell disease. Or they may want a child with a particular hair colour or sex. If their choice is free and informed then there is no reason to think that such a choice is immoral on grounds of force or coercion.

    The subjectivity of perfection

    Some who find the pursuit of perfection morally objectionable worry about more than coercion. They note that it is simply not clear which traits or attributes are properly perceived as perfect or optimal The decision about what trait or behaviour is good or healthy depends on the environment, culture, and circumstances that a child will face. Stigma and prejudice need not be the inevitable result of choice.

    Views about what is perfect or desirable in a human being are, more often than not, matters of taste, culture, and personal experience. But they are not always simply the product of subjective feelings. There are certain traits—physical stamina, strength, speed, mathematical ability, dexterity, and acuity of vision, to name only a few—that are related to health in ways that command universal assent as to their desirability. It would be hard to argue that a parent who wanted a child with better memory or greater physical dexterity was simply indulging his or her biases or prejudices. As long as people are not forced to make choices about their children that are in conformity with particular visions of what is good or bad, healthy or unhealthy, there would seem to be enough consensus about the desirability of some traits to permit parents to make individual choices about the traits of their children in the name of their health. And if no coercion of compulsion were involved it could even be argued that parents should be free to pick the eyebrow shape or freckle pattern of their children or other equally innocuous traits as long as their selection imposed no risk for the child, did not compromise the child's chance of maximising his or her opportunities, or lead to parents becoming overly invested in superficial aspects of the child's appearance or behaviour. 4 6



    Embedded Image

    The next generation: will they be designer babies?

    (Credit: ROBIN LAURANCE/IMPACT)

    A parent might concede that their vision of perfection is to some degree subjective but still insist on the right to pursue it. Since we accept this point of view with respect to child rearing, allowing parents to teach their children religious values, hobbies, and customs as they see fit, it would be difficult to reject it as overly subjective when matters turn to the selection of a genetic endowment for their child.

    For many years cosmetic surgeons, psychoanalysts, and sports medicine specialists have been plying their trades without all people with big noses or poor posture feeling they need to visit specialists to have these traits altered. Some people choose to avail themselves of these specialists in the pursuit of perfection. Many do not. If there is a slope from permitting individual choice of one's child's traits to limiting the choices available to parents it is a slope that does not start with individual choice. And if there is a problem of a slope then it must be shown why it is morally permissible for parents to seek betterment after a child is born but why such efforts are wrong if genetic alteration is used. There is nothing terrible about subjectivity in a decision to indulge preferences about the traits of one's child as long as those preferences do nothing to hurt or impair the child.

    Equality

    Another objection to allowing eugenic desires to influence parenting is that this will lead to fundamental social inequalities.5 Allowing parental choice about the genetic makeup of their children may lead to the creation of a genetic “overclass” with unfair advantages over those who parents did not or could not afford to endow them with the right biological dispositions and traits. Or it may lead to homogenisation in society where diversity and difference disappear in a rush to produce only perfect people, leaving anyone with the slightest disability or deficiency at a distinct disadvantage. Equity and fairness are certainly important concepts in societies that are committed to the equality of opportunity for all. However, a belief that everyone deserves a fair chance may mean that society must do what it can to insure that the means to implementing eugenic choices are available to all who desire them. It may also mean that a strong obligation exists to try and compensate for any differences in biological endowment with special programmes and educational opportunities. It is hard to argue in a world that currently tolerates so much inequity in the circumstances under which children are brought into being that there is something more offensive or more morally problematic about biological advantages as opposed to social and economic advantages.

    It is difficult to argue in a world that tolerates the creation of homogeneity through the parental selection of schools, music lessons, religious training, or summer camps that only environmentally engineered homogeneity is morally licit. The fact that those people with privileged social backgrounds go on to similar sorts of educational and life experiences does not seem sufficient reason to interfere with parental choice.

    No moral principle seems to provide sufficient reason to condemn individual eugenic goals. While force and coercion, compulsion and threat have no place in procreative choice, and while individual decisions can have negative collective consequences, it is not clear that it is any less ethical to allow parents to pick the eye colour of their child or to try and create a fetus with a propensity for mathematics than it is to permit them to teach their children the values of a particular religion, try to inculcate a love of sports by taking them to football games, or to require them to play the piano. In so far as coercion and force are absent and individual choice is allowed to hold sway, then presuming fairness in the access to the means of enhancing our offsprings' lives it is hard to see what exactly is wrong with parents choosing to use genetic knowledge to improve the health and wellbeing of their offspring.

    References

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