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From state eugenics to private eugenics
Baillière’s Clinical Obstetrics and Gynaecology Vol. 13, No. 4, pp 533–541, 1999
B A I L L I È R E ’ S
6
PRACTICE & RESEARCH
BEST
From state eugenics to private eugenics Jean-Noel Missa
MD, PhD
Professor of Philosophy and Adjoint Director Centre de Recherche Interdisciplinaire en Bioethique, Universite Libre de Bruxelles, Campus du Solbosch, Bat NA3, 50 Avenue Franklin Roosevelt, CP 175/01, B050 Brussels, Belgium Translated by Dr Francoise Kohane-Shenfield
Eugenics—or ‘the cultivation of a race’—is a concept dating from the latter part of the 19th century. It preceded the new science of genetics by merely 25 years. Negative eugenics stressed especially the exclusion of negative characteristics and was associated with the practice and theory of radical eugenics between the two World Wars. In order to redress ‘the decline of the race’, reinforcement by positive eugenics was also advocated. After the atrocities committed by the Nazis there was a lull in the practice and discourse of eugenics. More recent technical advances in assisted reproduction techniques and the genome project, however, have revived the eugenics debate. State eugenics and eugenics as an individual choice ought to be distinguished. Key words: eugenics (positive and negative); heredity; genetics; reproduction.
THE INTRODUCTION OF THE ‘EUGENICS’ CONCEPT BY GALTON, AND ITS EVOLUTION AT THE BEGINNING OF THE 20TH CENTURY In 1883, the statistician Francis Galton, cousin of the famous Darwin, coined the term ‘eugenics’, and defined it as ‘the cultivation of a race’ in his book Inquiries into Human Faculty and its Development. [Eugenic questions are] questions bearing on what is termed in Greek, eugenes, namely, good in stock, hereditarily endowed with noble qualities. This, and the allied words, eugeneia, etc, are equally applicable to men, brutes, and plants. We greatly want a brief word to express the science of improving stock, which is by no means confined to questions of judicious mating, but which, especially in the case of man, takes cognisance of all influences that tend in however remote a degree to give to the more suitable races or strains of blood a better chance of prevailing speedily over the less suitable than they otherwise would have had. The word eugenics would sufficiently express the idea; it is at least a neater word and a more generalised one than viriculture, which I once ventured to use.
He believed that most human behaviour had an innate component, and proposed favouring the birth of hereditary gifted children in order to practically improve the ‘human race’. In 1900, eugenics was fashionable. Whilst Mendel’s laws of hybridization were being rediscovered by botanists at the beginning of the 20th century, Bateson coined the term ‘genetics’ when describing the science of heredity on animals in 1905. In 1909, 1521–6934/99/040533 + 09 $12.00/00
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the term ‘gene’ was coined. A year later, T. Hunt Morgan, one of the fathers of genetics who studied Drosophila, and himself not directly involved in the eugenics movement, described hereditary particles as material grains in the chromosomes’ structure. H.J. Muller, one of his collaborators, became one of the main proponents of the eugenics cause in the 1930s. At the beginning of the 20th century, Carnegie financed an experimental center near New York dedicated to the study of evolution. Its director, Charles Davenport, propagated eugenics theories, mixing Mendel’s theories with fantastic speculations. He enrolled young students to study the physical and mental pedigree of whole families. The information collected was the base of his publication in 1911 of Heredity in Relation to Eugenics, where he claimed that any trait commonly found in several members of a family should be considered hereditary and he attempted to explain their distribution according to Mendelian laws. This not only included specific disorders such as polydactyly, albinism and Huntingtons’s chorea, but also insanity, epilepsy, alcoholism, criminality and feeblemindedness. He recommended a negative eugenics programme. Simultaneously, several eugenics societies were founded. The Racial Hygiene society was created in Berlin in 1904, the Eugenics Education Society was founded in the UK in 1907, and the American Eugenics Society in the USA in 1911. The first Eugenics congress took place in London in 1912, followed soon after by the creation by the French of the ‘society for the study of the questions relating to the improvement of future generations’. Thus, at the beginning of the century, eugenics was barely distinct from the new science of human genetics. Several societies were created in Europe, and several journals appeared regularly on the subject, such as the American Eugenics Society Journal of Heredity, and the British Eugenics Review. Soon, after the First World War, the subject was included in several universities’ curricula. THE PRACTICE AND THEORY OF RADICAL EUGENISTS BETWEEN THE TWO WORLD WARS Between the two World Wars, radical eugenics held a three point discourse, encompassing Darwin’s theory of evolution by selection, the belief in the physical and mental decline of the population at large and the notion of the hereditary transmission of mental handicap. Furthermore, racial overtones were frequent both in the USA and in Germany. It was argued that medical progress and the softening of mores encouraged the survival of the weak. This notion of ‘negative selection’ was based on the alleged decreased demography of the ‘superior classes’ and increased birth rate of those deemed inferior, with the consequence of lowering the general population level. This theory was reinforced by the notion of ‘differential birthrate’ of Karl Pearson (1909), who argued that ‘inapt families’ had a higher rate of reproduction than ‘valuable’ families, partly due to the progress of ‘social hygiene’ and medicine. Literature, by Emile Zola and Thomas Mann for instance, is full of these themes of human degeneration. In 1903, the British Parliament ordered an inquiry into the threat of ‘national deterioration’ (Searle, 1976: p. 2, 32–33, cited in Kelves, 1985). In the USA, Gosney (1934) asserted that ‘it is clear that under existing conditions the average level of intelligence and of physical and mental fitness in the American population is declining steadily from generation to generation. The exact rate of this decline is debatable. The fact that the decline exists, is not debatable’. In order to counter this and to stop this ‘decline of the race’, theoreticians proposed a ‘negative eugenics’ plan of reproduction.
