Friday 14 September 2012

Is Eugenics Morally Justifiable?


Eugenics is a loaded term. Ask most people what they think of when they hear the word eugenics and it would seem that the most common thought process nearly always leads to Nazism and the holocaust. Much of the objection to eugenics in academia and the general population stems from its uses in the early twentieth century; and for good reason. Questions on the modern day morality of eugenics almost always end in its rejection based on the visions of extreme horror and oppression that it carries (Caplan et al., 1999). Arguments against the morality of eugenics often stem from the idea of coercion and force, and the application of a third party influence on what is the perfect image of humanity (Savulescu, 2005). Indeed Nazi Germany is the most salient illustration of this point, the forcing at a governmental level of an image of the perfect society onto a mostly unwilling population through policy. The purpose of this essay is to explore eugenics, in both its early form and modern day equivalent, and to rationally assess whether there is a true difference between eugenics at the beginning of the twentieth century and eugenics now, at the beginning of the twenty-first century. The differences between genetic manipulation for the benefit of society as a whole and manipulation for the benefit of the individual will be explored; as will its morality and practical feasibility. Some areas of eugenics may be considered to be practical in their application, but not morally justifiable and vice versa; it is the aim of this essay to draw such conclusions in such a way that those conclusions drawn are from a scientific and objective viewpoint, free from the personal bias and morality of the reader and writer alike. This essay will be divided into three sections, firstly a historical overview of eugenics, secondly on the practicality of eugenics and how its practicality is intrinsically linked to its morality, and finally on its morality in modern day society as well as the potential future of the field.  

What is Eugenics?
After the dawn of Darwinism and the first steps towards an understanding of human evolution eugenics began to adopt an evolutionary framework. Sir Francis Galton began to organise his ideas on human evolution and made the claim that society must prevent itself from “regression towards mediocrity” as he considered human society to be interrupting and even preventing the mechanisms of natural selection from working (Galton, 2001). Eugenics as an idea, as mentioned above, is often always associated with Nazi Germany however 1930’s Germany was not the only country who ran such programmes. Examples of eugenic policy could be found throughout European countries as well as the Unites States. Eugenics at the turn of the 20th century is closely linked to ideas about race as well as being interwoven into thinking about the control of populations and social and racial hygiene (Dikotter, 1998). Eugenics as a school of thought was discussed and debated widely amongst academics and intellectuals across the world and is not just placed solely within the confines of far right conservative thinking but also with liberal thinkers as well (Dikotter, 1998). It was believed to be a morally justified way of systematically improving the heredity of human populations, with many academics expressing distaste with the actions taking place in Nazi Germany but praising any effort to advance humanity (Dikotter, 1998).

Eugenics in the 21st Century: A Wolf in Sheep’s Clothing?
 The debate over the moral justifiability of eugenics is one that is continuing today. Fierce debates between academics, ethicists, bioethicists and those in the medical profession are raging over whether modern day eugenic practices can even be labelled as such and whether or not humanity has a social responsibility to improve the health and heredity of populations. The debate itself has become increasingly more complex as the human genome began to be mapped and the great advancements in genetics have occurred. Whilst some claim that modern day eugenic teachings, or genetic counselling as it is often referred to, is morally justified to improve the quality of life of the individuals who choose to adopt such ideas (Savulescu, 2005); others claim that “new eugenics” is merely a change in the tactics and packaging that echo from the early 20th century (Hansen et al., 2008). As highlighted by Allen Buchanan in his book “Beyond Humanity?” the idea of enhancement through such things as biotechnologies or genetic counselling is a polarising idea that often leaves people enthralled or filled with dread. Posing an argument strongly in favour of the use of biological enhancements, Buchanan states quite strongly that much of the anti-enhancement movement is wrong in its assertions (Buchanan, 2011). Those who are against the idea of biomedical enhancements and genetic counselling often claim that those offering such a thing draw distinctions between what is a “fit and able” body and what is an “unfit” body, an idea based functionally on the fallacy there is a fixed line that separates the able bodied from the infirm or the disabled (Hansen et al., 2008). Hansen makes the controversial statement that modern day debates between geneticists and bioethicists are a chilling echo of similar debates on life worthiness in Nazi Germany. He further claims that contemporary genetic counselling, medicine and bioethics are frequently flippant about the basic and universal human rights afforded to the disabled, and are often dual intentioned; with one hand attempting to spare individuals distress and aid decision making and with the other hand attempting to spare the state costs and demands on the health care system (Hansen et al., 2008). Buchanan and his contemporaries disagree with much of the statements that anti-enhancement writers throw into the debate. It is stated by Buchanan that the anti-enhancement arguments are often empty and reasonable debate is replaced by seemingly impenetrable rhetoric and lacks much needed empirical credence, with many writers using sweeping generalisations that lack a fundamental clarity of argument (Buchanan, 2011). Buchanan goes a long way, with often strong and emotive language, to refute and prove that genetic enhancement is in fact a moral imperative. There are concerns over what will happen to humanity if such genetic enhancements actually come to fruition, to quote Francis Fukuyama “Once we are able to, in effect, breed people with saddles on their bodies, and others with boots and spurs?” (Fukuyama, 2002); a statement that highlights the problem of a world where there may well be two distinct categories of human being, the enhanced and the normal. Buchanan mentions that many people fear a morally bifurcated society, in which those that can afford expensive enhancements will have a decisive economic and moral advantage over those who are worse off (Buchanan, 2011).

