Heredity and Hope by Ruth Schwartz Cowan
The subtitle, The Case for Genetic Screening, seems to say it all. But Cowan comes at the topic as an historian with an interest in medical ethics. Here’s how she makes her case:
1. She shows that historically the folks who came up with eugenics were different from the folks who came up with genetic screening. She is aware of the possibility of genetic fallacy, but I think she knows that people like it when their ideas flow from pure springs. She focuses on Tay-Sachs, beta-thalassemia, sickle-cell anemia, and PKU, showing that with the partial exception of sickle-cell, the drive for genetic testing came from parents whose children suffered from genetic diseases and from communities at high risk for the genetic disease. Thus, genetic screening is a bottom-up social phenomenon, not a top-down mandate. For the beta-thalassemia chapter, she spent some time on Cyprus, where the disease is relatively common, and her on-the-ground knowledge shows.
2. She shows that from a population genetics point of view there’s a big difference between eugenics and genetic screening. Eugenics, she says, is a system of encouraging the fit to bear more children and perhaps discouraging or preventing the unfit from bearing children. Eugenics thus promotes ‘good genes’ in the population, the literal translation of eugenics. Modern genetic screening, by contrast, makes it easier for those with bad genes to bear children for two reasons. First, screening lets people with deleterious recessives find partners without such recessives, so the recessive alleles still stay in the population. Second, screening makes couples who both have the same deleterious recessive allele more willing to bear children, since they know they can abort a homozygotic recessive fetus. She actually has some decent anecdotal data on the second point. Thus, she repeatedly emphasizes that genetic screening is simultaneously “anti-eugenic” and “pro-natalist.”
3. She tells a lot of human-interest stories about important firsts in genetic screening, focusing on happy endings. Given the importance of the law of small numbers, this is probably a good idea, and it’s a relatively painless way for her to show how science and medicine work in the real world.
The book is exceptionally well-written, and while her history of eugenics contains few surprises, her history of the successes and failures of genetic screening was quite gripping. She also covers the basics of Mendel from scratch, so feel free to hand the book to anyone who took high-school biology. Functionally, Cowan does the same thing for genetic screening that The New Republic did for tough-on-crime policies in the 80′s and 90′s: Cowan does some liberal hand-wringing while telling the reader that no, you’re not becoming a Brownshirt if you agree to an amnio…..
Related: Heredity and Hope: The Case for Genetic Screening by Ruth Schwartz Cowan.
Labels: Bioethics
I think the Eugenecists got a bum rap; they weren’t all evil Nazis. Some were evil Socialists or evil Communists or evil Social Democrats. Some, whisper who dare, may not have been especially evil at all.
Second, screening makes couples who both have the same deleterious recessive allele more willing to bear children, since they know they can abort a homozygotic recessive fetus. She actually has some decent anecdotal data on the second point.
Questions: Isn’t aborting a homozygotic recessive fetus eugenic? Hasn’t the percentage of children born with Down Syndrome gone down steadily in the last 30 years? Isn’t this eugenics? I’m not against it but don’t we need to talk straight instead of PC?
Questions: Isn’t aborting a homozygotic recessive fetus eugenic? Hasn’t the percentage of children born with Down Syndrome gone down steadily in the last 30 years? Isn’t this eugenics? I’m not against it but don’t we need to talk straight instead of PC?
depends on how you define eugenic. the fitness of DS suffers is VERY low (most males seem to be sterile). additionally, DS seems to be due to de novo mutations each generation, so it isn’t changing the long term genetic load….
bioIgnoramus: Agreed—there’s nothing all that bad about “good genes” (aka eugenics) per se. Who can be against more good things, whether good meals at a restaurant or good manners in a society or good genes in a population?
It’s the combination of eugenic ideas + guv’mint mandates that leads to the bad outcomes most folks worry about. Well, that plus the fact that what is “the good” is always a matter for legitimate debate, whether regarding meals or manners or, well, genes…..
But Cowan is a clever enough rhetorician to avoid that issue entirely—she doesn’t fight every battle, just the ones that are easy to win. A smart approach, given her intended audience….
Herrick wrote: “It’s the combination of eugenic ideas + guv’mint mandates that leads to the bad outcomes most folks worry about.”
:laugh: I’d argue that it’s the combination of *anything* and government mandates that leads to the bad outcomes most folks worry about.
PhilB