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Alexis Carrel (1935; p. xiv) wrote that the danger could be countered by educating susceptible young people to an understanding of the dangers of marrying into families with tuberculosis or psychiatric disease. He also thought it ought to be reinforced by positive eugenics, fostering ‘the union of the best racial elements through the indirect means of education and economic advantages’. In the USA, Landman (1934) established a list of ‘misfits’ (those who did not have a useful role in society) including the mentally ill and handicapped, the dependant (blind, deaf and unemployed) and the ‘infectious’. He estimated the misfits to account for 20% of the then 125 million USA population. The heredity of feeblemindedness was a fundamental tenet of eugenics. The psychologist Goddard (1914) introduced three categories of mental handicap (or feeble mindedness): idiots, imbeciles and morons (corresponding to mental ages below 3 years, between 3 to 7 years, and from 8 to 12 years, respectively) described in the Kallikak family, which became the popular labels corresponding to rendering of the Binet and Simon intelligence tests. He asserted that ‘mental deficiency is a condition of the spirit or the brain which is transmitted in a similar fashion to this of hair or eye colour’. Extreme means such as sterilization of those carrying ‘bad genes’ was advocated only for hereditary conditions, but the segregation of undesirable individuals in specialized institutions and the surveillance and tutoring of the feebleminded were proposed in order to reduce the number of ‘dysgenic’ individuals. Furthermore, prenuptial certificates of good health were advocated in order to fulfil this aim. It is interesting to note that although the encyclic Casti conubi condemns this practice in 1932, it was introduced by the Vichy government in 1942. Several American States enacted legislation favouring the sterilization of criminals ‘idiots and imbeciles’, and by 1944, more than 40 000 operations had been performed. Similar laws were passed in Alberta, Finland and Denmark. In Germany, sterilization laws were introduced in 1932 using mostly economic arguments, after Hitler was influenced by the racist interpretation of the book on heredity by Baur et al (1931). Between 1934 and 1939, 300 000 chronically ill and mentally ill patients were sterilized, thanks to new legislation passed in 1933, rationalized by economic theory, in order to prevent ‘the procreation of defective individuals [which] burdens financially the working people’. Thomalla (1934) wrote that ‘in a state which is desperately fighting for its existence, as in Germany, it is a simple problem of arithmetic whether to allow for all eternity the procreation of defectives, thereby most heavily burdening financially the working people, or whether to interfere before it is too late with the career of the worst and most costly of this kind of defectives’. CRITIQUE OF THE SCIENTIFIC BASIS OF THE RADICAL EUGENICS THEORIES PRACTISED IN THE 1930s AND 1940s During this period, some renowned scientists wanted to reform the eugenic theories which had become simplistic and pseudoscientific. At the third congress on Eugenics, Pearl (1927, cited in Kevles, 1985: p. 122) asserted that ‘Eugenics has rapidly become a mingled mess of ill-grounded and uncritical sociology, economics, anthropology and politics, full of emotional appeals to class and race prejudice, solemnly put forward as science, and unfortunately accepted as such by the general public’. The reformers such as J. Huxley and J.B.S. Haldane wished for a more scientific basis, since they appreciated that the application of Mendelian laws to mental illness was purely speculative. ‘We know little, if any, more about the transmission of feeble mindedness through heredity than we do of the heredity of mental illness’ wrote Cox in 1934. Even today, the
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genetic basis of behaviour and mental illness remains relatively little known, but it is established that most behavioural characteristics depend on multiple genes and are strongly influenced by the environment. According to Huxley (1948: p. 57), social and environmental factors are as important as genetic factors in the decline of man. He stated that eugenics was not a special branch of natural sciences, but of social sciences, and bemoaned the consequences of the defeat of the Lamarkian school (which stated that educational benefits were incorporated into human nature and transmitted to the next generation); in his opinion, this led the radical eugenists to neglect the effects of the environment and of social reforms. Reformers, such as Haldane (1948) also questioned the thesis of ‘differential fecundity’. Cox (1934: p. 188) stated that ‘Social standing is not a virtue’, and Muller (1938) challenged the notion that a sterilization policy might decrease mental handicap along the generations. They nevertheless affirmed their belief in eugenics. Their doctrine is examined below. THE PROGRAMME OF THE EUGENICS ‘REFORMERS’ In spite of their criticism, they still believed in eugenics theories. In Out of the Night, Muller (1938: p. 112) asserted that the progress observed in the new science of genetics may enable a policy of social improvement, centred around the control of reproduction of the population as a whole; he advocated birth control, and its universal knowledge and understanding, through ‘education and propaganda’, with legalized and codified terminations of pregnancy as a back up. He also described, in a prophetic manner, embryo transfer between women, surrogacy between species, parthenogenesis, and ectogenesis (Haldane also wrote of ectogenesis in Daedalus in 1923). Sex selection was seen as possible and would result in ‘radical changes’, artificial insemination was advocated for the transmission of superior genes from ‘a superior man’, a method termed ‘germinal choice’ by Muller. Huxley spoke of differentiating sex between lovers, and procreation between people who admired each other. EUGENICS AFTER THE SECOND WORLD WAR Because of the atrocities committed in the name of eugenics by the Nazis, the proponents of the theory become less vocal after the world-shattering events of the war. Eugenic sterilizations, however, continued in the USA and Scandinavia. After the discovery of DNA in 1953, genetics slowly acquired scientific status. This was followed by the discovery of genetic codes in the 1960s, and the first applications in clinical genetics. Genetic counselling centres slowly appeared in hospitals. Prenatal diagnostic methods using amniocentesis were practised from the early 1970s. Genetic counselling became widely available, making it possible to inform future parents about the risk that their child-to-be might be carrying the genes for a congenital anomaly. In cases of grave risk without any therapeutic solution an abortion was offered. Thus prenatal diagnosis was practised, leading to negative eugenics at a time when therapeutic abortions (termination of pregnancy, TOP) became legal in several countries (UK in 1967, USA in 1975 and France in 1975). The proponents of positive eugenics continued to strive for their belief in the genetic transmission of intellectual characteristics. Inspired by Muller’s (1935) thesis, and according to the criteria of ‘physical health, a developed social sense, and the
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highest possible intelligence’ the businessman Robert Graham proposed the creation of a sperm bank of ‘remarkable’ men. In 1971 the ‘Herman J. Muller Repository for Germinal Choice’ was established, but this was after the two men had fallen out for political and ideological reasons, and was against the deceased Muller’s widow’s wishes. Graham asked several Nobel prize winners to donate their sperm. This project seems derisory nowadays but it is interesting to note that several laureates contributed and a few children were born after the artificial insemination of their preserved sperm.