For many there is a fear that modern day genetic advancements and medicine will be an unwelcome return of a “backdoor to eugenics” (Duster, 2003). This notion is addressed using a concept coined by the French Philosopher Michel Foucault, known as governmentality (Foucault, 1982), in a piece by Thomas Lemke. Governmentality is a thought process that links the political strategies of the state to the individuals capacity to control and mediate itself and the mobilisation of truth that results in the formation of moralistic subject positions (Foucault, 1982). Lemke states that much of the debate surrounding what can be considered modern day eugenic thoughts stem from the historico-political continuity or discontinuity between the old and new eugenic movements (Proctor, 1992, Paul, 1994). The advancements made in genetics since the peak of the eugenics movement in the early 20th century have been vast and there is no longer the polar opposites of nature versus nurture, or of genetic determinism versus the environment; instead it is now understood that there is a complex relationship between genes and the environments and that often more than one single gene code for a particular physical expression (Lemke, 2005). The advancements in genetics have highlighted, credibly, that gene mutations are a natural phenomenon and are spread far and wide in any population, and so this renders the older eugenic arguments of strength through the purification of the gene pool obsolete and downright absurd; a point that was articulately translated from German to English by Lemke (Propping, 1992). Molecular biology and science in the modern day, along with genetic engineering, have become, as their main function, mere informational services that regard the DNA molecule as a code that can be read and potentially one that can be rewritten (Kay, 2000). Lemke goes on to claim that for a person to identify potential risks genetically within individuals, does not necessarily mean that they serve to identify an unavoidable biological fate and it also does not highlight a potentially uncontrollable situation. What genetic screening does provide is a field of vision that was previously unattainable, the field is that of intervention; individuals are now able to monitor their genetic codes and identify pathways that could potentially lead to chronic pathological states (Lemke, 2005). Indeed research has already shown that there are genetic factors involved in the regulation of several diseases, such as heart disease, cancer and diabetes (Clark, 1997). Whether or not such behaviours constitute eugenic thought is of further debate, in fact some have argued that if such an action as genetic screening is inherently eugenic then so is the act of choosing not to screen because it involves a normative decision. With the act of not screening for potential genetic risk factors it is argued that this is one option of many, but still a very real one that involves the decision not to interfere (Kitcher, 1996). Genetic screening itself has caused great controversy amongst many different groups. Medical literature has seen an enormous surge in interest in genetic risks and as such a large amount of discourse has been presented. The impact on the views of pregnancy have been astounding with some suggesting that nearly all pregnancies can be regarded as risk or tentative pregnancies (Rothman, 1987). The discussion soon becomes a question of whether such actions can be considered to be eugenic in their thoughts, and whether such actions can be morally justifiable. When comparing to what is considered to be old eugenics, then such actions are not even on the same parallel. The discourse on risk in pregnancy depends solely on the individual autonomy of those involved and by no means does the authority of the state enter into such an equation (Lemke, 2005). It is observed that in the place of state control there is instead “apparatuses of risk, aiming at the productive enhancement of the individual human capital in the name of self-determination and choice” (Lemke, 2005). Medical experts only now seek to advise and inform the individual so as to attempt to assure that “sound” genetic decisions are made. The rise of “risk” as a label for many individuals has allowed for the debate on the morality of genetic tampering and screening to become more lucid, as the construction of risk individuals has made moralising on behaviours that seem deviant in nature easier as well as allowing for the assignment of guilt and responsibility (Douglas, 1990).  The moral advantage to the analysis of the genome and genetic diagnostics is that it relies much less on genetic determinism, with relations to genes and diseases; what it does instead is provide individuals with a framework to build a reflexive relationship between the requirements of society and individual risk profiles (Lemke, 2004). The fundamental difference between new and old eugenics or genetics is that an individuals autonomy to make a decision for themselves is greatly upheld, the older view of genetic determinism in the relationship between genotype and phenotype makes this position far more difficult to keep up (Lemke, 2005).

