Untitled

July 19,1991

Genetic Choices

Men are not going to embrace eugenics. They are going to embrace the first likely, trim figured girl with limpid eyes and flashing teeth who comes along, in spite of the fact that her germ plasm is probably reeking with hypertension, cancer, hemophilia, color blindness, hay fever, epilepsy, and amyotrophic lateral sclerosis.

Logan Clendening (1884-1945)

When I was a student, the eugenics movement was gasping its last breath. That was the movement that proposed the improvement of the human race by selective breeding, in much the same way as domestic animals are bred for desirable traits. The final death knell for the movement came when Hitler brought those ideas to their logical conclusion by exterminating everyone the Nazis considered inferior.

Tay-Sachs disease dooms an infant to a degeneration of the brain that results in certain death usually before age 6. The agony of parents with a Tay-Sachs baby is indescribable. Now, a person can, with a blood test, find out if he/she is carrying the gene for Tay-Sachs disease. If a couple is at risk of bearing a child with Tay-Sachs disease, they can be informed of that fact early enough before birth so that the fetus can be tested to find out if it will get the disease. If it has the disease, an abortion can be performed. My use of the term "it" for a fetus will tell you where I stand on the subject of abortion. I do not consider a fetus a person any more than I consider an egg or sperm as some form of life deserving the protection of society. Everyone draws a line somewhere, and I have drawn mine.

Other types of deformities can also be detected before birth by a variety of techniques, most being fairly safe to both mother and fetus. It is now possible to detect the dominant Huntington's Chorea gene before birth. This disease causes tremors, brain degeneration and death, but usually in late middle age; after one has raised his/her children --half of whom will carry the gene for the disease.

It's now just a matter of time before the gene(s) for Alzheimer's disease will be isolated and, as with other genes, may be detectable in people who have not yet showed signs of the disease. It may eventually be possible to detect the gene in a fetus.

With abortion being legal in most places, a number of choices, that never existed before, are now available.

With Tay-Sachs disease, it would take someone who was immune to human suffering to deny a woman the abortion of a fetus that was doomed to die in infancy; particularly since the woman has the option of then having a child who will be normal. In this case, abortion is a means of preventing a large amount of suffering, not as a means of birth control. The same argument can be advanced for spina bifida, Down's syndrome and other crippling conditions. During the presidential debates, George Bush said that he would be in favor of denying an abortion to a woman carrying a fetus with Tay-Sachs disease. I attribute this to his ignorance, not heartlessness. He needs some educating. So does Mike Dukakis, who could have nailed Bush to the wall with that one.

At the trivial end of the spectrum is abortion in order to choose the sex of a child.

Between these two extremes are a number of grey areas worth pondering. Among these are pregnancy in drug-addicted mothers and women with AIDS. The children of drug addicted mothers have a good chance of ending up as wards of the state. Many babies born to mothers with AIDS will have the disease and will die in infancy. Those babies without AIDS will lose their mothers at an early age.

I don't think that you would find many physicians who would think twice about aborting a badly deformed fetus or one who will develop a disease like Tay-Sachs. Many would refuse to recommend or perform an abortion to choose the sex of a child. Many would feel the same way about Huntington's chorea or Alzheimer's disease, which manifest their symptoms later in life.

The fact is that these choices are no longer theoretical. They are now a fact of life --or death. Like most choices in life, the amount of suffering involved should be considered. People who are categorically opposed to abortion have opted for it when faced with the certainty of giving birth to an infant that would never even reach adolescence. Society is faced with the problem of dealing with infants who will not survive to adulthood or who will not have a mother.

There are people who are working very hard to eliminate these options.

Next column

Return to the Medicine and Health Home Page

Return to Ira's Home Page