can we learn from eugenics? · heredity to reshape society presents itself. indeed, critics of...

Journal ofMedical Ethics 1999;25:183-194

Can we learn from eugenics?Daniel Wikler University of Wisconsin, USA

AbstractEugenics casts a long shadow over contemporarygenetics. Any measure, whether in clinical genetics orbiotechnology, which is suspected of eugenic intent islikely to be opposed on that ground. Yet there is littleconsensus on what this word signifies, and often onlya remote connection to the very complex set of socialmovements which took that name. After a briefhistorical summary of eugenics, this essay attempts tolocate any wrongs inherent in eugenic doctrines. Fourcandidates are examined and rejected. The moralchallenge posed by eugenics for genetics in our owntime, I argue, is to achieve social justice.(7ournal ofMedical Ethics 1999;25:183-194)Keywords: Eugenics; genetics; ethics; justice

I. Eugenics yesterday and todayThe word "eugenics" may be unfamiliar to mostpeople today, but for a period of about sixty-fiveyears, roughly 1880 to 1945, both that term andthe theories of human "improvement" which itdenotes were in wide currency. Francis Galton, acousin of Darwin, invented the term and launcheda movement to improve the human race, or at leastto halt its perceived decline, through selectivebreeding. His ideas spread quickly, and by the1920s eugenics movements existed all over theworld. Eugenics, a movement for social better-ment clothed in the mantle of modern science,claimed the allegiance of most genetic scientistsand drew supporters from the political right, left,and centre. Unfortunately for that movement, andindeed for much of mankind, eugenics wasembraced by Hitler and his Nazi followers,tarnishing its name forever. After the fall of theThird Reich, eugenic ideas quickly lost theircachet, becoming virtually taboo in the UnitedStates and Europe, where the term "eugenic" isnow used primarily as an epithet.We should not forget eugenics. Eugenics casts a

shadow over the use of genetics in our own era,which promises so much for health, industry,agriculture, and other fields. But that shadow isindistinct. It is often quite unclear whether a newpractice in medicine or biotechnology has aeugenic cast, and whether it ought to be opposedon that ground if it does. We can learn much bystudying the history of the movement and by

engaging in careful moral analysis and assessmentof its doctrines.

Eugenics has many lessons:

1. Eugenics is a valuable case study whichdemonstrates how the prestige of science canbe used to disguise the moral premises andmotives for a social movement, and how class,racial, and other biases can exert powerful anddamaging influence over such a movementwhile remaining virtually invisible to itsadvocates. And it is another illustration of thesad thesis that good (or, at least, high-minded)intentions can lead to evil consequences.

2. Eugenics offers a perspective on the practicesof our own era, the second moment in historyin which the prospect for using the science ofheredity to reshape society presents itself.Indeed, critics of certain practices in clinicalgenetics, and of some contemplated uses forthe genetic technology of the future, maintainthat these are eugenics in disguise. We must beable to evaluate this claim so that we can avoidthe errors and wrongs of the past as we framepublic policies for genetics in the future.

3. We should avoid an unthinking rejection ofevery eugenic thought or value. The fact thateugenicists were in favour of a particular meas-ure or goal is not in itself sufficient reason tooppose it. We need a good analysis of whicheugenic aims were wrong-headed, and why. Wemight judge that some of the questions towhich eugenicists proposed answers ought notbe ignored, and indeed that they are now giventoo little attention, in part because of theireugenic associations.

This paper provides both a brief history of theeugenics movement and a moral analysis of someof its tenets. I begin by recounting briefly the riseand fall of this complex international movement. Ido not in any way wish to revise the very badreputation which the eugenics movement cur-rently suffers, and where old-style eugenics isadvocated today, as in Singapore' and China,"'conventional criticisms of these ideas still apply.When we turn to contemporary practices in clini-cal genetics whose status as "eugenic" is in

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184 Can we learn from eugenics?

dispute, however, the arguments must be moresubtle. I argue that the label "eugenic" does insome instances apply, but that when this is thecase the "eugenic" effect or intent of the practicesought not always to engender alarm or opposition.Though we rightly reject all of the programmes

practised or proposed by the eugenics movementin its heyday, I will argue that this retrospectiveevaluation does not point unequivocally to arejection of any and all eugenics for the future.

II. Eugenics pastTHE RISE OF EUGENICSThough the literature of eugenics extends back toPlato, the modern movement took its cue frombiology: first, Darwin's theory of natural selection,with a boost later on from Mendelian genetics.Galton understood that the theory of naturalselection had important implications for under-standing the development of the human species,and sought to investigate the possibility thattalents and virtues of character and personalitywere inherited along with other traits, offeringtheir bearers advantages in natural selection. Gal-ton coined the term "eugenics" in 1883, definingit as the "science of improving stock-not only byjudicious mating, but whatever tends to give themore suitable races or strains of blood a betterchance of prevailing over the less suitable thanthey otherwise would have had".5 His research,enhanced by statistical methods developed as heneeded them, convinced him that society's stockof talent could be greatly enlarged if members offavoured families were to increase their rate ofchildbearing ("positive eugenics"). The balanceshould be further improved, he believed, bydiscouraging from reproducing those who had lessto offer ("negative eugenics").

Galton's influence was nearly immediate. Dar-win declared himself persuaded by his cousin'seugenic arguments, and Galton attracted anumber of distinguished disciples. In Germany,the Racial Hygiene Society was formed in Berlinby 19056; the English Eugenics Education Societywas founded in 1907, with Galton elected honor-ary president the next year.7 In the UnitedKingdom and the United States, the movementdrew on the middle and upper-middle classes;many professionals and academics were attractedto it.'-0 During the decades 1890-1920, eugenicideas were advanced also in numerous non-English-speaking countries as diverse as Norway,Brazil, and the Soviet Union. Both a research pro-gramme and a popular movement, eugenics wastaught at leading universities, and received atten-tion in standard biology textbooks.