SHOULD WE FEAR NOWADAYS NEW FORMS OF EUGENICS? Both eugenic discourse and eugenic practice remained isolated during the 20 years that followed the Second World War. But in recent years, technological and scientific advances in assisted reproduction and genetic engineering have revived the eugenics debate. The human genome project, the possibility of gene therapy, and advances in the diagnosis not only of monogenetic diseases but also of the genetic predisposition to some cancers and other multifactorial diseases have led to a renewal of the eugenics question, and made the re-examination of some fundamental ethical dilemmas necessary. By giving hope that the sites of several genes implicated in hereditary diseases might be found, together with the knowledge of their structure, the human genome project might allow considerable progress, both at diagnostic and therapeutic levels, to be made. The appearance of new technologies allowing the manipulation of genetic material, the diagnosis and treatment of monogenic diseases and the study of genetic predisposition to cancers or multifactorial diseases might all engender new forms of eugenics. There are indeed still, at the end of this century, fantasies associated with positive eugenics, as illustrated by these centred around germ cell therapy; in a book relating the progress of the mapping of the human genome, Daniel Cohen (1993: p. 261) expresses explicitly the possibility of improving the human genome, stating that ‘man has stayed more simple than its creative achievements. We are missing a degree of vitality, a better level of neuronal integration. I believe in the possibility of a new human biological evolution, conscious and organised, as man is impatient and will not wait for the anachronistic natural selection’. This eugenic discourse is in complete accord with the spirit of Muller and J. Rostand. Furthermore, the themes of the decline of the species, dear to the first eugenists, reappear: ‘The future man, who will master perfectly the laws of genetics, will be the master of his own evolution and not of his degeneracy’. Cohen also mentions the possibility of the eradication of mental illness, and forecasts the early cure of myopathies, manic depression and Alzheimer’s disease with a ‘genetic scalpel’. Scientists are not alone in contemplating a return to positive eugenics. In the same spirit, the American philosopher T.H. Engelhardt argues that positive eugenics totally befits the principles of autonomy and beneficence. He holds a very liberal discourse: ‘as we develop the capacities to engage in genetic engineering not only of somatic cells but of the human germ line, we will be able to shape and fashion our human nature in the image and likeness of goals chosen by persons. In the end, this may mean so radically changing our human nature that our descendants may be seen by subsequent taxonomists as a new species. If there is nothing sacred about human nature (and no merely secular argument could show it to be sacred), there is no reason why, with proper reasons and with proper caution, it
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Is it still possible today to apply a eugenics programme to populations as a whole? With regards to positive eugenics, it is still in the realm of science fiction. Even sociologists who denounce the possible consequences of the progress of biotechnologies do not take this seriously. As Duster (1992: p. 183) wrote ‘the lebensborn programme surely left a frozen shroud on the direct plan to produce “good offspring”. Only a small lunatic fringe exists at the periphery, proposing the selective breeding of good genes’. The strict regulation of scientific activity is also an insurance against such activities. Neither Dr Moreau nor Frankenstein, still haunting the public psyche, have much in common with present day scientists. Research is very much anchored into the social frame, the difficulties and controls of funding application procedures ensure the submission of projects to ethics committees, and practice is guided by both national and international standards, whilst human experimentation has been regulated since the end of the 1960s. Isolated cases of abuse are still possible, but altogether the procedures involved in setting up research offer appropriate protection. Thus, if it is generally agreed that positive eugenics is in the realm of science fiction or fantasy, negative eugenics, however, is still a concern. It is not difficult to obtain a consensus about grave life-threatening genetic diseases, but the problem lies at the other end of the continuum. Public policies about diseases that are not life-threatening, but mean dependency for instance, are more difficult to decide. The plethora of scientific publications on the genetic basis of intelligence, mental illness and some socially deviant behaviours have revived the debate begun by the radical eugenists at the beginning of the century. The ideological slant of such debate must be firmly put in a epistemological context. The editor of Nature, John Maddox wrote thus: ‘there is a danger that too zealous and uncritical advocacy of the importance of human genome studies to the exclusion of others may provoke disbelief, distrust and resentment. Especially in relation to human behaviour, it is possible to exclude the influence of nurture only by dismissing as unimportant a century of psychology and psychoanalysis. Most geneticists will probably agree that nurture still has a place. But to fail to say as much, explicitly, may generate more disbelief and even resentment than ethical worries have yet engendered. That would be a misfortune for a programme of such high promise’ (Maddox, 1993: p. 107).
Since the introduction of preimplantation genetic diagnosis (a new form of prenatal diagnosis linked to in vitro fertilization (IVF) techniques) the debate on negative eugenics has regained strength. The embryo in vitro may be analysed at the stage of a few cells by DNA analysis. Such an embryo carrying a serious hereditary condition such as cystic fibrosis for instance (first described by Handyside et al, 1992) is not replaced in utero. Without this technique, the parents would have a 25% chance of an affected child. One of the French scientists hostile to the technique has voiced his objections in the language of eugenics: this is the discourse of J. Testart (1992a,b) who thinks that ‘this is the beginning of a soft, democratic and insidious eugenic practice’. He goes further, explaining that ‘the concerns raised by the Human Genome
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enterprise . . . will lead to a rapid multiplication of genetic markers, [and then] to the progressive stigmatisation of all embryos as relatively abnormal. There will not be any “normal” individuals amongst these potential beings, and we will have to keep the least bad embryos according to criteria still to be delineated’. This position is unconvincing. We must reflect on the ethical problems raised by new technology and science as they present within the current economic, social, scientific and medical context, and not from a science fiction scenario. For instance, should a couple wish for a child ‘à la carte’, this implies the need to undergo IVF in order to modify the human genome (Leroy, in press). This technique is complex and not without its psychological and financial consequences, and has a moderate success rate. Thus it is used only by the few couples who need assisted reproduction because of fertility problems, or those who want to avoid the birth of a child with a serious genetic abnormality. It is therefore unlikely that it would be practised on a large scale for the sake of eugenics. The scientific and social context has radically changed since the 1930s. Genetic engineering and assisted reproduction techniques now enable the realization of some of the practices prophesied by Muller, such as IVF, embryo transfer and sex selection. But, at the same time a better understanding of the science of medical genetics, makes for an even more utopian programme of negative eugenics aiming to ‘improve the race’. It is now understood, contrary to the thoughts of radical eugenists, that the polygenic character of most human characteristics makes it impossible to attribute complex characteristics such as intelligence or ‘social sense’ to single genes. Thus, if negative eugenics cannot be applied to multifactorial and polygenic diseases, there are only a small number of chromosome abnormalities or monogenic serious diseases that would qualify for a negative eugenics programme. This negative selection has of course already been practised since the implementation of prenatal diagnosis by amniocentesis at the beginning of the 1970s. This has allowed numerous couples bearing genetic anomalies to have a healthy child. This selection is acceptable as long as it is a function of the free individual choice of the couples concerned, and that obligatory screening is avoided: screening is proposed and not imposed, the couple accepts it or not, in a similar manner to a woman making the ultimate decision to accept or not a therapeutic termination of pregnancy after information and counselling. As long as the autonomy of the person(s) concerned is respected, there is no fear of eugenics in prenatal diagnosis. As Pembrey (1994: pp 3–4) wrote: ‘any public health objective that does not align with the aspirations of the very families it aims to help, it is likely to be viewed as State inspired eugenics . . . Families use prenatal diagnosis as a means of having healthy children whilst avoiding the risk of giving birth to an affected child . . . As Modell et al (1980) illustrated in families with thalassaemia, in the presence of genetic counselling but absence of acceptable prenatal diagnosis, many woman are too frightened to take the risk and therefore forego . . . having [further] children altogether . . . A reduction in the birth incidence of a genetic disorder may be the consequence of genetic counselling and prenatal diagnosis services, but it depends on what parents choose to do. This view that reduction in the birth incidence of genetic disorders is not an appropriate objective for genetic services is finding wide acceptance.’