In terms of genetic intervention there are two perspectives to consider, one from a public health angle and the other from a personal choice angle. From a public health perspective the aim is to establish a cost-benefit analysis, similar to those used by the state when assessing the economic viability of capital projects, one that involves the avoidance of harm to groups and confers benefits (Buchanan et al., 2000); the assumption here is that this is the most appropriate manner to assess the moral viability of using genetic interventions. It goes as far as to even recognise an ethical framework surrounding the application of scientific knowledge and technology, but it assumes that good and practical ethical reasoning is utilitarian in nature; as in the greatest good for the greatest number of people (Buchanan et al., 2000). The issue is that the public health perspective has been a dominant shadow over eugenics and has produced often disastrous consequences and unspeakable inhumanity, simply by assuming that it is morally justifiable to discard the moral rights of the minority in favour of the greater good for the majority; however this is simply not the case in modern society (Buchanan et al., 2000). The personal choice model is generally seen as far more compatible with modern society and is absent from the overtones of the oppressive state that inevitably come with thoughts on eugenics ideas. Genetic services in the modern medical profession are merely private goods provided for private consumption of the individual. The choice to use such interventions is, as mentioned previously, up to the choice of the individual (Buchanan et al., 2000). However the latter perspective is not without its critics who fear that new genetics is exclusionary and still just as dangerous as old genetics. Some argue that the worst product of genetic interventions is genetic discrimination; such examples have been permanently etched into history as a warning to humanity in the present. It is now argued by some that discrimination and eugenics have become depersonalised and privatised by allowing the individual the right to choose for themselves (Ho, 1998). Ho argues further that this form of eugenic practice is even more dangerous to society than previous incarnations as it cannot be properly opposed, as it is promoted under the guise of free choice and scientific progress; a term he often uses to describe such actions is “bad science and big business” (Ho, 1998). As Ho eloquently states “if screening is eventually going to be applied to ‘predisposing’ genes and to genes whose connection to dubious conditions is increasingly tenuous, we shall slip insensibly and quietly into an era of human genetic engineering dictated purely by corporate interests” (Ho, 1998), a future that he claims will lead to the exploitation of those weakest in society for profitable gains. Such an outcome is discussed by Buchanan, and his colleagues, in their detailed book on the ethics of genetic intervention. They claim that the argument that new genetics is exclusionary and silently dangerous is one of the biggest and most compelling arguments against the morality of genetic intervention. New genetics is seen by many members of the disability rights movement as a proxy for the exclusion of those individuals who are in possession of so called “bad genes” from their most basic of human rights; the right to equal respect and consideration (Buchanan et al., 2000). It is argued by disability rights movements that new genetics can be used to deny those who are victims of “defective” genes the right to be classes as persons with the same moral worth as those who are not unfortunate enough to possess such genes (Buchanan et al., 2000). It is this that has caused many to suggest that new genetics is a harrowing echo of its oppressive predecessor. However Buchanan refutes such a claim by suggesting that genetic science is now no longer about service to a particular nationality or “race”, and lacks the same exclusionary or particularistic nature as old eugenics; rather it is now used to service humanity as a whole, which he claims is a moral imperative for all science (Buchanan et al., 2000). A rather salient point on the morality of genetic intervention is one made by the disability rights movement is that new genetics does not seek to change society to fit those individuals who suffer from a disability, they instead seek to change individuals to fit the society (Buchanan et al., 2000). Disability rights activists claim that many of those who claim that it is morally and ethically correct to intervene genetically in those individuals at risk of disability are fundamentally wrong in their definition of disability (Amundson and Tresky, 2007). Disability is defined as a socially constructed disorder, with there being a dichotomy, in the biomedical definitions, between disability and impairment. Impairment is defined as the biomedical category in which an individual is considered a deviation from the norm and disability is defined as the disadvantage to the impaired individual of encountering environmental barriers that limit their participation (Amundson and Tresky, 2007). It is this distinction that has been described as “the leading theoretical achievement of the disability rights movement” (Wasserman et al., 2005), and it has been argued that the lack of understanding of this distinction amongst bioethicists and those who are pro-genetic intervention leads much of their arguments to be fruits of the poison tree. Furthermore there has been presented an argument that claims that it flies in the face of human nature to even consider genetic interventions or modifications of any kind, and there in lies what is truly amoral about genetic science. However it can be said, and it is done so by many, that there is nothing inherently wrong with altering or destroying human nature because of the fact that human nature contains both the good and the bad aspects of humanity. It is because of this that altering human nature does not necessarily result in the loss of humanity’s ability to make judgements on what is perceived as good, instead it is because we possess a conception of such a thing as good that it allows us to evaluate human nature more closely (Buchanan, 2008). Buchanan claims that appealing to human nature does not illuminate any great issue in this debate but rather it obscures the debate over genetic enhancement (Buchanan, 2008).   

