You're probably a eugenicist

¹Let me start this essay with a love story.

Susan and Patrick were a young German couple in love. But, the German state never allowed Susan and Patrick to get married. Shockingly, Patrick was imprisoned for years because of his sexual relationship with Susan.

Despite these obstacles, over the course of their relationship, Susan and Patrick had four children. Three of their children—Eric, Sarah, and Nancy—had severe problems: epilepsy, cognitive disabilities, and a congenital heart defect that required a transplant. The German state took away these children and placed them with foster families.

Patrick and Susan with their daughter Sofia - credit dpa picture alliance archive

Why did Germany do all these terrible things to Susan and Patrick?

Eugenics.

No, this story didn’t happen in Nazi Germany, it happened over the course of the last 20 years. But why haven’t you heard this story before?

Because Patrick and Susan are siblings.

One of the aims of eugenics is to intervene in reproduction so as to decrease the number of people born with serious disabilities or health problems. Susan and Patrick were much more likely than the average couple to have children with genetic problems because they are brother and sister. So, the German state punished this couple by restricting them from marriage, taking away their children, and forcefully separating them with Patrick’s imprisonment.

Patrick Stübing filed a case against Germany with the European Court on Human Rights, arguing that the laws forbidding opposite-sex sibling incest violated his rights to family life and sexual autonomy. The European Court on Human Rights’ majority opinion in the Stübing case clearly sets out the eugenic case for those laws: that the children of incest and their future children will suffer because of genetic problems. But the dissenting opinion argued that eugenics cannot be a valid justification for punishing incest because eugenics is associated with the Nazis, and because other people (for example, older mothers and people with genetic disorders) who have a high chance of producing children with genetic defects are not prevented from reproducing. Ultimately, the European Court on Human Rights upheld Germany's anti-incest law on eugenic grounds.

If Germany had punished any other citizens this severely on eugenic grounds—for example by imprisoning a female carrier of Huntington’s disease who was trying to get pregnant— there would be a huge outcry. But incest seems to be an exception.

Our instinctive aversion to incest is informed by intuitive eugenics. Not only are we reflexively disgusted by the thought of having sex with our own blood relatives, but we’re also disgusted by the thought of any blood relatives having sex with each other.

 Siblings and close relatives conceive children who are more likely to end up with two copies of the same defective genes, which makes those children more likely to inherit disabilities and health problems. It’s estimated that the children of sibling incest have a greater than 40 percent chance of either dying prematurely or being born with a severe impairment. By comparison, first cousins have  around a five percent chance of having children with a genetic problem—twice as likely as unrelated couples. In the UK, first cousin marriages are legal and these unions make up a disproportionate number of babies born with birth defects including those who die shortly after birth, likely numbering thousands per year. In the US, most states have outlawed first cousin marriage for eugenic reasons. For instance, in states like Arizona first cousin marriage is allowed, provided the cousins are infertile or over the age of 65.

If you agree that people who are genetically related should not have children, or should see a genetic counselor, congratulations, you’re a eugenicist.

While we heavily weigh the risk of closely related parents, we often discount even more serious risks simply because they don’t have the same visceral emotional impact as incest. For instance, between five and six percent of first cousins pass genetic disorders on to their children, but a parent with Huntington’s disease has a 50 percent chance of passing on the disease to their child. If one parent has schizophrenia, their child has a 10 percent chance of inheriting it; with two schizophrenic parents, the likelihood is 40 percent.

This would be consequential enough on its own, but there is strong evidence that people with mental disorders, including bipolar disorder, schizophrenia, and substance abuse, are more likely to be in relationships with one another. These relationships, like relationships between blood relatives, entail a risk: the children that result are much more likely to share their parents’ misfortune, which not only increases the number of these disorders but also their comorbidity, or the likelihood that one person will suffer multiple disorders. Most governments forbid sibling incest, but do not even provide education to people who are just as likely to pass on other devastating heritable conditions. We treat similar or elevated risks dissimilarly based on our instinctive feelings of disgust.