The popular eugenics movements, meanwhile,succeeded in rapidly introducing eugenic ideasinto public discourse. Accounts of generations ofmisfits in such "white trash" family lines as the"Jukes" and the "Kallikaks" were widely publi-cised, warning that an unwise reproductive actcould wreak havoc for generations.8

Following British successes at health exhibi-tions before the turn of the century, Americaneugenic organisations took a particular interest inmaintaining exhibits and events at state fairs andpublic expositions. "Fitter Families" competitionswere mounted at state fairs, with governors andsenators handing out awards.8The content of the eugenic programmes varied

considerably. Eugenicists tended to agree that thehuman race was in decline, but they differed overboth cause and remedy. The French and Brazilianeugenics movements were at least as concernedabout neonatal care as with heredity, and theirhereditarian thinking was Lamarckian-that is,they believed that parents passed on to their chil-dren characteristics acquired during theirlifetimes.' 12 Most eugenicists elsewhere acceptedGalton's view, buttressed by the "germ plasm"hypothesis of August Weismann, that selectionrather than environment determined heredity.Eugenicists tended to draw from this account theimplication that medical care frustrated evolutionby permitting the unfit to survive and reproduce(though Darwin and a number of others who heldthis view none the less continued to supporthumanitarian measures).

Eugenicists differed also in their practicalproposals and legislative aims. While action onbehalf of positive eugenics was limited to suchmild measures as family allowances, some eugeni-cists (particularly in the United States and, later,Germany and Scandinavia) did not hesitate to callfor coercive measures, either sexual segregationor, later, involuntary sterilisation, to prevent thoseimagined to have undesirable genes from propa-gating their kind.

In Germany, eugenics became an integralelement of medical thinking, which envisioned athree-way division of health care involving medi-cal care for the individual, public health for thecommunity, and eugenics for the race.'3 '4 Eugen-ics, for some, was an extension of a tradition of asocial orientation in German medicine that hadproduced Rudolf Virchow and other pioneers ofpublic health.

Historians have generally followed DanielKevles's7 classification of eugenicists, at least inEngland and the United States, as either "main-line" or "reform". In the United States and


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Britain, mainline eugenics was largely (but notexclusively) conservative in political orientation.

Galton was but the first of a long line of eugeni-cists who believed that those who excelled (at leastin fields such as science and literature, wheresocial position was insufficient for advancement)were distinguished from others in their possessionof great natural, inherited talent. Indeed, themainline eugenicists tended to believe that a per-son's station in life reflected his or her capabilitiesand could thus be used as an indication of thegenes likely to be passed down to subsequent gen-erations. To the extent that eugenics is remem-bered at all, what is recalled tends to be the"mainline" movement, with its conservative poli-tics and its tendencies towards class bias, racism,and xenophobia, all of which foreshadowed theNazis'embrace of eugenic doctrines.

In actuality, however, there once were eugeni-cists all over the political spectrum. The "reform"contingent, often socialists, and including many ofthe leading figures in the science ofhuman genet-ics, accepted eugenic goals, but were unsparinglycritical of the mainline eugenicists' research,biases, and proposals. Hermann Muller, anAmerican geneticist who later won a Nobel prizefor demonstrating the effect of radiation on chro-mosomes, insisted that natural talent could not beassessed in a society such as the United States,which did not offer equal opportunities foradvancement to its citizens; only under socialismcould the fit be identified as such, and thenencouraged to multiply.The labels "mainline" and "reform" do not do

justice to the great variety of viewpoints and goalsassociated with the eugenics movements. Indeed,as Diane Paul has observed, one sign of the ubiq-uity of eugenic thinking was the attempt by partieson all sides of particular social disputes to furthertheir cause by demonstrating that their recom-mendations would have the strongest eugeniceffect.'5 Eugenics, seen as an avenue for the appli-cation of science to social problems, was attractiveto some of the architects of the modern welfarestate, such as the Progressives in the United Statesand the Scandinavian Social Democratic parties.16

Indeed, much of the opposition to eugenicsduring that era, at least in Europe, came from theright. The eugenicists' legislative successes inGermany and Scandinavia were not matched insuch countries as Poland and Czechoslovakia,even though measures had been proposed there,largely because of the conservative influence inthese countries of the Catholic Church.'7 TheChurch opposed eugenics in principle (and wasvirtually the only institution to do so), but this wasof a piece with its opposition to abortion and con-

traception: then, as now, the Church was opposedto limitations on fertility, and its opponents wereoften on the left.To be sure, early eugenicists were also oppo-

nents of birth control, since they believed that itsuse by the upper classes exacerbated the degen-eration of the gene pool. But not all eugeniciststook this position. The eugenic banner was seizedalso by feminists, who argued that control overfertility, along with emancipation generally, per-mitted women to improve the race through sexualselection.

THE NAZI DEBACLEEugenics in Germany, while distinctive in having amedical leadership, had been marked by much thesame divergences of opinion as the movements inother countries. Though numerous prominenteugenicists were racist and anti-Semitic, otherswere avowedly anti-racist (and some were Jews),and a number stood on the political left.6 TheNazis imposed a uniformity ofviewpoint, securingthe allegiance of the many eugenicists who ralliedto their cause for a thoroughly racist, nationalisteugenic programme that recognised no limits inthe pursuit of "racial hygiene".

