Analytical Piece

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Second Opinions

The Old Eugenics and the New Genetics Compared

Merryn Ekberg*

Summary. One of the greatest fears associated with the new genetics is the resurgence of eugenics, but too often this assumes the new genetics is eugenics without investigating the diverse definitions and interpretations of eugenics. The aim of this paper is to critically investigate the concept of eugenics in theory and in practice and to question whether the new genetics is a renewal, reform or return of eugenics. The discussion is oriented around six key arguments that illuminate the central points of convergence and divergence between the old eugenics and the new genetics. Ulti- mately, the paper concludes that despite significant procedural, legislative and administrative differ- ences between the old eugenics and the new genetics, and despite significant spatial, temporal and cultural variations in interpretation and implementation, at the ideological level, there is essentially no difference. The old eugenics was genetics and the new genetics is eugenics.

Keywords: old eugenics; new genetics; social history of medical genetics

While the end of the Second World War saw the collapse of the old eugenics, the discovery of the helical structure of DNA in 1953 gave birth to the new genetics. For many analysts, recent developments in human genetics signal a renewal, reform or return of eugenics, while for others, the new genetics is entirely separate from the old eugenics. The aim of this paper is to critically examine six key arguments that have been raised to distance the new genetics from the old eugenics. These contested argu- ments are that the old eugenics was racial politics whereas the new genetics is preventive medicine. Second, the old eugenics was discriminatory towards women whereas the new genetics offers new opportunities for women. Third, the old eugenics was discriminatory against the disabled whereas the new genetics offers new opportunities for the disabled. Fourth, the old eugenics was oriented around an ethos of collectivism and the promotion of social rights whereas the new genetics is focused on an ethos of individualism and the protection of individual rights. Fifth, the old eugenics was coercive whereas the new genetics is voluntary. Finally, the old eugenics was based on flawed science whereas the new genetics is grounded in accurate science.

The Old Eugenics was Racial Politics whereas the New Genetics is Preventative Medicine

Describing the old eugenics as racial politics and the new genetics as preventive medicine is the first argument advanced to distance the new genetics from the old eugenics. Racial

*University of Northampton, Northampton NN2 7AL, UK. E-mail: [email protected]

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eugenic programmes are fuelled by the politics of identity and difference. Initiated and sustained by a powerful majority, racial eugenic policies target minority ethnic groups, with a short-term view of discouraging these groups from reproducing and a long-term view of eliminating these groups from society. In contrast, medical genetics targets groups of individuals with dominant or recessive gene mutations, with a short-term view of preventing the vertical transmission of genetic disease and a long-term view of eliminating the social and economic burden of genetic disease from society. On the surface, the old eugenics exemplifies racial eugenics and the new genetics medical eugenics. Beneath the surface, however, many of the old eugenic policies exploited medical metaphors to justify xenophobic attitudes and to legitimate racist policies and many of the research projects that utilise the new genetics exploit ethnic biodiversity in their attempt to understand the origins of human disease mutations and to discover novel mutations that confer an increased susceptibility or resistance to disease.1

While eugenics in the UK was primarily oriented towards reproducing upper-class values, eugenics in the USA was used to vindicate racial policies. Racial prejudice informed the early eugenic policies of anti-miscegenation and immigration restriction, sexual segregation laws prohibited blacks from marrying whites, and under the Immigra- tion Restriction Act of 1924, immigration was restricted to Northern and Western Europeans.2 Following this American model, a more extreme form of racial eugenics emerged in Germany. In Nazi Germany, racial hygiene was the engine that fuelled the Holocaust. Nazi propaganda constructed the Jew as ‘the Other’, the alien, distinct and inferior race, which posed a threat to the master Aryan race. The dysgenic Jew was constructed as a biological threat to the strength and superiority of the Aryan race and hence, as a threat to the power and prosperity of the German nation. The real enemy was the fictitious Jewish gene, not the Jewish person. Jewish genes were constructed and perceived as polluting the purity of Aryan genes, ‘not by military force but by procrea- tion, by the force of life itself’.3 The German war against the Jews was a biological war.

This distinction between the old eugenics as racial politics and the new genetics as preventive medicine rapidly disappears when one recalls how the Germans exploited medical imagery to disguise racial policies. In a compelling history of the Nazi genocide, Lifton and Markusen emphasise how medical discourse was used to legitimate the mass killing. Nazi propaganda portrayed the Jew as a malignant cancer, infectious bacterium or invasive parasite. These authors suggest that:

[T]his medical imagery was no mere colourful metaphor: it was a social theory of decay, a social diagnosis containing a clear direction of treatment. As early as 1920, Hitler had made clear that the only solution for the Aryan malady was the removal of Jews from the midst of our people.4

Other historians reiterate and reinforce this metaphor in which Germany was the body, the Jew was the pathology and Hitler was the physician. The final solution was

1Atkin 2003. 2Varma 1996. 3Rothman 1998, p. 61. 4Lifton and Markusen 1990, p. 57.