Eugenics, a literal translation of the Greek for "good birth," aims to improve the population through interventions. Positive eugenics aims to increase “good” and “desirable” traits, whereas negative eugenics aims to reduce “bad” or “undesirable” traits. The scare quotes are meant to indicate that there are and have been divergent views on the meaning of these words in the history of eugenic interventions. The taboos attached to even the most rational and objective discussion of eugenics only aggravates the confusion, promoting a widespread ignorance of even the definition of eugenics. Eugenics is actually an expansive concept with which most people agree in principle, but disagree with some of the terrible ways it’s been implemented. We are all eugenicists—but in selective, inconsistent, and often hypocritical ways.

In terms of the population, eugenics can be implemented at many different levels. Eugenics can be coercive and violate people’s freedom of mate choice and reproduction, but it can also be libertarian, relying on social influence, persuasion, and reproductive education. Consider the diverse goals of some historical eugenicists. Francis Galton (1822–1911), who coined the term, wanted to encourage geniuses to marry one another, so they could create a new “race” of super-smart people. The North Carolina Eugenics Board coerced thousands of Black women into getting sterilized. Progressive Black eugenicists like Kelly Miller (1863–1939) and W. E. B. Du Bois (1868–1963) wanted to encourage educated Black families to have more children to uplift Black Americans. Chinese sociologist Pan Guangdan (1898–1967) wanted to improve the overall health of the Chinese people (and helped to eradicate foot binding). Nazis murdered thousands of disabled people and others who were considered genetically defective. Rabbi Joseph Ekstein founded Dor Yeshorim in 1983 to reduce debilitating genetic diseases such as Tay-Sachs and Cystic Fibrosis in Jewish families. The first prime minister of Singapore, Lee Kuan Yew (1923–2015) arranged matchmaking cruises for university graduates, and gave women graduates priority housing, in an attempt to increase the number of educated Singaporeans in the next generation.

“Good” also has different definitions. During this moment in history, “good” depends on whether you’re endorsing changing something genetically or environmentally. Most people agree that that being healthy, educated, happy, stable, intelligent, altruistic, and productive are good qualities. When it comes to preventing disability and increasing IQ, almost every environmental intervention is uncontroversially considered. We encourage people with mental health problems to take medication that may help them suffer less and become more productive. We take children away from families that neglect or mistreat them, not only so they do not suffer now, but also so they are more likely to become intelligent, productive members of society. We discourage harmful behavior with prison, fines, penalties, social disapproval, and exclusion and encourage altruistic behavior with social approval and tax incentives. Pregnant women and mothers bear much of the burden of trying to produce kids with good traits; any decision that might influence children, from drinking while pregnant to childhood nutrition, from the Mozart effect to video games, is moralized and supervised. Though there is very little evidence that some of these environmental interventions make much difference.

Historically, eugenicists were focused not only on genetically heritable characteristics but also potentially effective environmental and cultural influences on children’s traits. Chinese eugenicists led the charge to eradicate foot binding, and implemented programs of maternal education so they could provide better care for infants. Eugenicists also initiated the mandatory treatment of infectious diseases like syphilis, which causes blindness, deafness, and cognitive disability. If you think women should be treated for sexually transmitted infections or rubella so they don’t have a disabled child, you’re advocating the same goals as many historical eugenicists².

Those who rail against eugenics in any form engage in a technique where they conflate an easily defended position with a more difficult to defend position (AKA the Motte and Bailey strategy). The easily defended position is that we should not murder or forcibly sterilize people on the basis of their genetics or disability. This position is conflated with several more difficult-to-defend positions. These more difficult-to-defend positions include that we should not study the genetics of desirable or undesirable characteristics, that we should not label any characteristics as desirable or undesirable and that we should not consider how any policy could change the genetic propensities of future generations.