Eugenics was central to the entire Nazienterprise, joined with romantic nativist and racistmyths of the pure-bred Nordic. The emphasis on"blood" called for a purifying of the nation's genepool so that Germans could regain the nobilityand greatness of their genetically pure forbears.'8As Robert Proctor'4 and other historians have

shown, the subsequent programmes of sterilisa-tion, "euthanasia" of the unfit (a programme thattook the lives of tens of thousands of "Aryans,"mostly young children), and eventually the Holo-caust itself were part of the unfolding of this cen-tral idea. The sterilisation and "euthanasia"programmes, which did not initially target Jewsand other minorities, were an exercise in negativeeugenics designed to improve the native Germanstock from its degenerated condition. Legislationbarring sexual relations between Jews and "Ary-ans," and ultimately the Holocaust, were intendedto prevent further adulteration of the "pure" Ger-man nation with inferior genes. Jews and otherswho contributed evil genes were the diseaseafflicting the German nation, which Hitler, thephysician, would cure.These measures were complemented by a range

of other genetic interventions, ranging from anelaborate system of genetic courts passing judg-ment on the genetic fitness of those thought toharbour defective genes, to marriage adviceclinics, to the Lebensborn breeding programmefor SS men and other racially motivated initiatives


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in positive eugenics.6 The academic fields ofanthropology, biology, and medicine were refor-mulated in racial and eugenic terms, and the pro-fession ofmedicine in Germany was compromisedby its participation in government programmes ofidentification, sterilisation, and murder of thosedeemed unfit.6 18-20

DECLINE AND FALL

In its first years, Nazi eugenic programmes andpropaganda won the acclaim of eugenic leaders inthe United States. The Nazis flattered their coun-terparts overseas by pointing to legislation inCalifornia and elsewhere not only as precedentsbut also as models, and the authors of these stat-utes toured Germany and filed favourable reportsupon their return.2' After the Holocaust and thedefeat of the Germans, however, eugenicists inmost other countries distanced themselves fromGerman eugenics; since the Germans had pre-sented themselves as the most consistent and pur-poseful of eugenicists, the movement itself fell intogeneral disrepute. American eugenics organisa-tions experienced amnesia over their prewar affin-ity with their German counterparts, spoke outagainst racism, and urged Americans to considereugenics as a source of national strength.Nevertheless, the eugenics societies soon lost theirfollowers; the American society's journal wasrenamed the Journal of Social Biology, and whathad in prewar years been a virtual consensus infavour of eugenics among genetic scientists disap-peared within a decade. The movement's officeswere shut down, and the Rockefellers and otherfunding sources turned their attention to relatedbut more reputable concerns, such as worldpopulation control, the prevention of birth defects- and to genetics and molecular biology.22There is some controversy over the explanation

of the sudden disappearance of eugenics from ournational consciousness. The account given in thefirst histories of the eugenics movement was thateugenics was abandoned as the science of geneticsprogressed, leaving genetic scientists increasinglydubious of the central factual claims of the move-ment. A revisionist tradition points to thestrikingly rapid repudiation of eugenics by reputa-ble geneticists in the mid-1940s, a period markednot by any sudden increase in scientific knowledgebut by the scientists' strong interest in distancingthemselves from the Nazis. These accounts havedifferent implications for the future of geneticpolicy. If eugenics succumbed to the advancementof science, perhaps the lid on its coffin is nailed astightly shut as it needs to be. If, however, theretreat from eugenics was simply one of fashion,the movement has not been repudiated on the

basis of fact or even principle, and we mightunthinkingly (or, worse, consciously) return toeugenics when and if fashion changes again.Finally, if clinical genetics is simply eugenicsunder a different name, we must achieve a clearunderstanding of the morality of both.

III. Is eugenic doctrine inherently evil?The history of the eugenics movement is markedby a sorry record of pseudoscience, prejudice andbias, and, in its Nazi version, even mass murder.We can learn from eugenics that at least onemovement dedicated to the betterment ofhuman-kind through genetic improvement led to terriblewrongs. But must this goal point us in thedirection of evil? In the remainder of this essay, myquestion is whether there was, and is, a moralmisjudgment, an inherent wrong, at the heart ofeugenic doctrine; and, if so, in what it consists.The attempt to answer this question presents anopportunity to assess the choices open to us in thecoming decades of progress in genetics. If we areto avoid the errors and sins of the eugenics move-ment, we will need an account ofwhat these were.And the same holds true if we are to avoid theconverse danger of refraining from justifiableremedies and interventions because we mistakenlybelieve them to share the taint of eugenics.

This inquiry is an uneasy hybrid of history andmoral philosophy. Since our goal is to discernwhere the shadow of eugenics falls, the analysishas begun with a (brief) record ofwhat eugenicistsactually believed. But to comment on the applica-bility of their beliefs, goals, and values for thefuture, we must abstract from their historical con-text, trying instead to find themes which mightapply to our own time and yet which can reason-ably be attributed to the eugenicists of a centuryago.

EASY TARGETS

So much that the eugenicists believed, said, anddid has been repudiated that one need not look farto find their "errors". The eugenicists' scientificclaims and pretensions are a case in point. Indeed,present-day warnings of a return to eugenics oftenamount to cautions over untenable claims inbehavioural genetics, in particular the heritabilityof personality traits, and both genetic essentialismand determinism. Though debate continues onsuch claims - new discoveries of "the gene for"diverse behavioural characteristics appear fre-quently, and almost as frequently are laterwithdrawn - the bulk of the eugenicists' claims ofthe genetic basis of personality are now believed tobe erroneous.