IT IS NECESSARY TO DISTINGUISH ‘STATE EUGENICS’ AND ‘EUGENICS AS AN INDIVIDUAL CHOICE’ (OR ASSOCIATED WITH THE NEW REPRODUCTIVE TECHNIQUES) Thus, thanks to the progress of biology and medicine, and in particular assisted reproductive and gene therapy, eugenics is again present nowadays as a theme at the
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heart of bioethical debates. Denounced by some in conjunction with the progress in reproduction and genetics mentioned above, concerns are voiced as to the return of the eugenics dogma. But is it the same eugenics as the State eugenics of pre-war Germany, or as practised by contemporary China for instance? Is it fair, considering the emotional weight of the term ‘eugenics’ to use such vocabulary in the context of the respect of the liberty and autonomy of prospective parents? The sociologist P.A. Taguieff stated that ‘a risk of eugenic practice can only be assessed as a function of its presumed definition or socially constructed meaning . . . One therefore feels it is essential to distinguish State eugenics and the possible “eugenic practices” associated with the new reproductive techniques, as they are radically different phenomena. Indeed the “new eugenic practices” respect the individual choice of parents who wish to avoid the risk of serious handicap to their future child, whilst historically the eugenic movement was never very concerned with the respect of individual rights and freedom. In the classical definition by Galton and its followers, the aim of eugenics is the improvement of the human race, an objective totally remote from the decision of prospective parents to terminate a pregnancy which might lead to the birth of a handicapped child. Indeed the couple may choose not to have a TOP and ensure this potential life may realise its potential’ (Taguieff, 1994: p. 200).
Thomas (1995: p. 94) asked reasonably whether ‘anyone has the right to counter the improvements that science may offer, as long as eugenics is not associated any longer with nationalistic or racist prejudice, and is neither imposed nor a threat to personal freedom’. P.A. Taguieff further pointed out that ‘this does not represent the fantasy of the perfect child, but the wish to be prudent and apply beneficent wisdom in a totally pragmatic way. It shows a concern to use technology in a benevolent fashion, to avoid more suffering and solve a painful dilemma: not to procreate at all, or to give birth to one or more seriously handicapped children’. Technical progress is thus used as a means of avoiding genetically determined fate. This ‘new eugenics’ is totally foreign to the doctrine of improvement of human characteristics of the founders of eugenics, and represents an individual choice. REFERENCES Baur E, Fischer E & Lentz F (1931) Human Heredity. New York: Macmillan. [Translated from the original German]. Carrel A (1935) L’homme, cet inconnu. Paris: Plon. Cohen D (1993) Les Genes de l’Espoir. Paris: Robert Laffont. Cox IW (1934) The folly of human sterilization. Scientific American 150–151: 188–190. Duster T (1992) Retour à l’eugenisme. Paris: Kime. (Translated from English by Colette Estin). Engelhardt TH Jr (1986) The Foundations of Bioethics. Oxford: Oxford University Press. Galton F (1883) Inquiries into Human Faculty and its Development. London: Macmillan. Goddard H (1914) Feeble-Mindedness: Its Causes and Consequences. London: Macmillan. Gosney ES (1934) Eugenic sterilization. Scientific American 150–151: 18–21. Haldane JBS (1923) Daedalus or Science and the Future. (A paper read to the heretics, Cambridge on February 4th, 1923). London: Kegan Paul (Fifth edition published in 1925). Haldane JBS (1948) Hérédité et Politique. Paris: P.U.F. Handyside AH, Lesko JG, Tarin JJ et al (1992) Birth of a normal girl after in vitro fertilization and preimplantation diagnostic testing for cystic fibrosis. The New England Journal of Medicine. 327: 905–909. Huxley J (1948) L’eugenique et la societe. In L’homme, cet etre unique. Neuchatel: La Baconniere. [Original text first published in English in 1941]. Kevles DJ (1985) In the Name of Eugenics, Genetics and the Uses of Human Heredity. New York: Alfred A. Knopf. Landman JH (1934) Race betterment by human sterilization. Scientific American 150–151: p. 262. Leroy F (1966) L’embryon humain comme objet experimental. In Missa J-N (ed.) Le Devoir d’Experimenter. Brussels: De Boeck, pp 11–28.
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Maddox J (1993) Has nature overwhelmed nurture? Nature 366: 107. Muller HJ (1938) Hors de la nuit. Paris: Gallimard. French translation by Jean Rostand. Original edition: Out of the Night (1935) London: Vangard Press). Pearl R (1927) The biology of superiority. American Mercury 12, Nov. 1927: 260. [cited in Kevles DJ (1985)]. Pearson K (1909) The Scope and Importance to the State of the Science of National Eugenics. London: Dulau. Pembrey M (1994) Prenatal diagnosis and its ethical implications. A Report to the European Commission Group of Advisors on the Ethical Implications of Biotechnology, October 1994. Searle G (1976) Eugenics and Politics in Britain, 1900–1914. Noordhoff Publishing [cited in Kevles DJ 1985]. Thomalla C (1934) The sterilization law in Germany. Scientific American 150–151: 126–127. Taguieff P-A (1994) Retour sur l’eugenisme, question de definition (réponse à Testart, J.) Esprit 200, MarsAvril: 200. Testart J (1992a) Un entretien avec M. Jacques Testart. Le Monde 17 Decembre 1992: 17. Testart J (1992b) Le Desir du Gene. Paris: Editions Francois Bourin. Thomas J-P (1995) Les Fondements de l’Eugenisme. Paris: Presses Universitaires de France.
