A Century of Eugenics in America: From the Indiana Experiment to the Human Genome Era

9. Are We Entering a “Perfect Storm” for a Resurgence of Eugenics? Science, Medicine, and Their Social Context

193 nine Are We Entering a “Perfect Storm” for a Resurgence of Eugenics? Science, Medicine, and Their Social Context Linda L. McCabe and Edwar d R. B. McCabe The purpose of this volume is to consider the history and legacy of eugenics . No extant scientific or medical community is more conscious of the burden of the eugenic bequest than human and medical geneticists, since our discipline is historically rooted in eugenics and the eugenic movement.1 Perhaps in response to this disciplinary origin, geneticists often avoid discussions of eugenics, but such avoidance ignores the risk of eugenic resurgence and may in fact foster its reemergence by avoiding notice of the scientific, medical, and social factors that are realigning for the “perfect storm.” Factors Contr ibuting to a Possible R esurgence of Eugenics The following proposals appeal to significant portions of the U.S. population in the early twenty-first century. Taxpayers are distressed about spendingforthepoor,thementallyill,andtheincarcerated. Anincreased police presence is required to promote the rule of law. The citizenry are concerned about being overwhelmed by recent immigrants and their offspring, and many would support immigration reform that is more selective . But these were early twentieth-century positions espoused by Charles Davenport, who was the founding director of the Cold Spring Harbor Laboratory in 1904 and its Eugenics Record Office in 1910. Garland Allen argues that many of the economic and social influences that led to the American Eugenics Movement are present today, and these influences exist in a similar scientific context that is filled with genetic determinism. The early decades of the twentieth century, 194 · Linda L. McCa be a nd Edwa r d R . B. McCa be during which eugenics prospered in the United States, were turbulent socially, economically and politically. One response to this turbulence was Progressivism, which utilized a scientific approach to planning and management, engaging experts and managers to address rapid change and improve efficiency, initially in the industrial sector and eventually in government. These features had strong appeal to proponents of eugenics, whoarguedthatsciencecouldbeharnessedtoimprovegeneticoutcomes, and careful management of human breeding would be more efficient for society economically.2 The parallels are obvious between Davenport’s social and economic positionsdescribedaboveandsimilarproposalsheardtoday. Allenshows additional resemblances between the early twenty-first and early twentieth centuries and raises serious concerns: I would like to suggest that in the United States, immersed as we are in the present economic era of cutbacks and “bottom-line” mentality, we are on the brink of revisiting a mistake of the past, that is, regarding certain people as too expensive to maintain, and using genetic arguments to justify inhumane solutions in the name of efficiency.3 Allen adds: We seem to be increasingly unwilling to accept what we view as imperfection in ourselves and others. As health care costs skyrocket, we are coming to accept a bottom-line, cost-benefit analysis of human life. This mindset has serious implications for reproductive decisions. If a health maintenance organization (HMO) requires in utero screening, and refuses to cover the birth or care of a purportedly “defective” child, how close is this to eugenics? . . . If eugenics means making reproductive decisions primarily on the basis of social cost, then we are well on the road.4 Therhetoricofgeneticdeterminismandtheperceivedpowerofgenomics could fuel the resurgence of eugenics, though undoubtedly with a different name, and therefore it is essential to challenge such deterministic thinking whenever and wherever it arises. In this era of political and social polarization, reinvention of market economies, and a desire to maximize efficiency in all areas of our lives, will we be seduced into believing that science will be our salvation? Are we entering an era of neo-progressivism that could set the stage for the resurgence of eugenics? A r e W e Enter ing a “Per fect Stor m”? · 195 Scientific Cla ims a nd Expectations The media, public, and patients have exhibited a remarkable interest in the results of the Human Genome Project.5 A physician, Sandra Sabatini, asked her patients, “What are your expectations of the Human Genome Project?” and summarized the responses: “Cure diabetes and cancer”; “Prevent renal [kidney] failure, heart disease, and birth defects”; “Avoid hypertension, obesity, and osteoporosis”; and “Prolong life.” She added, “Most [of her patient-respondents] believe that these problems are either now solved or near to being solved.” How have these expectations been shaped?6 HoraceFreelandJudsonarguesthatthepublic’sunderstandingofthe Human Genome Project is distorted by the language used to describe...