It is inevitable that good or neutral ideas will sometimes be misused for terrible ends by bad actors. Despite the popular treatment of eugenics, the concept of eugenics is not synonymous with the worst things that have been done in its name. Consider other concepts we embrace in spite of their history of misuse. That democracies voted for slavery and have sent men to their deaths in needless wars does not invalidate the idea of government by consent. Psychiatry invented lobotomy and facilitated imprisonment and Soviet atrocities. Foster care removed indigenous children from their parents. In the case of contraception and abortion, progressives are willing to overlook the association with eugenics because of what they see as positive outcomes. Marie Stopes and Margaret Sanger were both eugenicists who wanted to prevent the unfit from breeding and also founded the organization that would become Planned Parenthood. Their transparently eugenic aims to improve the human race are literally written right on the contraception that they dispensed, the “pro race” and "racial" models of cervical caps. Even now, there is evidence that the legalization of abortion had eugenic effects and many states and countries, before Roe was overturned outlawed abortions on anti-eugenics grounds.  

A cervical cap stamped with “Racial” indicating its use as a tool of eugenics - via Wellcome Trust

Unlike eugenics, every conversation about democracy, foster care, psychiatry, or contraception do not devolve into outrage about how they are slippery slopes to genocide, mutilation, and racism. We ought to be capable of decoupling the history of a concept from its intention if the potential outcomes are good enough.

You might be asking yourself- why use the term “eugenics” at all? Can’t you just call it something different?

Well, not really.

We are not going to stop hearing about eugenics. Every time someone tries to call it something different, the “e” word and its association with historic injustice and abuse is invoked to end the discussion before it can begin.

When someone says that screening embryos for genetic diseases, giving educated women incentives to have children (like free child care for college educated women), or offering subsidized abortions for women addicted to drugs is "eugenics" they are absolutely using the term correctly. If bioethicists stopped using terms with contested definitions there would only be confusing new terms that would lead to a euphemism treadmill. All of the following key terms (to name just a few) have contested definitions and using them can cause confusion: autonomy, bioethics, consent, euthanasia, freedom, harm, health, justice and person. In my view, the only way to have a reasonable conversation about reproductive issues is to educate people on the meaning of eugenics. This tactic arguably also promoted clarity in the debate about "euthanasia".

Even though many people have tried to redefine any personal choices, and especially the personal reproductive choices of women as “not eugenics”, there is not a clear delineation between public policy and private choice. I discovered during my pregnancy how many default aspects of prenatal care are eugenic in their aims. A lot of prenatal care aims to evaluate an embryo or fetus for abnormality. A woman can “terminate for medical reasons”, a right that progressives would never dispute. Yes, terminating for medical reasons is a personal choice. But during my pregnancies I was not asked whether I wanted noninvasive prenatal testing, a nuchal translucency scan or genetic counseling for advanced maternal age; they were provided to me as a matter of course as they are provided by most countries with nationalized health care.

Eugenics concerns the decisions of individuals, not just the policies of the state. “Reprogenetics” uses reproductive technology to allow parents to select embryos with certain desirable traits or without disability. In the future, Parents are now able to select embryos with desirable characteristics. Both practices meet the definition of eugenics. But reprogenetics will have an even greater influence on the population as a whole when these techniques are more accessible and affordable.

Many of the same controversies around eugenics also apply, in principle, to reprogenetics. For example, the “expressivist objection” to reprogenetics is that, by using prenatal testing to try to choose a child without disability, we are expressing a discriminatory stance against disabled people. Anti-eugenic and anti-reprogenetics arguments often imply that when we reduce the number of disabled people in the population, bias against disabled people increases in society. But pursuit of this peculiar logic leads to repugnant conclusions, which may be exposed by applying the reversal test. Should we encourage pregnant women to drink alcohol and use drugs, or encourage drivers to forgo seat belts, in order to cultivate greater care and consideration when these acts result in more disabled people? Care and respect for disabled people can coexist with eugenics, as is demonstrated in Israel where prenatal testing is largely uncontroversial. As sociologist Aviad Raz stated, “There is a two-fold view of disability [in Israel]: support of genetic testing during pregnancy, and support of the disabled person after birth.”

