The Relation of Genetics to Control of Human Fertility

THE RELATION OF GENETICS TO CONTROL OF HUMAN FERTILITY* JOHN B. GRAHAM, M.D.t And God blessed Noah and his sons, andsaid unto them, Befruitful, and multiply, and replenish the earth. [Gen. 9:1] In the year 2525 / Ifman is still alive . . . [Rick Evans, 1969] Nothing concentrates the mind like waiting to be hanged. [Samuel Johnson, 1709-1784] I chose the first two quotations above because they seemed to illustrate nicely the difference between the human moods ofabout 3,000 years ago and today. I added the third quotation because it expresses my own feelings about the predicament in which we, the inhabitants of"Spaceship Earth," now find ourselves. I suppose I was asked to discuss the relation of genetics to control of human fertility for two reasons. It is known that I have been engaged in recent years in establishing a population program at the University of North Carolina and in attempting to convince our local and national leaders that our country must commit itself to fertility control.1 Also, it is not a secret that I have strong opinions and tend to express them recklessly . In this paper I shall attempt to be completely candid, exposing my assumptions, biases, fears, and ignorance. I shall say things which will make me unpopular with certain persons, including some ofthe sponsors of the Conference on Genetic Disease Control. Since I maintain with Harper [4], that "life is an existentialist game in which success is measured * A position paper presented to the Panel on Population Genetics at the Conference on Genetic Disease Control, Washington, D.C, December 4, 1970. t Alumni Distinguished Professor of Pathology, University of North Carolina, Chapel Hill, North Carolina 27514. 1 The entirely accidental way in which I became involved in human population control has been described elsewhere [1-3]. 615 by continuing to play the game" and since I fear that the end ofthe game may be in sight, I shall speak bluntly. My criticisms ofgenetics and geneticists will apply equally to all disciplines and scientists dedicated to "business as usual." First, I shall display my assumptions and beliefs so that you may understand my motives. Second, I shall describe some ofthe things I have been doing and some ofthe problems I have encountered. This will be followed by ajudgment about the relation ofgenetics to control ofhuman fertility which may upset you. I shall conclude with suggestions for human geneticists and other biomedical scientists who wish to become involved in working for the goal offertility control. 1 believe that civilization, if not life itself, on the planet Earth is in jeopardy for several reasons. These include unbridled nationalism in a context of nuclear overkill, rapidly increasing human populations for whose progeny there will be insufficient natural resources—including food—and accumulation ofthe toxic by-products ofindustrialization. I do not mean to imply that these three problems are equally serious or that I feel the same degree ofurgency about them. It is obvious that prevention of nuclear warfare is our first priority.2 While we could obliterate ourselves overnight in a nuclear war, population pressures could not possibly overwhelm us for many years. There is a link between the three main issues, however. Population growth interacts with and amplifies any tendency to go to war (to avoid facing intractable domestic problems or to settle international disputes), and population growth also forces the rate at which pollutants are accumulating. In the universe ofpossible responses to our predicament, control ofhuman fertility has the advantage ofbeing both a direct attack on the resources/people problem and a flanking attack on the other two problems, either ofwhich could be lethal. It is fashionable nowadays, particularly among demographers, to decry the "hysteria" of biologists and others about population growth. What shocks me is their equanimity about the probable quality of life on the planet thirty years hence when the population shall have reached 7 billion. This sangfroid seems to be based upon two assumptions for which evidence 2 A major scandal ofacademe is the paucity of work on conflict resolution being carried on by natural and social scientists and humanists. Courses, graduate studies, and centers are almost nonexistent despite the fact that...