B A I L L I È R E ’ S
6
PRACTICE & RESEARCH
BEST
From state eugenics to private eugenics Jean-Noel Missa
MD, PhD
Professor of Philosophy and Adjoint Director Centre de Recherche Interdisciplinaire en Bioethique, Universite Libre de Bruxelles, Campus du Solbosch, Bat NA3, 50 Avenue Franklin Roosevelt, CP 175/01, B050 Brussels, Belgium Translated by Dr Francoise Kohane-Shenfield
Eugenics—or ‘the cultivation of a race’—is a concept dating from the latter part of the 19th century. It preceded the new science of genetics by merely 25 years. Negative eugenics stressed especially the exclusion of negative characteristics and was associated with the practice and theory of radical eugenics between the two World Wars. In order to redress ‘the decline of the race’, reinforcement by positive eugenics was also advocated. After the atrocities committed by the Nazis there was a lull in the practice and discourse of eugenics. More recent technical advances in assisted reproduction techniques and the genome project, however, have revived the eugenics debate. State eugenics and eugenics as an individual choice ought to be distinguished. Key words: eugenics (positive and negative); heredity; genetics; reproduction.
THE INTRODUCTION OF THE ‘EUGENICS’ CONCEPT BY GALTON, AND ITS EVOLUTION AT THE BEGINNING OF THE 20TH CENTURY In 1883, the statistician Francis Galton, cousin of the famous Darwin, coined the term ‘eugenics’, and defined it as ‘the cultivation of a race’ in his book Inquiries into Human Faculty and its Development. [Eugenic questions are] questions bearing on what is termed in Greek, eugenes, namely, good in stock, hereditarily endowed with noble qualities. This, and the allied words, eugeneia, etc, are equally applicable to men, brutes, and plants. We greatly want a brief word to express the science of improving stock, which is by no means confined to questions of judicious mating, but which, especially in the case of man, takes cognisance of all influences that tend in however remote a degree to give to the more suitable races or strains of blood a better chance of prevailing speedily over the less suitable than they otherwise would have had. The word eugenics would sufficiently express the idea; it is at least a neater word and a more generalised one than viriculture, which I once ventured to use.
He believed that most human behaviour had an innate component, and proposed favouring the birth of hereditary gifted children in order to practically improve the ‘human race’. In 1900, eugenics was fashionable. Whilst Mendel’s laws of hybridization were being rediscovered by botanists at the beginning of the 20th century, Bateson coined the term ‘genetics’ when describing the science of heredity on animals in 1905. In 1909, 1521–6934/99/040533 + 09 $12.00/00
© 1999 Harcourt Publishers Ltd.
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the term ‘gene’ was coined. A year later, T. Hunt Morgan, one of the fathers of genetics who studied Drosophila, and himself not directly involved in the eugenics movement, described hereditary particles as material grains in the chromosomes’ structure. H.J. Muller, one of his collaborators, became one of the main proponents of the eugenics cause in the 1930s. At the beginning of the 20th century, Carnegie financed an experimental center near New York dedicated to the study of evolution. Its director, Charles Davenport, propagated eugenics theories, mixing Mendel’s theories with fantastic speculations. He enrolled young students to study the physical and mental pedigree of whole families. The information collected was the base of his publication in 1911 of Heredity in Relation to Eugenics, where he claimed that any trait commonly found in several members of a family should be considered hereditary and he attempted to explain their distribution according to Mendelian laws. This not only included specific disorders such as polydactyly, albinism and Huntingtons’s chorea, but also insanity, epilepsy, alcoholism, criminality and feeblemindedness. He recommended a negative eugenics programme. Simultaneously, several eugenics societies were founded. The Racial Hygiene society was created in Berlin in 1904, the Eugenics Education Society was founded in the UK in 1907, and the American Eugenics Society in the USA in 1911. The first Eugenics congress took place in London in 1912, followed soon after by the creation by the French of the ‘society for the study of the questions relating to the improvement of future generations’. Thus, at the beginning of the century, eugenics was barely distinct from the new science of human genetics. Several societies were created in Europe, and several journals appeared regularly on the subject, such as the American Eugenics Society Journal of Heredity, and the British Eugenics Review. Soon, after the First World War, the subject was included in several universities’ curricula. THE PRACTICE AND THEORY OF RADICAL EUGENISTS BETWEEN THE TWO WORLD WARS Between the two World Wars, radical eugenics held a three point discourse, encompassing Darwin’s theory of evolution by selection, the belief in the physical and mental decline of the population at large and the notion of the hereditary transmission of mental handicap. Furthermore, racial overtones were frequent both in the USA and in Germany. It was argued that medical progress and the softening of mores encouraged the survival of the weak. This notion of ‘negative selection’ was based on the alleged decreased demography of the ‘superior classes’ and increased birth rate of those deemed inferior, with the consequence of lowering the general population level. This theory was reinforced by the notion of ‘differential birthrate’ of Karl Pearson (1909), who argued that ‘inapt families’ had a higher rate of reproduction than ‘valuable’ families, partly due to the progress of ‘social hygiene’ and medicine. Literature, by Emile Zola and Thomas Mann for instance, is full of these themes of human degeneration. In 1903, the British Parliament ordered an inquiry into the threat of ‘national deterioration’ (Searle, 1976: p. 2, 32–33, cited in Kelves, 1985). In the USA, Gosney (1934) asserted that ‘it is clear that under existing conditions the average level of intelligence and of physical and mental fitness in the American population is declining steadily from generation to generation. The exact rate of this decline is debatable. The fact that the decline exists, is not debatable’. In order to counter this and to stop this ‘decline of the race’, theoreticians proposed a ‘negative eugenics’ plan of reproduction.