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Similarly, there are few defenders of theviolations of reproductive rights, and rights ofbodily integrity, involved in eugenic involuntarysterilisation programmes - to say nothing ofeugenic euthanasia, as practised on small numbersof infants in the United States and on a mass scaleby the Nazis.23 Diane Paul24 has pointed to thedevelopment of strong guarantees of reproductiveautonomy as a key difference between our own eraand that of the eugenicists, one which, it wouldseem, would preclude the kind of artificialselection which the eugenicists had proposed.Much the same can be said of the class biases

and racism which so marked the mainstreameugenics movements in the US and UK (to theextent that one historian defined eugenics as a waron the lower classes).'0 While these biasescertainly persist, anyone in the United States orBritain who openly advocated a eugenic pro-gramme that explicitly endorsed such attitudeswould be quickly reprimanded.Each of these attributes of eugenics - genetic

determinism, disregard for individual rights, andracial and class bias - is so closely linked to thereputation of eugenics that warnings of a return ofeugenics are often simply accusations of one ofthese fallacies and wrongs. If these were all thateugenics amounted to, the analogy of eugenics toProhibition in the United States, an historicalcuriosity ofno particular importance for our time,would be sustained, and the present paper couldend at this point. Put differently, we might arguethat if we try to imagine a eugenics movementfrom which we remove the class and racial biases,the faith that personality traits were fixed byheredity, and the conviction that the freedom ofthe individual to decide whether and with whomto procreate must be overridden in the name ofgenetic improvement, then it is not the eugenicsmovement we are imagining. For these attributesdefined the movement.

This kind of analysis, however, comes at thecost of rejecting the definition of eugenics given byGalton, who coined the term and initiated themovement. Galton's several definitions variedover the years, but they were variations on a sim-ple theme: using our understanding of the laws ofheredity to improve the stock of humankind. Initself, this notion is not necessarily committed togenetic determinism, violations of reproductiveliberty, class bias or racism. And though commonin the eugenics movements of 1883 or 1933, thesebeliefs and attitudes also affected other socialmovements and programmes, and indeed the dis-course of the educated classes generally. Ifwe maycarry Galton's core notion to the present,presumably more enlightened day, what sort of

programme would it entail? And will we find anyhint of a eugenic original sin, a wrong present evenin Galton's original conception?

IV. Five candidate wrongsI will survey five wrongs, or putative wrongs,which might be or have been alleged to be inher-ent in the core eugenic doctrine of improving thestock of humankind by application of the scienceof human heredity. Most, I believe, are not goodcandidates: either they are not inherent, or theyare not necessarily wrongs. But in the end, cautiontowards eugenics is still advised.

(I) REPLACEMENTThe first candidate wrong faults the core doctrineof eugenics on the grounds that it seeks "better"(or "fortunate") people rather than people whoare made "better" (or "fortunate"). This com-plaint faults eugenics for posing as a doctrine ofbenevolence. While "human betterment" is thename of eugenics's game, according to this view, itactually betters no humans. No person's diseasesare cured, and no individual's intelligence israised, by eugenic interventions even when (andif) they are successful in their own terms. Instead,the programmes cause the world to be populatedby individuals who have these advantages fromtheir beginnings. In essence, eugenics favourshealthy people over unhealthy people, and smartones over stupid ones. That may be acceptable asa basis for choosing friends, or even employees,according to this complaint, but it is not aparticularly noble social aspiration. Eugenics, inthis view, does not involve any hopes for our fellowhuman beings, but rather a preference for the sortof fellow human beings we have.Does this charge identify an inherent wrong in

eugenics? I think not. It does locate somethinginherent in the doctrine - selection is what eugen-ics was about - but the complaint does notsucceed in showing that it is really a wrong. Manysocial interventions of unquestioned benevolencehave unintended effects on the composition of thepopulation. As Derek Parfit" has taught a genera-tion of moral philosophers, this is simply (andtrivially) due to the fact that interventions withlarge-scale effects inevitably affect the circum-stances of human reproduction, such as themoments at which people engage in sexual inter-course. This in turn determines who will be born,for when it comes to identity and fertilisation,timing is everything. Each of us is the uniqueproduct of the union of a particular sperm and aparticular egg; the product of a different pairwould be someone else. Macroeconomic interven-


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tions, along with most other large-scale measures,result in different sperm being united, in sexualreproduction, with different eggs, and thus changethe cast of characters which will populate that partof the globe in the next generation. Yet good socialpolicies are not a bit objectionable for that reason.It is true that these policies, unlike eugenicprogrammes, do not aim to determine who will beconceived and born. Nevertheless, the effect islargely the same, and it is noteworthy that they areno less laudable for that.

In any case, this complaint against eugenicsproves too much. It would find fault with a wom-an's decision to marry one suitor rather thananother because the first would be the superiorparent; or another parent's decision to delay hav-ing a child until he or she was financially andemotionally ready to be a good provider and par-ent; and with parents who discouraged the mater-nal urges of an unmarried teenage daughter onsimilar grounds. Yet surely these choices areperfectly defensible. If the "replacement" com-plaint against eugenics applies to these as well, wemust reject its claim to have found a serious moralflaw in that doctrine.