Given how closely eugenics has been associated with Nazis and the Holocaust, it is interesting to consider the degree to which Jewish people have embraced eugenics. I wouldn’t be here to write this essay had my Jewish grandfather not fled the Nazis in the 1930s. The Talmud expressed eugenic principles about who could marry whom—for example, it is forbidden for a woman to marry a man with epilepsy— German genetic counselors are much more likely to express disapproval for eugenic principles than Israeli genetic counsellors. Israeli genetic counselors are more likely to endorse statements such as “it is socially irresponsible to knowingly give birth to an infant with a serious genetic disorder” and “it is important to reduce the number of deleterious genes in a population.” The Israeli National Program for the Detection and Prevention of Birth Defects offers free testing for many genetic diseases, and Israeli women are more likely to get tested than women in other countries.

Moreover, countries and states who have implemented eugenic policy offer evidence  against the idea that this is a slippery slope to abuses like murder and forced sterilization —Israel and Denmark two countries that have some of the most eugenic policies, also have some of the best provisioning for the disabled. States like Oregon, Nevada, Minnesota and Texas that have implemented eugenic laws against first cousin marriage nevertheless have very different reproductive and disability policies. In Oregon, women can have an abortion at any stage of pregnancy and for any reason and terminally ill patients can access physician assisted suicide. In Texas, the opposite policies are in place.

Despite the history of Nazi eugenics, Jews and the state of Israel embrace eugenic policies. The most comprehensive noninvasive fetal genotyping available at 11 weeks was developed in Israel. Further, abortions are legal and free in Israel if a fetus is found to have a genetic defect. While fewer abortions are performed in Israel than in other affluent countries, a much greater proportion of abortions are performed due to risk of birth defects. Orthodox Jews who oppose abortion use premarital genetic testing instead—an organization like Dor Yeshorim tests couples for genetic compatibility based on the likelihood that they will produce children with genetic problems such as Tay-Sachs. This eugenic match-making is very similar to George Church’s widely criticized “digid8” app. As geneticist Raphael Falk put it, “Whereas in Nazi Germany Jewish life was systematically destroyed in the name of eugenics, Zionists in the Land of Israel conceived of eugenics as part of their mission to restore the Jewish people.” Do you agree that women should be allowed to abort embryos with genetic defects or that couples from a small genetic pool, like Ashkenazi Jews, should be allowed to seek out genetic counseling before they marry? With regard to these issues, you’re a eugenicist.

But what about couples who can’t naturally have children on their own? Gay men and lesbian women were persecuted for so-called eugenic reasons during the horrific history of Nazi homophobia. Nevertheless, gay men and lesbian women in the US often use gamete donors from egg and sperm banks to have kids in a process that is transparently eugenic. From my experience as an egg donor, and from conversations with the many other egg donors I know, gay men often pay the most for eggs from “high quality donors” ³. They prize attractive, high IQ donors even more than opposite sex couples do. Organizations that recruit egg and sperm donors don’t just recruit for fertility, they also screen for mental and physical health, height, education, and criminal history—because that’s what their clients want and expect.

When these eugenic expectations are betrayed, gamete banks are severely criticized and may find themselves in legal jeopardy. In 2003, a lesbian couple, Wendy and Janet Norman, purchased sperm from a bank that promised their sample was sourced from a mentally stable, upstanding citizen pursuing a PhD. But the sperm donor lied; he did not disclose his struggles with bipolar disorder, schizophrenia, suicidal thoughts, and even obtaining an education. Nor did he disclose that he had served time in prison for burglary and that he was collecting disability for his mental illness. Wendy and Janet’s son has a significant mental disorder, violent tendencies, and suicidal thoughts. Based on genetics, it’s likely that three or four of the 36 children fathered by this sperm donor will suffer from schizophrenia. Behavioral genetics research also indicates that these children will be much more likely to have other mental illnesses and will be more likely to commit crime than if they had actually been fathered by a PhD with no mental illness and no criminal record. Janet and Wendy sued Xytex, the sperm bank they used, for false advertising. Their case and 12 other cases against the company have all been settled or dismissed.

