Few people realize that eugenics was the driving force behind the Nazis’ political philosophy of “Applied Biology.” Even fewer realize the essential contributions to eugenics by the United States, the world’s leader in eugenics. Indiana’s legislature was the first in the world to legalize involuntary sterilization, for example, and at least 12 countries had legalized involuntary sterilization before Nazi Germany did so in 1933. America provided legal, moral, and philanthropic support for Nazi eugenicists prior to the outbreak of WWII. German propagandists also highlighted the failure of American medical schools to admit African-Americans and could have also pointed to the exclusion of African-American doctors to the American Medical Association. Medical schools often had quotas for Jews and Italians—Edmund Pellegrino, one of the world’s great bioethicist physicians was denied admission because of his Italian heritage—and Nazi propagandists also noted that our Jim Crow laws defined African-Americans much more broadly than the Nuremberg Laws defined a Jew. Amanda Broderick discusses modern eugenics in her essay.
Genetics and Modern Eugenics
By Amanda Broderick
Throughout this course, we broached the subject of eugenic thought and action, mostly as it was carried out in the past during the Nazi regime and earlier in the United States. Since the end of World War II, the word and discussion of eugenics has been greatly decreased to almost zero because of stigma and belief that it was no longer relevant and simply an evil “Nazi concept” with no foundation in a modern context. While the Nazi regime used the idea of eugenics as an excuse for many of their actions such as sterilization without consent and the mass killing of different populations including the Jewish and the disabled, eugenic thought has also influenced action in modern United States with uninformed sterilization of female inmates in California happening as recently as 2010.1
Eugenics was initially defined as “well-born” but has morphed to mean “control of or improvement of genetic qualities in a population” in more modern times.2 Many of the thought processes underlying this definition of eugenics are still relevant to our society, especially as reproductive and gene-editing technologies advance. The availability and use of prenatal genetic testing, in-vitro fertilization and selection, and the possibility of even newer technologies, such as CRISPR, has sprouted a new chapter of ‘modern eugenic’ thought and fear. Prenatal testing allows for the detection of genetic abnormalities before birth, allowing parents to decide whether they will continue with a pregnancy. In-vitro fertilization allows for selection against embryos that have known severe genetic anomalies. CRISPR, while it has not yet been used in human embryos, gives the ability to specifically edit the genome before implantation to change any part of the genome that is unwanted. These technologies could be used to all but eradicate certain genetic conditions as well as to “enhance” the genome in ways not related to disease processes. The negative and positive implications of these technologies should be more widely debated and expanded upon so that genetic scientific advancements can continue without ethical boundaries being irreparably crossed or pushed too far.
Current philosophies on the use of these technologies is polarized. On one side of the spectrum, critics believe that using them at all is morally apprehensible and leads to greater discrimination of populations with certain disabilities or diseases. On the other side, philosophers, such as Peter Singer, believe that many eugenic concepts are logical and that if we have these technologies, they should be used without a doubt before children are born with severe disabilities. He believes this is the only logical solution because it will save both the family and the child from a more difficult life. He goes as far as to argue that families of babies born with severe mental or physical disabilities should be allowed to decide whether that baby should be euthanized or not after its birth (even up to an age of a few years before there is “selfawareness”). 3 Both views seem to be ignoring the intricacies of a lot of the situations in which these technologies may or may not be used. For example, in the latter argument, how is a disability or disease classified as severe enough to be “edited” out and who decides this? In the former, is it actually immoral to try to spare the family and child from a fatal and painful disease?
Taking a more moderate stance, there are many potential positives to these technologies, like curing or stopping fatal diseases. But if they are unregulated, they could be used in negative ways. One possible solution is that preventing disease (negative engineering) should be allowed but so called ‘enhancement’ eugenics (positive engineering) in which genes for eye color, athletic ability, ect are chosen for or changed.4 It is difficult, however, to ascertain exactly where to draw the line when deciding what diseases/disabilities are so severe as to warrant genetic modification/selection. Current disability rights groups and others fear that any type of selection causes more discrimination against those that are still born disabled.3 This type of discrimination to an already marginalized group is something that has had terrible consequences in the past. The most important thing to consider to avoid repeating these kinds of horrible atrocities of the past made under the guise of eugenics is that genetic technology choices must always be informed and with consent and never controlled by the government. Following these basic guidelines while keeping an open dialogue about where future technologies may lead or should be stopped will allow this aspect of medicine to grow in a morally responsible way.