Conclusion:
It is abundantly clear that the eugenics movement of the early twentieth century was morally abhorrent and unjustifiable. From a purely scientific basis, it was often based on shoddy and now rejected pseudoscience; pseudoscience that the field of anthropology has struggled to come to terms with and shed. The shadow of social Darwinism, race hygiene and the forced authority of state visions of the perfect society looms over the modern day equivalent and invokes strong emotion, backlash and fear over what the consequences of genetic engineering, intervention and counselling may bring to modern day society. Both those in favour and those against modern day genetic science have produced a vast amount of discourse that is often emotive and strong in its conviction that the other is morally wrong. On one hand there are those who suggest that it is our moral obligation and imperative to improve the well-being of individuals through the autonomy of individual choice, and that modern day genetic science only seeks to inform and advise those who could be potentially affected. On the other hand there are those who argue that such a path is dangerous in its application and morally bankrupt as it may potentially lead to a promotion of discrimination of those who are deemed to have a genetic disposition towards disability. In terms of the practical feasibility of eugenics in both the modern day and at the beginning of the twentieth century it can be argued that yes, it is very much a feasible option. Those states that adopted such schemes in the early twentieth century forced their image of perfection onto an often unwilling population and it was perfectly feasible for them to do so as the general populous had no choice. In modern day society the advances in technology and the theoretical standpoints of those who support genetic science have made it readily available and feasible for individuals to consume. The moral justifiability of such actions is a debate that is much more divided in its discourse than its practical feasibility. In terms of the early twentieth century form of eugenics, as mentioned above, the moral justifiability is clear; it simply is not moral for such actions to take place. However for the modern day equivalent, drawing a solid conclusion is a lot more difficult. It would appear that for the purposes of this essay that views on state control must be examined, if you believe that there should be an absence of state control and decisions on your lives and the lives of those you bring into the world should be left to the autonomy of the individual then it can be said that it is morally justifiable to allow for individuals to provide the best possible outcome for their children. When examining the benefits to society however it can be argued to the contrary, that it is morally bankrupt to attempt to enact changes in individuals using the guise of good science when it is abundantly clear that society needs an overhaul in its values. The utilitarian approach that so many seem to adopt, simply fails to take into account that individuals are not statistics but human beings and so it should not be a societal universal to force change upon others. 

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