When considering social media wielding power over the development of medical ethics, I believe one of the greatest issues being touched upon, yet never argued in a straightforward manner is that which is addressed in this quote: “If we enable the weak and the deformed to live and to propagate their kind, we face the prospect of a genetic twilight; but if we let them die or suffer when we can save them, we face the certainty of a moral twilight. How to escape this dilemma?” I recently found an exposition by Mark Lappé which logically and simply addresses this dilemma (or apparent dilemma) head-on. I must say that I agree with every argument I quote in this post, as all are impartial yet not impassionate.
Lappé acknowledges that “the recrudescence of a social concern for applied human genetics is mandated by an assumed or projected deterioration of the genetic quality of the species” and that the remedy is being attempted through expecting or urging those that are physically or mentally “weak” to refrain from procreating (negative eugenics—via pleas to social responsibility) and ensuring that healthy individuals procreating do not both contain deleterious recessive genes (genetic counseling—which Lappé refers to as “quasi-coercive). Due to the age of this paper, it doesn’t address newer abilities to utilize preimplantation genetic diagnosis to select certain features for a fetus, which is the most invasive and disturbing method of attempting to stop the alleged deterioration of the human race. Lappé then goes on to logically dismantle any arguments for the necessity of any of these remedies; He says
The consensus of the best medical and genetic opinion is that whatever genetic deterioration is occurring as a result of decreased natural selection is so slow as to be insignificant when contrasted to “environmental” changes, including those produced by medical innovation. Even where we have identified a disease in which medical advances can be shown to have increased the over-all population incidence, as in schizophrenia, few if any competent geneticists would advocate reducing the number of offspring schizophrenic individuals would be permitted to bear. The principal reason is ignorance. We simply do not know what (if any) intellectually desirable attributes are also transmitted with the complex of genes responsible for schizophrenia.
In addition to claiming that any concerns about genetic deterioration are illogical, Lappé further clarifies that, “The notion of a genetic “burden” imposed on society by individuals carrying deleterious variant genes is a misleading concept: the “burden” of deleterious genes is borne by families, not society,” And that, “A father bearing a heritable disorder himself or having experienced a lifetime of suffering in the genetic disability of his child would be the best judge to make the decision to deny life to his subsequent offspring… The moral obligations of parents faced with genetic disease are to conscientiously weigh and act based on the prospects for their children, not for society at large.” Since he claims that decreased natural selection (more “genetically inferior” offspring survive) is far outweighed by environmental changes (medical advances such that overall much more of the population survives), it is more of a familial than societal concern—it’s not likely (nor logical to assume) that if many “genetically inferior” individuals choose to procreate that society will become over-ran with the weak, rather than there will be more lines of families suffering from illnesses, while the overall societal prevalence of such illness won’t likely be affected. Lappé does highlight the fact that, “the increased survival of the defective and deformed is not the result of special and sometimes “precious” care of the weak, but rather is usually accomplished as an indirect result of dramatic improvements in health care to all infants.” But doesn’t doesn’t directly address the fact that his argument doesn’t negate the possibility of the percentages of the ill rising in society over a large amount of time, but the entirety of his arguments provide enough information that there’s not nearly enough scientific evidence of genetic deterioration for us to take on the moral burden of introducing methods of control that remind us of eugenic control. He ultimately claims, in full confidence and logical grounding, that “Decisions to have or not have children are best made by parents who have experienced genetic disease in their own families, not by society. Society’s obligation is to provide universal maternal and postnatal care, even at the cost of survival of the congenitally handicapped. To do less is both to deprive the healthy of the optimum conditions for their development and to jeopardize the moral tone of society itself.” I believe it’s imperative that the public hears these arguments before they can condone full-fledged genetic control, shrouded in true logic, such that we come to face a “moral twilight”.