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social isolation and quarantine, followed by surgery, chemotherapy, gas therapy and extermination.5

This link between race and genetics continues today in the many research projects that utilise the new genetics to study disease patterns in isolated populations, although the highly problematic term ‘race’ has been largely replaced by alternatives such as ‘ethnic group’ or ‘population’. As Haraway suggests, ‘populations’ rather than ‘races’ have become the new scientific object for identifying, categorising and analysing patterns of variation, mutation and pathology.6 In many cases, this link between medical genetics and ethnic groups is advantageous for including minority interests in science priorities and for extending the benefits of genome research to minority groups. Research on the unique disease pathology of different ethnic groups, for example, may ultimately be advantageous for developing specialised medical services and for conducting public awareness campaigns for these target groups. Tay-Sachs screening among Ashkenazi Jewish communities or thalassemia screening among Mediterranean communities are two prominent examples. Yet, despite these benefits, there remains a risk that by viewing different ethnic groups as distinct biological groups with their own pathogenesis, benevolent science can easily turn into racial prejudice and could be used to legitimate a return of past eugenic policies of segregation, exclusion, discrimination or genocide.7 It is for this reason that many ethnic communities and indigenous populations have become sceptical of the motives of genetics researchers and have declined to participate in collect- ing, analysing or manipulating their genetic resources.8 For these groups, the new gen- etics is understood as a continuum of the old racial eugenics, rather than the development of a new tool for preventive medicine.

The Old Eugenics was Discriminatory towards Women whereas the New Genetics Offers New Opportunities for Women

A second argument advanced to distance the new genetics from the old eugenics maintains that the old eugenics was discriminatory towards women, whereas the new genetics offers new opportunities for women. As women assume greater responsibility for reproduction and since eugenics is primarily oriented towards promoting responsible reproductive choices and influencing reproductive behaviour, there is a clear relationship between the women’s movement and the eugenics movement. Indeed women of repro- ductive age were the primary target in the eugenical campaigns of the early twentieth century, and remain the primary target in the twenty-first century repro-genetic testing industry.

Projections of the maternal instinct, the culture of motherhood and family values were embodied in the positive eugenic policies of the early twentieth century. Encouraging mothers to stay at home to nurture children was applied eugenics as were laws preventing married women from full-time employment.9 Moreover, reinforcing this western social

5Chorover 1979; Muller-Hill 1988; Proctor 1988. 6Haraway 1997. 7Atkin and Ahmad 1997; Gannett 2001; Varma 1996. 8Takeshita 2001. 9Hasian 1996.

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tradition of the patriarchal nuclear family, and the eugenic ideal that for the greater good of society, children should be born into responsible families with nurturing mothers and sup- porting fathers, resulted in the unjust practice of labelling women who conceive out of wedlock as ‘feeble-minded’. Women guilty of this dysgenic act were frequently institutio- nalised and sterilised. The sterilisation laws of the old eugenics therefore were not only dis- criminatory towards ethnic minorities, they disproportionately affected women. Furthermore, this practice was not limited to the United States and Britain; ‘Sweden sterilised around 60,000 people (mostly women) between the 1930s and 1970s’.10

With the arrival of the new repro-genetic technologies, the relationship between eugenics, genetics and women has become more complex. Indeed, feminists promoting women’s reproductive rights have an ambivalent relationship with eugenics in theory and the new repro-genetics in practice. Feminists acknowledge that the new genetic diagnos- tic tests offer new opportunities for women to minimise the risk of bequeathing to their child the misfortune of a genetic disease. At the same time, however, feminists insist that the new genetics remains discriminatory towards women and hence, there is a conti- nuum between the new genetics and the old eugenics. Women seeking individualised genetic services consistently assume greater responsibility than men. Most physicians offer genetic testing to the woman first and only if she is a carrier does the physician suggest that the male is tested.11 In addition, women feel greater social pressure to consent to prenatal genetic testing because they assume greater responsibility for the health of their child. In particular, pregnant women are expected to optimise the health of their foetus and this includes testing their foetus for genetic risk.12 One of the consequences of this is that women feel more guilt if they refuse testing and the resulting child is born with a preventable genetic disease. Finally, women often feel responsible if their son is diagnosed with an X-linked disorder such as Duchenne muscular dystrophy, haemophilia or Fragile X because these conditions are transmitted from the maternal X chromosome.13

As women carry the foetus, their bodies are subject to the invasive procedures per- formed in the name of eugenics. Some women are coerced into having diagnostic tests by obstetricians who refuse to treat them unless they agree to testing, and some have the tests performed without their knowledge or explicit consent.14 This risk inten- sifies with migrant women, disabled women or women from other minority groups where there may exist a cultural or communication barrier between the obstetrician and the patient. A study by Green, for example, found that it is common practice among British obstetricians to refuse to perform amniocentesis unless the woman agrees in advance to termination.15 Green suggests that prenatal testing of all foetuses is rapidly becoming routine practice among obstetricians, removing agency and choice from women, and making testing more coercive and less voluntary.