(II) VALUE PLURALISMWilhelm Johannsen, the Danish geneticist, askedin 1917, who was to set the criteria for ideal man:"But what is the ideal? Who shall be responsiblefor the decision? The complexity of society makesit impossible that one single human type should bethe best. We need all different types ofhumanity."26 It is not uncommon to find theeugenicists blamed for promoting a particularconception of human perfection, failing to appre-ciate the essential plurality of values and ideals ofhuman excellence. Like others, they assumed thatthe ideal would be similar to themselves, or at leastto those whom they most admired. Mainlineeugenicists in the UK and US, largely members ofthe upper-middle professional classes, hoped for asociety in which each person would attain theirlevel of virtue, and despised those who failed todisplay the proper bourgeois values. Nazi racialhygienists, many of whom considered themselvesto be of "the Nordic type", valued the Nordictype. Hermann Muller, the socialist geneticist andeugenicist, extolled a wide range of models,including Lenin, Gandhi, and Sun Yat-Sen; surelya heterogeneous group. But all of these were, likeMuller himself, exceptionally brilliant men. As thequestion attributed to Johannsen, a scientist andreluctant eugenicist, demonstrates, the difficultyof defining human perfection was not entirely loston the eugenicists, but the strident rhetoric ofmuch of the mainline eugenics literature brooked

no opposition and admitted to no doubt over whatconstituted a "healthy" and virtuous style of life.We might suppose, therefore, that what is wrong

with eugenics is a denial of the plurality of ideals ofa valuable human life. Eugenics, according to thiscomplaint, must inevitably impose a particularvision of human perfection. Those who urgeeugenics show a limitation of moral understand-ing and fail to realise that theirs is but one of amultiplicity of such visions, shaped differently bydiverse cultural traditions and circumstances andby moral reason. This limitation in understandingis potentially harmful to people of the sort theeugenicists hope not to reproduce, since it deniesto them the self respect which accompanies theaspiration to raise children in one's own image,should this be the desire of those parents.

Is this the wrong, or a wrong, inherent ineugenics? Understood as a claim about thehistorical eugenics movement, as opposed to thepure Galtonian ideal, I believe that the complaintis partly right but mostly wrong. If directed to theideal itself, as it might be realised in the future, itis again mostly wrong. The complaint is rightabout the historical movement in that themainline eugenicists made no secret of their fero-cious, and in some cases, murderous, disdain forthe very kinds of people whose fertility theywished to curb. Davenport27 celebrated the deathof a child born to a prostitute:"I recall the impassioned appeal of a sociologistfor assistance in stopping the frightful mortalityamong the children of prostitutes. But the daugh-ters ofprostitutes have hardly one chance in two ofbeing able to react otherwise than their mothers.Why must we start an expensive campaign to keepalive those who, were they intelligent enough,might well curse us for having intervened on theirbehalf? Is not death nature's great blessing to therace?"

Oliver W Holmes, America's celebrated SupremeCourt judge, wanted no more of the sortrepresented by the petitioner Carrie Buck, thethird of "three generations of imbeciles" who hadpropagated "enough",28 and in refusing herpetition to remain fertile, opened the floodgates ofsterilisation in American institutions.20

Today, we rightly abhor these sentiments, and,of course, the even more repugnant judgmentsabout human "types" which animated the Nazis.Nevertheless, the failure to respect the plurality ofvalues was not the central problem, even of main-line eugenics. The traits which the eugenicistsbelieved heritable and worthy of cultivation wereones which are valued by people with widely vary-ing ideals of personal development, plan of life,


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and family structure. Though some eugenicistsdid believe there to be particular genes for drunk-enness, "shiftlessness", and the like, in the mainthe eugenicists focused on a very short list of traitsabout which there is little controversy. Intelligencedominated the list, or was the only item on it; self-control and a few other very general virtues weresometimes added. For many eugenicists, a longlist of objectionable phenotypic traits, rangingfrom sloth to immorality, were the result of thelack of the genes thought to be necessary for thesecardinal virtues. There is little real dispute overthe value of these all-purpose talents, even amongthose who reject the class snobbery of themainline eugenicists. Whatever one's favouredpursuit or style of living, intelligence and self-control help one make the most of it. When weconsider a future eugenics programme, based onGalton's core idea, we can easily envision one thatwould focus exclusively on these all-purposeadvantages.Value pluralism need not be an issue.

It remains true that the mainline eugenicistswere anything but tolerant of personal and socialideals which differed from their own. Theyfavoured breeding humans with an eye tointelligence and self-control because they thoughtthat these traits were necessary if a person were tolead a "proper" kind of life, ie one like their own.Claims of this kind, for example that the poor aretoo stupid to understand the difference betweenright and wrong, or to exercise the restraint neces-sary for the nuclear family, resurface today in suchworks as Herrnstein and Murray's book, The BellCurve.'0 But the transmissible characters targetedby the intervention remains one on which there isagreement regardless of differing ideals of humanperfection. Value pluralism could become an issuein eugenics, even if it is not inherent in the coreidea. Deaf parents who wish to abort fetuseswhich do not test positive for inherited deafness,and dwarf parents who want only a child with thegene for achondroplasia, hold unconventionalvalues, and their freedom to act on them is at issuein the ethics of clinical genetics. The Europeanparliamentary panel on genetic engineering,headed by a Green representative to the GermanBundestag, held that genetic screening requires usto decide what are "normal and abnormal,acceptable and unacceptable, viable and non-viable forms of the genetic make-up of individualhuman beings before and after birth".3' If we everacquire an ability to influence personality andcharacter through genetic choice or manipulation- to choose, for example between aggressive andgentle dispositions - this debate will be of crucialimportance.

Everyone supports the goal of health, andthough we do not share precisely the sameconcepts of health (and of disability), diversity ofopinion is limited to a few disputed instances.When genetic interventions are aimed at enhanc-ing the genome of the healthy individual, however,the scope of potential disagreement is nearlyunlimited. Some of us may live long enough to seethe genetic advances which will occasion suchdebates. Nevertheless, eugenic programmes couldavoid the problem of value pluralism simply bylimiting its focus to those human characters onwhose desirability there is universal or widespreadagreement.