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Alexis Carrel (1935; p. xiv) wrote that the danger could be countered by educating susceptible young people to an understanding of the dangers of marrying into families with tuberculosis or psychiatric disease. He also thought it ought to be reinforced by positive eugenics, fostering ‘the union of the best racial elements through the indirect means of education and economic advantages’. In the USA, Landman (1934) established a list of ‘misfits’ (those who did not have a useful role in society) including the mentally ill and handicapped, the dependant (blind, deaf and unemployed) and the ‘infectious’. He estimated the misfits to account for 20% of the then 125 million USA population. The heredity of feeblemindedness was a fundamental tenet of eugenics. The psychologist Goddard (1914) introduced three categories of mental handicap (or feeble mindedness): idiots, imbeciles and morons (corresponding to mental ages below 3 years, between 3 to 7 years, and from 8 to 12 years, respectively) described in the Kallikak family, which became the popular labels corresponding to rendering of the Binet and Simon intelligence tests. He asserted that ‘mental deficiency is a condition of the spirit or the brain which is transmitted in a similar fashion to this of hair or eye colour’. Extreme means such as sterilization of those carrying ‘bad genes’ was advocated only for hereditary conditions, but the segregation of undesirable individuals in specialized institutions and the surveillance and tutoring of the feebleminded were proposed in order to reduce the number of ‘dysgenic’ individuals. Furthermore, prenuptial certificates of good health were advocated in order to fulfil this aim. It is interesting to note that although the encyclic Casti conubi condemns this practice in 1932, it was introduced by the Vichy government in 1942. Several American States enacted legislation favouring the sterilization of criminals ‘idiots and imbeciles’, and by 1944, more than 40 000 operations had been performed. Similar laws were passed in Alberta, Finland and Denmark. In Germany, sterilization laws were introduced in 1932 using mostly economic arguments, after Hitler was influenced by the racist interpretation of the book on heredity by Baur et al (1931). Between 1934 and 1939, 300 000 chronically ill and mentally ill patients were sterilized, thanks to new legislation passed in 1933, rationalized by economic theory, in order to prevent ‘the procreation of defective individuals [which] burdens financially the working people’. Thomalla (1934) wrote that ‘in a state which is desperately fighting for its existence, as in Germany, it is a simple problem of arithmetic whether to allow for all eternity the procreation of defectives, thereby most heavily burdening financially the working people, or whether to interfere before it is too late with the career of the worst and most costly of this kind of defectives’. CRITIQUE OF THE SCIENTIFIC BASIS OF THE RADICAL EUGENICS THEORIES PRACTISED IN THE 1930s AND 1940s During this period, some renowned scientists wanted to reform the eugenic theories which had become simplistic and pseudoscientific. At the third congress on Eugenics, Pearl (1927, cited in Kevles, 1985: p. 122) asserted that ‘Eugenics has rapidly become a mingled mess of ill-grounded and uncritical sociology, economics, anthropology and politics, full of emotional appeals to class and race prejudice, solemnly put forward as science, and unfortunately accepted as such by the general public’. The reformers such as J. Huxley and J.B.S. Haldane wished for a more scientific basis, since they appreciated that the application of Mendelian laws to mental illness was purely speculative. ‘We know little, if any, more about the transmission of feeble mindedness through heredity than we do of the heredity of mental illness’ wrote Cox in 1934. Even today, the
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genetic basis of behaviour and mental illness remains relatively little known, but it is established that most behavioural characteristics depend on multiple genes and are strongly influenced by the environment. According to Huxley (1948: p. 57), social and environmental factors are as important as genetic factors in the decline of man. He stated that eugenics was not a special branch of natural sciences, but of social sciences, and bemoaned the consequences of the defeat of the Lamarkian school (which stated that educational benefits were incorporated into human nature and transmitted to the next generation); in his opinion, this led the radical eugenists to neglect the effects of the environment and of social reforms. Reformers, such as Haldane (1948) also questioned the thesis of ‘differential fecundity’. Cox (1934: p. 188) stated that ‘Social standing is not a virtue’, and Muller (1938) challenged the notion that a sterilization policy might decrease mental handicap along the generations. They nevertheless affirmed their belief in eugenics. Their doctrine is examined below. THE PROGRAMME OF THE EUGENICS ‘REFORMERS’ In spite of their criticism, they still believed in eugenics theories. In Out of the Night, Muller (1938: p. 112) asserted that the progress observed in the new science of genetics may enable a policy of social improvement, centred around the control of reproduction of the population as a whole; he advocated birth control, and its universal knowledge and understanding, through ‘education and propaganda’, with legalized and codified terminations of pregnancy as a back up. He also described, in a prophetic manner, embryo transfer between women, surrogacy between species, parthenogenesis, and ectogenesis (Haldane also wrote of ectogenesis in Daedalus in 1923). Sex selection was seen as possible and would result in ‘radical changes’, artificial insemination was advocated for the transmission of superior genes from ‘a superior man’, a method termed ‘germinal choice’ by Muller. Huxley spoke of differentiating sex between lovers, and procreation between people who admired each other. EUGENICS AFTER THE SECOND WORLD WAR Because of the atrocities committed in the name of eugenics by the Nazis, the proponents of the theory become less vocal after the world-shattering events of the war. Eugenic sterilizations, however, continued in the USA and Scandinavia. After the discovery of DNA in 1953, genetics slowly acquired scientific status. This was followed by the discovery of genetic codes in the 1960s, and the first applications in clinical genetics. Genetic counselling centres slowly appeared in hospitals. Prenatal diagnostic methods using amniocentesis were practised from the early 1970s. Genetic counselling became widely available, making it possible to inform future parents about the risk that their child-to-be might be carrying the genes for a congenital anomaly. In cases of grave risk without any therapeutic solution an abortion was offered. Thus prenatal diagnosis was practised, leading to negative eugenics at a time when therapeutic abortions (termination of pregnancy, TOP) became legal in several countries (UK in 1967, USA in 1975 and France in 1975). The proponents of positive eugenics continued to strive for their belief in the genetic transmission of intellectual characteristics. Inspired by Muller’s (1935) thesis, and according to the criteria of ‘physical health, a developed social sense, and the
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highest possible intelligence’ the businessman Robert Graham proposed the creation of a sperm bank of ‘remarkable’ men. In 1971 the ‘Herman J. Muller Repository for Germinal Choice’ was established, but this was after the two men had fallen out for political and ideological reasons, and was against the deceased Muller’s widow’s wishes. Graham asked several Nobel prize winners to donate their sperm. This project seems derisory nowadays but it is interesting to note that several laureates contributed and a few children were born after the artificial insemination of their preserved sperm.
