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THE CAMBRIDGE FORUM

Emmanuel College 22nd November 2002

The Medical Ethics Alliance took part in a discussion on "Eugenics", before an undergraduate audience. This took the form of a discussion with answers from guests to questions posed by members of the audience. In a well attended meeting in the Old Library the Alliance was able to make a number of points.

The Nuffield Council Report on "Genetics and human behaviour" 2002 was quoted with approval by the Alliance. In particular the statements;

"Eugenics literally means well born and equates to the doctrine that humanity can be improved by selective breeding"

"Eugenics raises questions about what kinds of people should or should not be born"

This was discussed in connection with the two commonest genetic disorders namely Downs syndrome and cystic fibrosis. The deficiencies in proper ante natal counselling in connection with Downs was highlighted. It had been pedjudiced by outdated information, negative stereotyping, prejudicial images or offensive terminology, which had the potential to stigmatise Downs persons. The positive attributes of such people were mentioned and the great progress made in their lives in the last 40 years. The problems of social acceptability were world wide and historically they were hidden or institutionalised.

The steps involved in good genetic counselling were then contrasted with the hurried or minimal time and understanding given by midwives in over busy ante natal clinics. The subtle pressures that were applied to parents to have tests with the purpose of aborting affected unborns was explored. The steps that good genetic counselling in the other condition, namely cystic fibrosis was discussed. Amongst the options open to parents were the continuation of an affected pregnancy given the regard that the parents had towards their previously affected child and the progress made in on modern treatments, together with the new therapeutic possibility, gene therapy.

Some of the historical laws that in most industrialised European countries were recalled which culminated in the Nazi programmes of sterilisation and so called "euthanasia" which led directly to the death camps. Sterilisations continued in some countries until the 1960s but not in Britain. There in 1914 the Mental Deficiency Act allowed the compulsory detention of individuals in institutions to control their fertility. On the unsavoury background of eugenics the Nuffield Report was again quoted;

"Eugenics has proved itself historically to have been a cruel and always problematic doctrine, not least because it elevates abstractions, the "race", the "population", and more recently the "gene pool" above the needs and rights of individuals and families."

For the most part, eugenicists approved of people who were most like themselves or shared their values and perspectives.

As for the future; the concept of transgenicism or the possession of the genes of more than one organism was mentioned and the latest hubris tic idea that through transgenicism, human evolution could be directly controlled.

There was quite a lot of discussion on questions of justice between generations and whether there should or could be effective restraints backed by international agreements. There were differences of opinion on the status of the unborn and the ending of life before birth. Some say a distinction between pre and post viable life and some adhered to the view that unborn life acquired increasing value with gestation.

There was considerable discussion on whether a child should be born after pre implantation diagnosis as a source of cells or perhaps tissue to treat a sibling. One panellist thought that one could use another for a purpose if it also served the purpose of the donor i.e. being born into a loving family. On the other hand the Alliance saw a moral problem in anyone being created intentionally to serve the purposes of another.

The meeting closed after considering the ethical difficulty of imposing a transmittable genetic change on one generation which would then be transmited to future generations in perpetuity. The Alliance said there was no ethical frame for dealing with this. It was agreed that there should be legal constraints on what was done. There was disagreement about religious arguments, which some panellist thought irrational, or based on special insights not shared by others. On the other hand it everyone came into these deliberations with their own beliefs and that common ground could be found in the seeking the common good and promoting human flourishing. The Alliance thought that justice, and in particular justice between generations was the best way to find solutions to many question touching on unborn and future children.

The Cambridge Forum meeting was conducted with courtesy and understanding and was followed by a quiet, and closely attentive audience.