(III) STATISMIn a recent address, James Watson" reviewed theodious history and possible future of eugenics andconcluded that the most important safeguard wasto eliminate any role for the state. He provided astrong case. The great wrongs visited on vulner-able people in the name of eugenics - institution-alisation, sexual segregation, sterilisation, and, inGermany, murder on a mass scale - could not haveoccurred without the agency of the state. In Eng-land, where the state's role was minimal, eugenicsmay have been offensive but it did not violateindividual rights (though some of its supportershoped for eventual acceptance of involuntarysterilisation)."3

Since involuntary sterilisation, supported bylegislation, is perhaps the most notorious wrongcommitted by eugenicists aside from the Nazicrimes, Watson's emphasis on the role of the stateis understandable. Still, many would take issuewith his contention that the state is the chiefenemy. Critics of current practices in clinicalgenetics claim that counsellors and physicians areoften, even routinely, directive towards someclients, and that this subtle coercion continueswithout the explicit backing of the state. Moreo-ver, what Troy Duster34 has called "backdooreugenics" threatens to visit harm on the geneti-cally disfavoured through the cumulative effect ofmany private decisions on the part of employers,insurers, and prospective parents. As RobertWachbroit35 has observed, government and societymight conceivably switch roles, with the formerintervening in private choice in order to preservethe liberties and wellbeing of those whose genesthreaten disease or disability. In such a scenario,denying a role to the state might hasten eugenicevils rather than protecting against them. If the"backdoor" concern is justified, we ought not toconclude that the wrongs of eugenics can beavoided as long as the state forswears any eugenicintent.


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Thus a strong state role is not essential for aeugenic programme. True, it may be difficult towin compliance with eugenic prescriptions with-out the long arm of the law. That is why Galton,imagining a fully voluntary regime, mused thateugenics might have to be instated as a civilreligion in order to induce members of society tomake the sacrifices required. Eugenics neverattained this status, whether in the UK orelsewhere (not even in contemporary Singapore,where the head of state has been an enthusiast).The British eugenics movement was no less"eugenic" for being a citizen's movement relyingon voluntary measures, and from this fact itfollows that statism is not a source of wrongsinherent in the core of the eugenic programme.

(IV) "COLLECTIVISM"An alternative analysis locates the wrong inherentin eugenics in its concern for the genetic wellbeingof the group rather than that of the individual. Inthis view, concern for the individual is benign.Indeed, genetic intervention might be mandatory,from the moral point of view, in certain cases.Parents who knowingly bring into being childrenwho suffer agonising and deadly defects might beaccused of "wrongful life". The fateful turntowards eugenics occurs, in this view, when wewiden our interest from the individual child to thegroup, hoping not that our own sons anddaughters will be healthy but that the population'sgene pool will be improved.

This is a "collectivist" vision in the sense thatthe object of our concern is the group as such,while our concern with the individuals whoconstitute the group is primarily in the contribu-tion which they might make towards the wellbeingof the collective.Narrowly defined, "collectivism" doctrines are

those according to which interests inhere in thecollective entity or group in addition to thegroup's members' interests. Much of eugenicwriting, whether "mainline" or "reform", was col-lectivist in this sense. More loosely, we mightunderstand the label "collectivist" for eugenicdoctrines or policies which locate interests only inindividuals, but which condone trading of thewellbeing of some for that of others. SocialDemocratic eugenicists in Scandinavia, for exam-ple, were often candid in noting the burdenimposed by eugenic sterilisation upon those steri-lised, but justified the practice in terms of thereduced burden of dependents.'6According to this understanding of where the

wrong in eugenics lies, a bright line can be drawnhere, one that both distinguishes medical geneticsfrom eugenics and locates the wrong inherent in

the latter. If we draw the line here, we reject thenotion that parents who seek "the perfect baby"are themselves engaging in eugenics. This under-standing of eugenics provides a green light tomedical genetics, which can be permitted to con-tinue its rapid development without the worry thatit is revisiting the errors of the past.But what, precisely, is the wrong which this view

attributes to eugenics? Consider these three state-ments:

1 a. I favour a genetic intervention because I wantmy child to have the "best" (healthiest, etc)genes.

lb. We favour genetic interventions (on behalf ofeach of us) because we want our children tohave the "best" (healthiest, etc) genes.

1 c. I favour genetic interventions (for each personin our group) because I want our children tohave the "best" (healthiest, etc) genes.

If 1 a is morally acceptable, surely it doesn'tbecome wrong when voiced by several people (inthe form of lb). And how can I be faulted byendorsing that group's hope (1c)? lb and Ic aremerely the aggregate ofmany instances of 1 a. Onemight expect to hear 1 c uttered by, say, a healthofficial, or a legislator who sponsors a measurewhich would provide genetic services to largenumbers of people. Concern for the welfare oflarge numbers of people is part of such a person'sjob description.

Consider, in contrast:

2. The sum total of benefits involved in aprogramme of genetic interventions will begreater than the costs.

Here we seem to come closer to a "collectivist"view, for 2 does not claim that the benefits for eachindividual might outweigh the costs. It leaves openthe possibility that some may lose while othersbenefit, promising only that the magnitude of thelatter will be greater.However, this appearance may, I believe, be

misleading. Statements such as 2 are often madeby way of justifying the use of public funds. Thepoint of the intervention in such cases is not tosave public money, for the professed (and, we mayassume, the actual) goal is to ensure that as manychildren as possible are born with genes whichmake their lives go well. Given the endlesscompetition which exists for public funds, how-ever laudable their purpose, it always helps if onecan argue that the net social cost is zero or better.This calculation has been a trump card in debatesover health care allocation when played by


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advocates for perinatal medical care, and it mightapply equally well for a programme aiming toprovide better genes.