SHOULD WE FEAR NOWADAYS NEW FORMS OF EUGENICS? Both eugenic discourse and eugenic practice remained isolated during the 20 years that followed the Second World War. But in recent years, technological and scientific advances in assisted reproduction and genetic engineering have revived the eugenics debate. The human genome project, the possibility of gene therapy, and advances in the diagnosis not only of monogenetic diseases but also of the genetic predisposition to some cancers and other multifactorial diseases have led to a renewal of the eugenics question, and made the re-examination of some fundamental ethical dilemmas necessary. By giving hope that the sites of several genes implicated in hereditary diseases might be found, together with the knowledge of their structure, the human genome project might allow considerable progress, both at diagnostic and therapeutic levels, to be made. The appearance of new technologies allowing the manipulation of genetic material, the diagnosis and treatment of monogenic diseases and the study of genetic predisposition to cancers or multifactorial diseases might all engender new forms of eugenics. There are indeed still, at the end of this century, fantasies associated with positive eugenics, as illustrated by these centred around germ cell therapy; in a book relating the progress of the mapping of the human genome, Daniel Cohen (1993: p. 261) expresses explicitly the possibility of improving the human genome, stating that ‘man has stayed more simple than its creative achievements. We are missing a degree of vitality, a better level of neuronal integration. I believe in the possibility of a new human biological evolution, conscious and organised, as man is impatient and will not wait for the anachronistic natural selection’. This eugenic discourse is in complete accord with the spirit of Muller and J. Rostand. Furthermore, the themes of the decline of the species, dear to the first eugenists, reappear: ‘The future man, who will master perfectly the laws of genetics, will be the master of his own evolution and not of his degeneracy’. Cohen also mentions the possibility of the eradication of mental illness, and forecasts the early cure of myopathies, manic depression and Alzheimer’s disease with a ‘genetic scalpel’. Scientists are not alone in contemplating a return to positive eugenics. In the same spirit, the American philosopher T.H. Engelhardt argues that positive eugenics totally befits the principles of autonomy and beneficence. He holds a very liberal discourse: ‘as we develop the capacities to engage in genetic engineering not only of somatic cells but of the human germ line, we will be able to shape and fashion our human nature in the image and likeness of goals chosen by persons. In the end, this may mean so radically changing our human nature that our descendants may be seen by subsequent taxonomists as a new species. If there is nothing sacred about human nature (and no merely secular argument could show it to be sacred), there is no reason why, with proper reasons and with proper caution, it
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Is it still possible today to apply a eugenics programme to populations as a whole? With regards to positive eugenics, it is still in the realm of science fiction. Even sociologists who denounce the possible consequences of the progress of biotechnologies do not take this seriously. As Duster (1992: p. 183) wrote ‘the lebensborn programme surely left a frozen shroud on the direct plan to produce “good offspring”. Only a small lunatic fringe exists at the periphery, proposing the selective breeding of good genes’. The strict regulation of scientific activity is also an insurance against such activities. Neither Dr Moreau nor Frankenstein, still haunting the public psyche, have much in common with present day scientists. Research is very much anchored into the social frame, the difficulties and controls of funding application procedures ensure the submission of projects to ethics committees, and practice is guided by both national and international standards, whilst human experimentation has been regulated since the end of the 1960s. Isolated cases of abuse are still possible, but altogether the procedures involved in setting up research offer appropriate protection. Thus, if it is generally agreed that positive eugenics is in the realm of science fiction or fantasy, negative eugenics, however, is still a concern. It is not difficult to obtain a consensus about grave life-threatening genetic diseases, but the problem lies at the other end of the continuum. Public policies about diseases that are not life-threatening, but mean dependency for instance, are more difficult to decide. The plethora of scientific publications on the genetic basis of intelligence, mental illness and some socially deviant behaviours have revived the debate begun by the radical eugenists at the beginning of the century. The ideological slant of such debate must be firmly put in a epistemological context. The editor of Nature, John Maddox wrote thus: ‘there is a danger that too zealous and uncritical advocacy of the importance of human genome studies to the exclusion of others may provoke disbelief, distrust and resentment. Especially in relation to human behaviour, it is possible to exclude the influence of nurture only by dismissing as unimportant a century of psychology and psychoanalysis. Most geneticists will probably agree that nurture still has a place. But to fail to say as much, explicitly, may generate more disbelief and even resentment than ethical worries have yet engendered. That would be a misfortune for a programme of such high promise’ (Maddox, 1993: p. 107).
Since the introduction of preimplantation genetic diagnosis (a new form of prenatal diagnosis linked to in vitro fertilization (IVF) techniques) the debate on negative eugenics has regained strength. The embryo in vitro may be analysed at the stage of a few cells by DNA analysis. Such an embryo carrying a serious hereditary condition such as cystic fibrosis for instance (first described by Handyside et al, 1992) is not replaced in utero. Without this technique, the parents would have a 25% chance of an affected child. One of the French scientists hostile to the technique has voiced his objections in the language of eugenics: this is the discourse of J. Testart (1992a,b) who thinks that ‘this is the beginning of a soft, democratic and insidious eugenic practice’. He goes further, explaining that ‘the concerns raised by the Human Genome
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enterprise . . . will lead to a rapid multiplication of genetic markers, [and then] to the progressive stigmatisation of all embryos as relatively abnormal. There will not be any “normal” individuals amongst these potential beings, and we will have to keep the least bad embryos according to criteria still to be delineated’. This position is unconvincing. We must reflect on the ethical problems raised by new technology and science as they present within the current economic, social, scientific and medical context, and not from a science fiction scenario. For instance, should a couple wish for a child ‘à la carte’, this implies the need to undergo IVF in order to modify the human genome (Leroy, in press). This technique is complex and not without its psychological and financial consequences, and has a moderate success rate. Thus it is used only by the few couples who need assisted reproduction because of fertility problems, or those who want to avoid the birth of a child with a serious genetic abnormality. It is therefore unlikely that it would be practised on a large scale for the sake of eugenics. The scientific and social context has radically changed since the 1930s. Genetic engineering and assisted reproduction techniques now enable the realization of some of the practices prophesied by Muller, such as IVF, embryo transfer and sex selection. But, at the same time a better understanding of the science of medical genetics, makes for an even more utopian programme of negative eugenics aiming to ‘improve the race’. It is now understood, contrary to the thoughts of radical eugenists, that the polygenic character of most human characteristics makes it impossible to attribute complex characteristics such as intelligence or ‘social sense’ to single genes. Thus, if negative eugenics cannot be applied to multifactorial and polygenic diseases, there are only a small number of chromosome abnormalities or monogenic serious diseases that would qualify for a negative eugenics programme. This negative selection has of course already been practised since the implementation of prenatal diagnosis by amniocentesis at the beginning of the 1970s. This has allowed numerous couples bearing genetic anomalies to have a healthy child. This selection is acceptable as long as it is a function of the free individual choice of the couples concerned, and that obligatory screening is avoided: screening is proposed and not imposed, the couple accepts it or not, in a similar manner to a woman making the ultimate decision to accept or not a therapeutic termination of pregnancy after information and counselling. As long as the autonomy of the person(s) concerned is respected, there is no fear of eugenics in prenatal diagnosis. As Pembrey (1994: pp 3–4) wrote: ‘any public health objective that does not align with the aspirations of the very families it aims to help, it is likely to be viewed as State inspired eugenics . . . Families use prenatal diagnosis as a means of having healthy children whilst avoiding the risk of giving birth to an affected child . . . As Modell et al (1980) illustrated in families with thalassaemia, in the presence of genetic counselling but absence of acceptable prenatal diagnosis, many woman are too frightened to take the risk and therefore forego . . . having [further] children altogether . . . A reduction in the birth incidence of a genetic disorder may be the consequence of genetic counselling and prenatal diagnosis services, but it depends on what parents choose to do. This view that reduction in the birth incidence of genetic disorders is not an appropriate objective for genetic services is finding wide acceptance.’
