- The New Eugenics: Selective Breeding in an Era of Reproductive Technologies by Judith Daar
The first two decades of the twenty-first century have been a time of rapid change in the accessibility and use of assisted reproductive technologies (ART). Judith Daar, a professor of law at UC Irvine, begins her new book on this topic with a compelling story about two women who, beginning in 1999, sought to use ART to have a child together with the assistance of a sperm donor. Citing religious objections, the first physician they visited refused to provide them with the ART services necessary to achieve their goal. However, like multiple other cases of reproductive discrimination described in this book, this story ended happily with the birth of a child, due to a combination of legal intervention and access to another fertility clinic. Many other similar stories, we are left to presume, have not had such a successful [End Page 825] conclusion for the individuals involved but never made it into the public spotlight and thus were difficult to trace and analyze.
Daar’s focus in The New Eugenics, on individuals who were denied access to ART by providers due to their social identity or situation, is an extremely important, timely, and quickly evolving topic in the early twenty-first century. Unfortunately, most of the content and scholarly engagement in this book was already a decade or more old when it was published. New medical technologies almost always go through a period of limited availability and restricted access. Since 2007, many of the legal, professional, and ethical correctives that the cases in this book cried out for have been established, as the social acceptability of same-sex marriage and childrearing has increased.
Many historians of medicine will be dissatisfied with Daar’s use and application of the term “the new eugenics” (p. 184). While she dedicates an early chapter to describing American eugenics, notably ending in the 1940s, Daar does not define what she means by the new eugenics until the final chapter. Historians of medicine will likely find her conception to be overly narrow. For Daar, the new eugenics takes place when a government policy, insurance plan, or individual provider’s decision restricts access to ART, but does not occur when parents use ART to select one embryo over another based on its genetic traits. Thus, Daar’s new eugenics is not hereditarian, but based on economic wellbeing, luck, or values about the proper childrearing environment. Mindful of the continuing expansion and use of prenatal genetic testing, many historians of medicine will be hesitant to accept that Daar’s examples of reproductive discrimination are the most significant or wide-ranging instances of “the new eugenics” (p. 184). Her analysis would have benefited greatly from engagement with the seminal contributions to the history of eugenics by Diane Paul, as well as important recent work by Nathaniel Comfort and Alexandra Stern.1
The discrimination that Daar points to in this book is real and important. However, The New Eugenics is in need of more analysis that addresses limited access to ART as more broadly reflective of a free market healthcare system in an unequal and unjust society, where many people do not have access to the healthcare they need to preserve their life, livelihood, and wellbeing. Many of the instances of discrimination described in this book were limited to the decision of one physician, who was often successfully sued, while another ART provider was identified and used. Undoubtedly, the reproductive discrimination that Daar compellingly describes continues in 2017 and takes a real psychological toll on those affected. In the closing pages, Daar suggests a series of policies to increase access to ART, which many progressives would likely support, but preferably as part of a larger reform of our healthcare system. To focus resources on just one narrow, though [End Page 826] important, area of healthcare, will strike historians of medicine as similar to the 1970s decision by the U.S. government to...