Consider, finally:

3. A programme of genetic intervention will limitthe number of people who are a burden toothers.

Have we, with this step, crossed the line to the"collectivist" position? And if so, does this claimpartake of eugenics's original sin? The answer, Ibelieve, is not as straightforward as it mightappear.We might begin by noting that if this claim does

in fact put us on the wrong side of that imaginarymoral line, we may have stepped over it a bit ear-lier. I just argued that a cost-benefit calculation,such as 2, need not be motivated by a wish to savesociety some money. But of course it could be.This might be the real goal in a particular instanceeven when the advocates of a programme offer itmerely as a justification for the use of publicfunds. In either case, 2 would be in the same moralcompany as 3.But is 3 "collectivist", where we understand

that term as betraying concern for individuals onlyinsofar as they add to or detract from the wellbe-ing of the group, and is it morally repugnant forthat reason? We should note, first, that 3 is notnecessarily "collectivist" in the narrow sensedefined above, according to which the beneficiaryis a collective entity, be it the Reich, theRevolution, or the Race, for which no sacrifice ofindividual wellbeing can be too great. Nazi eugen-ics, of course, was a collectivism of this other sort,obsessed with the glory of the reified Volk. Butthat is no part of the original Galtonian eugenics,at least at its core.More to the point, the core notion of eugenics

does not necessarily ask for sacrifice of any sort.Programmes which isolated or sterilised tens ofthousands of people, and of course those whichresorted to murder, imposed the greatest of sacri-fices, but Galton's original proposal did not callfor these measures. English eugenics, for all theirconcerns over the excess fertility of the unfit, gen-erally proposed voluntary curbs on reproduction.7

In any case, the sacrifice which a eugenicprogramme might ask of prospective parents islikely to be much less onerous as technologydevelops. In Galton's day, eugenics was mainlyconcerned with who mated with whom and howmany children resulted. For the "unfit", childless-ness (even if voluntary) was the price of eugeniccorrectness. Today, a eugenic principle might callfor prospective parents to screen pregnancies so

that the children they bring to term have thegreatest feasible genetic advantages. Tomorrow,these same parents might be encouraged to availthemselves of genetic interventions to cure and toenhance. Excepting perhaps the fetuses which areaborted as a result of such a programme, no onewould be asked to make sacrifices. Becauseparents almost always seek advantages for theirchildren - health above all - there is a congruencebetween a eugenicist's concern for the public anda parent's concern for his or her child. Wherethere is not, a voluntary programme would leavethe decision to the parent. The potential childwhose conception or birth is avoided by this inter-vention does not count in the moral calculationwhich "collectivism" insists we make. Commonsense must concur.

Nevertheless, this kind of eugenic programmemight claim some actual, living victims. Asdisability-rights advocates have insisted, it is diffi-cult to argue for public programmes on the basisof claims like 3 without suggesting, in the same actof speech, that the existence of people who aredependent on others is a fact to be regretted; andthis sends the message that these lives are not, insome sense, valuable. I will not take the trouble toargue that this sentiment is reprehensible and thatthe opposite message ought to be the cornerstoneof public policy, both in genetics and elsewhere.Every person is valuable, and not only for anycontribution which he or she might make to oth-ers. The rhetoric of mainline eugenics in the UKand the US, with its denunciations of "humanfilth" and "human rubbish," are justificationenough for the abysmal reputation of these move-ments, even apart from the programmes of masssterilisation and murder which followed in theirwake. Perhaps we have found, therefore, some hintof an "original sin" of eugenics. In the series1 a-lb-i c-2-3, it occurs somewhere between 2 and3, when we begin to calculate the value of geneticimprovement not in terms of the wellbeing of theindividual whose genes are less likely to cause thatindividual to suffer, and more likely to enhancethat individual's wellbeing, but for the effectwhich the existence of that individual might haveon the wellbeing of others. But this is not quite"collectivism", and I would urge that this wrong,if it is that, be given a different rubric: unfairness.

(V) FAIRNESSIn the United States and England (though not inGermany), the fields of eugenics and public healthinvolved different people, expert professions,journals, and aims. But the two movements sharedmany assumptions and attitudes. As CharlotteMuller noted in her insightful review, the gross


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differences in health status across racial andincome lines tended to be explained in terms ofheredity.36 Burdens imposed by eugenics were jus-tified by the analogy to public health, as JusticeHolmes did, when he compared sterilisation tovaccination.28

Martin Pernick37 has noted extensive overlapeven in the jargon of the two fields, each of whichresorted to "isolation" and "sterilisation" of theindividuals who were thought to pose threats tothe wellbeing of the public. Eugenics was oftendescribed in medical terms,38 for example as aneffort to prevent the spread of (genetic) diseasefrom generation to generation. Hitler was laudedas the great doctor ofthe German nation, rescuingthe Aryan gene pool from the genetic diseaseintroduced by Jewish infestation.'4

Public health had one more characteristic incommon with eugenics: it created and struggledwith many of the same moral problems. A persist-ing theme in the ethics of public health is thegreater effectiveness often achievable if theinterests of some are sacrificed to the interests ofothers. Despite the great protection Americansenjoy in the inviolability of the person, publichealth requirements sometimes have priority, asHolmes's reference to vaccination policy shows.How to balance these benefits and burdens is aquestion of distributive justice which public healthprogrammes will always have to face.

