Designing Our Descendants: The Promises and Perils of Genetic Modifications

10 The Hidden Eugenic Potential of Germ-Line Interventions

c h a p t e r t e n The Hidden Eugenic Potential of Germ-Line Interventions Troy Duster, Ph.D. The Universality of Trained Incapacity In the early part of the twentieth century, Thorstein Veblen coined the term trained incapacity, which unfortunately has fallen from use. The misfortune is substantial, because while the term is rarely deployed, the social phenomenon that Veblen was characterizing is more a feature of the professions and disciplines today than in his times. Professions,Veblen pointed out, train their members or practitioners to see certain aspects of a problem, but in so doing those practitioners become trained to not see other aspects of a problem. Thus by the nature of the training , we are typically blind to the subtle and sometimes subterranean workings of a disciplinary or professional perspective and its implications—unless or until someone outside the “tunnel” calls it to our attention. Nowhere is this more poignantly and sometimes fatally clear than in medical diagnoses. The medical specialist who focuses on one internal organ (e.g., liver ailments) can become so narrow that he or she is bound by a bias in perspective to miss a critical diagnosis of the malfunctioning of another part of the body. Medical mis- takes account for more than 100,000 deaths annually in the United States alone, and the New England Journal of Medicine recently published a study estimating that more than 11,000 heart attacks are misdiagnosed.1 Trained incapacity is no less a feature of professional and disciplinary perspectives on social, economic, and political problems.Veblen was trained as an economist,and he was profoundly aware that his profession’s concentration on market forces often blinded it to other explanations of behavior in the market. No one escapes trained incapacity in this formulation, precisely because all professionals are guided by a perspective that strongly inclines them to hone in on some matters—and by that very process, forces them to exclude, ignore, or simply not even consider other factors.2 For psychologists trained to focus on the psyche of the individual, that gaze can often make them oblivious to larger structural forces in the social context that might shed as much light on the individual behavior or individual condition. For example, during the Great Depression , many men were diagnosed as clinically depressed but only in hindsight was the connection to economic depression so obvious. Sociologists, on the other hand,concentrate so much on organizational and institutional structures and group relations that they often develop the trained incapacity to recognize a potentially serious individual problem that a psychiatrist or clinical psychologist is far more likely to recognize. Thus, when I turn now to what I will characterize as the trained incapacity of bioethicists, I do so not to exceptionalize or draw a caricature of this enterprise , but to show how the domination of a perspective from a field of inquiry can produce systematic and unwitting blind spots that generate their own sets of unexamined ethical and social problems. The Trained Incapacity of a Bioethicist’s Perspective There is an overwhelming tendency for ethicists, medical specialists, clinical geneticists, philosophers, and the best-intentioned guardians of a notion of rights and obligations in Western societies to concentrate their ethical gaze on the states of minds and physical conditions of individuals—to the near exclusion of the fate of social groupings to which individuals belong. In an influential treatise on reproductive choice, for example, John Robertson3 acknowledged that social and economic constraints such as access to employment , housing, and child care might play a role in the decision to have a child. However, the overarching theme, to which he returns again and again, is Hidden Eugenic Potential 157 that reproduction “is first and foremost an individual interest.”4 This is not to suggest that all bioethicists concentrate primarily or exclusively on individual issues of autonomy and decision making.Rather,those bioethicists who do engage the group level (of effects, concerns, and group autonomy) do so at the margins. There are certainly good reasons for this kind of professional bias that can appropriately rivet our attention to the individual. For example, from one perspective , medical experimentation does occur on individuals. Some of the earliest informed consent requirements for the protection of human subjects originated out of a concern that individuals be informed about any experiments performed on them, and indeed, that individual participation in...