Eugenics

A brief history of eugenics and sample cases for thought

1. Eugenics

2. Eugenics From Greek ( eugenes ) "well-born" from eu , "good, well" and genos , "race, stock, kin” It is a set of beliefs and practices that aims at improving the genetic quality of the human population.

3. Eugenics “Good genes” or “good birth” The use of genetics to improve the health of a population

4. Plato’s The Republic “The best men must have intercourse with the best women as frequently as possible, and the opposite is true of the very inferior.” Proposed the establishment of a fixed lottery in which each person was assigned a “marriage number” corresponding to a quantitative assessment of their fitness He believed this system would lead to a predictable improvement of the human race.

5. Evidence of Eugenics in History Sparta: phenotypic selection through infanticide Weak or undesirable babies were abandoned Rome: Fourth Table of Roman stated that deformed children would be put to death

6. Sir Francis Galton Inspired by Darwin’s Origin of Species Believed societies in favor of spending resources on the weak were in opposition to natural selection Elitist, believing strongly that some people were both mentally and physically superior to others Thought we should make “enhanced” humans by essentially speeding up evolution His approach to eugenics was based upon social statistics

7. Positive vs Negative Eugenics Positive eugenics (Francis Galton): Encourage people with “good genes” to have more children Negative selection: Don’t allow “bad genes” to be reproduced Forced sterilization or abortion Marriage restrictions “Euthanasia”

8. Nazi Germany Practiced negative and positive eugenics Forced sterilization, euthanasia Awarded Aryan women for having many children with Aryan men Some argued that the Holocaust was "a vast dysgenic program to rid Europe of highly intelligent challengers to the existing Christian domination by a numerically and politically minuscule minority.” ~Seymour W. Itzkoff

9. United States Alexander Graham Bell recommended deaf individuals not be allowed to marry Thirty states adopted legislation to perform forced sterilization on those deemed “mentally unfit.”

10. The Carrie Buck Case

11. Genetics and Medicine Genetic testing Prenatal genetic testing Pre-implantation genetic diagnosis Genetic counseling for prospective parents

12. Genetic Testing

13. Genetic Testing Predictive testing: Polycystic kidney disease Fluid-filled sacs grow on kidneys, possibly other organs Autosomal dominant (50% chance if one parent is affected) Onset: 30 to 40 years, possibly earlier/later No cure available; life-prolonging treatment possible (dialysis or kidney transplantation)

14. Genetic Counseling “An informative and supportive dialogue regarding a known, potential, or unsuspected genetic condition.” Manic-depressive illness (Kay Redfield Jamison) “To whom is the genetic counselor responsible? The patient or married couple alone? Other family members? Future generations who may suffer increasing numbers of persons with genetic defects?” Ruth Macklin, “Moral Issues in Human Genetics: Counseling or Control?”

15. Prenatal Genetic Testing Cystic fibrosis Recessive (25% chance if both parents are carriers) Life expectancy: 30 years Carrier test available to pregnant couples or those planning to become pregnant

16. Prenatal Genetic Testing Pre-implantation genetic diagnosis

17. Prenatal Genetic Testing

18. Nash Case Fanconi Anemia : Recessive (25% offspring affected ) Dismorphologies , mildly reduced IQ, leukemia by 6-7 years old, require hematopoetic stem cell transplant (bone marrow) to survive, donor must be HLA (human lymphocyte antigen) matched

19. Nash Case

20. Nash Case 6-year-old Molly affected by Fanconi Anemia (FA) Nashes hope to have more unaffected children Seek 2-stage PGD: FA- & HLA match for Molly 5 IVF cycles to get 1 matched embryo Adam born 8/2000 in Denver; cord blood flown to MN for transplant in late 9/2000

21. What would YOU do We are the Ethics Review Board for General Hospital, a local public hospital. The Review Board has to determine a policy for the hospital regarding whether PGD should be permitted for the following purposes: to help two CF carriers avoid passing on the disease; to help a couple produce umbilical cord cells for an existing child with Fanconi’s anemia; to help a couple select the sex of their child for “family balancing”; To help a short couple produce a taller child.