Despite the fact that genetic technology willpermit some eugenic goals to be achieved withoutburdening prospective parents, a public policy ofproviding "better" genes to future generations isbound to impose social costs. Even a fully volun-tary, medically oriented programme-what iscalled "clinical genetics" today and which strenu-ously avoids any association with the eugenics ofold-must answer to advocates for the disabledwho claim that the wellbeing of the disabled is putat risk when genetic screening programmes try toensure that none with their disabilities will beconceived or born. Bioethicists have warned ofdecreasing tolerance of differences, once weacquire the power to choose "the best", and thisintolerance might impose social sanctions onthose who declined to make such choices.More concretely, it is not unreasonable to fear

that if it once again becomes respectable to advo-cate eugenics, the wrongs of the past will return infull force. I have argued that eugenics, consideredas a set of principles, need not assume geneticdeterminism, nor advocate or condone racism orclass bias. In actual practice, however, what guar-antee can there be that a eugenic programmewould not be guided by these still prevalent beliefsand attitudes? Similarly, we could imagine, in

principle, a eugenic programme which avoidscoercive measures, particularly sterilisation, butwhat assurance do we have that these measuresmight not eventually be viewed as justified, if pub-lic policy seeks to provide "better genes" and thebenefits they might bring to society?The ethics of eugenics and the ethics of public

health, therefore, are closely related. Neither,unfortunately, has received the same attention asthe ethics of personal health care. What standardof justice should be used in guiding any neweugenics? The first pages of Rawls's A Theory ofJustice include this famous passage:

Each person possesses an inviolabilityfounded on justice that even the welfare of societyas a whole cannot override. For this reason justicedenies that the loss of freedom for some is maderight by a greater good shared by others. It doesnot allow that the sacrifices imposed on a few areoutweighed by the larger sum of advantagesenjoyed by many. Therefore in a just society theliberties of equal citizenship are taken as settled;the rights secured by justice are not subject topolitical bargaining or to the calculus of socialinterests."39

This is not a bad starting position: public policy ingenetics, whether or not it is termed eugenics,ought not to infringe personal liberty. But thisdoes not necessarily call on us to avoid any risk ofburdening some individuals for the sake of thegenetic wellbeing of future generations. I am notpersonally persuaded, for example, that the threatof stigmatising the disabled requires us toabandon the effort to ensure that future genera-tions are free of avoidable disability. But this kindof concern points us to a valid question of justiceand also to an irony.The point about justice is that genetic benefits

provided in services used by a particular pair ofparents may have adverse effects on others, andwe are bound to reflect on the fairness of theresulting distribution ofbenefits and burdens. Theirony is that this very admonition pulls us towards,and possibly over, the bright line which boundsthat which we identified as a possible wronginherent in the core notion of eugenics. This lineis crossed when the goal of our genetic interven-tion is not only the wellbeing of the individual, butalso the effect on others of bringing this personinto the world. If we are required by distributivejustice to consider the effects upon all members ofthe community when we contemplate geneticinterventions, this moral imperative is in effecttelling us to consider not only the benefit of acontemplated intervention for a particular indi-vidual, but also for others. If there is a wrong


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inherent in the core Galtonian eugenic project, itsurely has to do with this very move, which takesus beyond the "medical" or "clinical" focus on thepatient at hand (or, in the case of procreation, onthe child to be) to the society as a whole. In thelatter, wider view, the patient recedes from theforeground and a moral judgment is made on thebasis of a calculation which takes into account theclaims of many.

V. ConclusionWhere does the shadow of eugenics fall? Is there awrong inherent in the core Galtonian eugenicprogramme? And what guidance might the answerto this question give us in deploying the resourcesof the new genetics?One respectable position which I have not taken

up directly in the above is that the core notion ofeugenics may be benign, because it is trivial. Noone objects in principle, according to this view, tousing what we know of the science of heredity toimprove the chances of future generations forachieving greater wellbeing. What rouses passion-ate debate are the means to be used; or the prob-lem of value pluralism; or one of the other "easytargets" which are discussed in II, above.

Perhaps so. Much of the controversy over Chi-na's law on maternal and infant health care hasindeed focused on its apparent threat of coercion,rather than its goal of a generation of healthy Chi-nese children.40 But clearly some who expressconcern about a return of eugenics in the West areworried by the move from "medical" concern forthe individual to "eugenic" ambitions for improv-ing the gene pool in general, even if coercion is notproposed as a means to this end. Perhaps theworry is roused by the fact that this move wasaccompanied, early in this century, by greatwrongs, harms justified by the greater good, andthe fear that once the "collective" goal isestablished, the demand for sacrifices by individu-als will not be long in coming. In some cases,however, the complaint against "eugenics" seemsto be lodged against those who profess concern forthe genes of humankind apart from the genes ofone individual patient, whether or not the broaderconcern be advanced by coercion or other harms.

I do not see that much hangs on the resolutionof this question. In either case, we can draw theimportant (if obvious) lesson that progress ingenetics must pay attention to these questions ofdistributive justice. This very general, yet morallycrucial, requirement ought to guide us now, as wedecide which programmes of genetic testing andscreening to undertake, and also in the future, aswe contemplate the possibility of refashioning thehuman genome to engineer a new, perhaps

improved version of homo sapiens. Done justly,the genetic wellbeing of "the group" is a properobject of concern. The question of moralimportance is not whether this constitutes eugen-ics; it is whether it can be done fairly and justly. Itwasn't, the last time it was tried.

Credits and acknowledgementsThis essay overlaps my contribution to AlisonThompson and Ruth Chadwick's book, GeneticInformation: Acquisition, Access, and Control, Lon-don: Plenum, 1998; my "Eugenic values", in Sci-ence in Context, 1998; 10:3-4; and parts of a forth-coming book (tentatively titled Genes and SocialJ7ustice), co-authored by Allen Buchanan, DanBrock, Norman Daniels and myself, to bepublished by Cambridge University Press. Theauthor is indebted to Diane Paul for help withsources and interpretations.

Daniel Wikler, PhD, is Professor in the Program inMedical Ethics, Department of History of Medicineand in the Department of Philosophy, University ofWisconsin, USA.

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