IT IS NECESSARY TO DISTINGUISH ‘STATE EUGENICS’ AND ‘EUGENICS AS AN INDIVIDUAL CHOICE’ (OR ASSOCIATED WITH THE NEW REPRODUCTIVE TECHNIQUES) Thus, thanks to the progress of biology and medicine, and in particular assisted reproductive and gene therapy, eugenics is again present nowadays as a theme at the
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heart of bioethical debates. Denounced by some in conjunction with the progress in reproduction and genetics mentioned above, concerns are voiced as to the return of the eugenics dogma. But is it the same eugenics as the State eugenics of pre-war Germany, or as practised by contemporary China for instance? Is it fair, considering the emotional weight of the term ‘eugenics’ to use such vocabulary in the context of the respect of the liberty and autonomy of prospective parents? The sociologist P.A. Taguieff stated that ‘a risk of eugenic practice can only be assessed as a function of its presumed definition or socially constructed meaning . . . One therefore feels it is essential to distinguish State eugenics and the possible “eugenic practices” associated with the new reproductive techniques, as they are radically different phenomena. Indeed the “new eugenic practices” respect the individual choice of parents who wish to avoid the risk of serious handicap to their future child, whilst historically the eugenic movement was never very concerned with the respect of individual rights and freedom. In the classical definition by Galton and its followers, the aim of eugenics is the improvement of the human race, an objective totally remote from the decision of prospective parents to terminate a pregnancy which might lead to the birth of a handicapped child. Indeed the couple may choose not to have a TOP and ensure this potential life may realise its potential’ (Taguieff, 1994: p. 200).
Thomas (1995: p. 94) asked reasonably whether ‘anyone has the right to counter the improvements that science may offer, as long as eugenics is not associated any longer with nationalistic or racist prejudice, and is neither imposed nor a threat to personal freedom’. P.A. Taguieff further pointed out that ‘this does not represent the fantasy of the perfect child, but the wish to be prudent and apply beneficent wisdom in a totally pragmatic way. It shows a concern to use technology in a benevolent fashion, to avoid more suffering and solve a painful dilemma: not to procreate at all, or to give birth to one or more seriously handicapped children’. Technical progress is thus used as a means of avoiding genetically determined fate. This ‘new eugenics’ is totally foreign to the doctrine of improvement of human characteristics of the founders of eugenics, and represents an individual choice. REFERENCES Baur E, Fischer E & Lentz F (1931) Human Heredity. New York: Macmillan. [Translated from the original German]. Carrel A (1935) L’homme, cet inconnu. Paris: Plon. Cohen D (1993) Les Genes de l’Espoir. Paris: Robert Laffont. Cox IW (1934) The folly of human sterilization. Scientific American 150–151: 188–190. Duster T (1992) Retour à l’eugenisme. Paris: Kime. (Translated from English by Colette Estin). Engelhardt TH Jr (1986) The Foundations of Bioethics. Oxford: Oxford University Press. Galton F (1883) Inquiries into Human Faculty and its Development. London: Macmillan. Goddard H (1914) Feeble-Mindedness: Its Causes and Consequences. London: Macmillan. Gosney ES (1934) Eugenic sterilization. Scientific American 150–151: 18–21. Haldane JBS (1923) Daedalus or Science and the Future. (A paper read to the heretics, Cambridge on February 4th, 1923). London: Kegan Paul (Fifth edition published in 1925). Haldane JBS (1948) Hérédité et Politique. Paris: P.U.F. Handyside AH, Lesko JG, Tarin JJ et al (1992) Birth of a normal girl after in vitro fertilization and preimplantation diagnostic testing for cystic fibrosis. The New England Journal of Medicine. 327: 905–909. Huxley J (1948) L’eugenique et la societe. In L’homme, cet etre unique. Neuchatel: La Baconniere. [Original text first published in English in 1941]. Kevles DJ (1985) In the Name of Eugenics, Genetics and the Uses of Human Heredity. New York: Alfred A. Knopf. Landman JH (1934) Race betterment by human sterilization. Scientific American 150–151: p. 262. Leroy F (1966) L’embryon humain comme objet experimental. In Missa J-N (ed.) Le Devoir d’Experimenter. Brussels: De Boeck, pp 11–28.
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Maddox J (1993) Has nature overwhelmed nurture? Nature 366: 107. Muller HJ (1938) Hors de la nuit. Paris: Gallimard. French translation by Jean Rostand. Original edition: Out of the Night (1935) London: Vangard Press). Pearl R (1927) The biology of superiority. American Mercury 12, Nov. 1927: 260. [cited in Kevles DJ (1985)]. Pearson K (1909) The Scope and Importance to the State of the Science of National Eugenics. London: Dulau. Pembrey M (1994) Prenatal diagnosis and its ethical implications. A Report to the European Commission Group of Advisors on the Ethical Implications of Biotechnology, October 1994. Searle G (1976) Eugenics and Politics in Britain, 1900–1914. Noordhoff Publishing [cited in Kevles DJ 1985]. Thomalla C (1934) The sterilization law in Germany. Scientific American 150–151: 126–127. Taguieff P-A (1994) Retour sur l’eugenisme, question de definition (réponse à Testart, J.) Esprit 200, MarsAvril: 200. Testart J (1992a) Un entretien avec M. Jacques Testart. Le Monde 17 Decembre 1992: 17. Testart J (1992b) Le Desir du Gene. Paris: Editions Francois Bourin. Thomas J-P (1995) Les Fondements de l’Eugenisme. Paris: Presses Universitaires de France.