If you think it’s good for egg and sperm banks to screen donors for disability or mental health problems, you’re a eugenicist. If you think it is right for the government to punish gamete vendors who do not adequately screen for such problems, you’re a eugenicist. If you think it makes sense that customers would want gametes from mentally stable people without a criminal record, you’re a eugenicist. If you’re truly anti-eugenics, you should think that this lawsuit against Xytex is illegitimate and deeply immoral. Many Jewish people, lesbian mothers, and gay fathers have embraced modern eugenics in the domain of choosing their children’s genes, even though eugenics has in the past been associated with discrimination against people like them.

There is nothing especially strange about screening one's own children for disability, choosing an egg or sperm donor based upon their personal history and characteristics, or receiving genetic counseling. The clients of egg and sperm banks are doing explicitly what many of us do intuitively. What young couple hasn’t talked about what their children might be like? They wonder whether their child might inherit a sharp wit or a knack for mechanics. We often choose the people we have children with, in part, because we hope the things we love about them will pass on to the next generation. It’s normal for people to consider the personality and the physical and mental health of the opposite sex partners of their sons and daughters or sisters and brothers. This too, is eugenics.

There are very positive mainstream bioethical treatments of eugenics. Philosophers like Peter Singer and Julian Savulescu have argued that if we would do anything to make our children happy and successful in their upbringing, we also have a moral imperative to do everything we can to genetically facilitate those outcomes. Thomas Douglas and Katrien Devolder have made an altruistic moral case that we should try—environmentally and genetically—to create children that are the most likely to benefit society and the world and the least likely to cause harm to others. And yet most intellectuals are either too ignorant or afraid of public reproach to give these ideas an open hearing.

As I said, we are not going to stop hearing about eugenics. Those unable to get past “OMG it’s eugenics” should be aware that they are ceding the discussion of social policy and reprogenetics to the people who can. If this topic is discussed openly, we can ensure that it is conducted with a deep consideration of our moral values and acknowledgement of our human biases and moral flaws. To justify the consideration of the genetics of future generations and even their biological enhancement doesn’t mean resuscitating master race theories or a contemptuous disregard for the value of human life and autonomy any more than it does for psychiatry, foster care, and contraception.

The scientific consensus is that nearly all traits of importance, certainly including psychological characteristics  have a substantial genetic component including the characteristics that enable our individual well-being, like mental and physical health and those that influence others’ well being, like productivity, intelligence, and compassion.

Nearly every social policy has some influence on who has kids and how many kids they have, from prison to free tuition, from abortion waiting periods to free prenatal care. But the taboos attached to the very concept of eugenics are thwarting important discussions about how we improve our shared future. Instead of acknowledging the potential of eugenic policies to improve lives, the state chooses brutal remedial methods like prison or the lottery of foster care. In the case of Patrick Stübing, the state could have just offered to pay him to get a vasectomy, a choice he ended up making anyway, instead of throwing him in prison. More benevolent methods like free or incentivized contraception are rarely used to ameliorate these problems because anything that sounds like eugenics is dismissed out of hand. This moratorium on discussing eugenics prevents clarity of thought in how policy influences reproductive choices and how these reproductive choices have a deep impact on the future. If we are willing to disrupt people’s lives, to make them suffer, to collect their wages, or alternatively to reward people and give them incentives, shouldn’t we permit conversations about how this will influence the character of future people?

The scientific consensus on behavioral genetics should allow us to appreciate that genes and reproduction will have a huge effect on the flourishing of future generations. Those who reflexively denounce any attempt at changing the genetic composition of the next generation—whether through genetically informed dating apps or government incentives—are defending the status quo at the expense of potentially valuable progress and causing harm we cannot fully appreciate. Only when our conversations about morality and obligation move past the mere mention of eugenics can we unlock an important means of improving the world.

Footnotes:

1. This essay is based on a Hereticon talk I gave in January of 2022 while I was pregnant (here is an interview I gave that week). The talk was recorded and might be published by the organizers eventually.

2. This argument inspired by the ridiculous argument that Body Mass Index (BMI) is bad because it was associated with eugenics

3. One of the primary criterion among opposite sex couples is how well the child will pass as theirs genetically. Gay men and lesbian women, often unconstrained by this provision, are more likely to just pick the donor that maxes out on qualities they consider desirable.