10Kevles 1999. 11Rowley et al. 1993. 12Lemke 2002. 13Mahowald, Levinson and Cassel 1996. 14Marteau, Slack and Kidd 1992. 15Green 1995.

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The sterilisation of unmarried welfare mothers, supported by 97 per cent of obstetri- cians in the United States, is a further example of the continuance of sexual discrimination in the new genetics.16 Also eugenic is the proposal for welfare cash bonuses for women dependent on welfare to use long-term contraceptives or to undergo sterilisation.17

These examples lead Andrews to conclude that the new genetics is a return of the old eugenics. In her words: ‘the language used in the current debate on preventing pregnan- cies in women on welfare sounds like the language used in the earlier eugenics movement’.18

The Old Eugenics was Discriminatory Against the Disabled whereas the New Genetics Offers New Opportunities for the Disabled

A third argument advanced to separate the new genetics from the old eugenics asserts that the old eugenics was discriminatory against the disabled whereas the new genetics offers new opportunities for the disabled. The eugenic programmes of the early twentieth century were based on the concept of positive eugenics, defined as encoura- ging those with qualities considered to be socially desirable to produce more children, or negative eugenics, defined as discouraging the less fit members of society from reprodu- cing and transmitting their undesirable traits to offspring. Among those labelled unfit to procreate were paupers, criminals, social degenerates and the physically and intellectually disabled. Indeed, it is noteworthy that when the Germans first adopted eugenic policies, it was children with disabilities, not the Jews, who were the first victims. As Rothman notes: ‘children under the age of three with Down’s syndrome were the first group the Nazi gassed’.19 Only later was the programme extended to eliminate Jews and justified by constructing ‘Jewishness’ as biologically inferior and a social pathology.

While the new repro-genetics is ostensibly guided by the benevolent intent of reducing or eliminating genetic disease and disability, disability rights activists perceive the new genetics as a form of disability oppression and hence, argue that the new genetics is a continuum of the oppressive policies of the old eugenics.20 In response, Harris argues that the aim of the new repro-genetic technologies is not to restrict the reproductive rights of the genetically weak, but to protect the rights of children to be born without a genetic impairment. According to Harris, the new genetics is not discriminatory towards the disabled, rather it offers new opportunities for the disabled. By using pre- implantation or pre-natal genetic testing services, people disabled by a genetic mutation now have the opportunity to produce offspring without the mutation and thus, to have children that they may not otherwise have had for fear of transmitting the mutation. Furthermore, Harris advocates the use of germ-line gene therapy because it ‘offers the prospect of enabling the genetically weak to produce and give birth to the genetically strong’.21

16Horsburgh 1996. 17Hand 1993. 18Andrews 2001, p. 86. 19Rothman 1998, p. 59. 20Parens and Asch 1999; Saxton in Solinger (ed.) 1997; Shakespeare 1998. 21Harris 1993, p. 183.

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These fervent discussions over whether eugenic programmes aim to reduce disability or disabled people are amplified by disagreement over how to define disability and by a failure to distinguish between the medical model of disability and the social model of disability.22 Uncertainty persists over where to draw the line between ability and disability, normal and pathological, disease and disability and, in particular, between disability as the result of physical impairment and disability as an outcome of social stigma and prejudice. Eugenic thinking makes subjective judgements about where to draw the line between when a life is worth living and when living is worse than not living. These selective judge- ments were made in the old eugenic policies that emerged in the early twentieth century and continue to be made with the new genetic diagnostic tests.

Many commentators suggest that the new genetics is an intensification of the negative eugenic goal of selecting against disability. According to King, for example, with the advent of pre-implantation and pre-natal testing technologies, selecting against disability has become easier and hence, the eugenic potential greater. He further suggests that selection against disability becomes easier the earlier the genetic test is performed. With amniocentesis and selective abortion at 14 weeks, the decision remains an emotional decision. With chorionic villus sampling and abortion at eight weeks, the decision is less traumatic. With pre-implantation diagnosis, the decision becomes much easier because abortion is removed from the selective process. In his words, ‘embryos which are still outside the mother’s body have a far lower emotional weight than a foetus which a couple already think of as their baby’.23 A parallel concern has been expressed by Rothman who suggests that the pre-test stage of a pregnancy is now considered to be a ‘tentative pregnancy’, which means that the parent–child bonding is not just delayed during the pre-test phase, bonding has never begun.24

The Old Eugenics was Oriented to the Ethos of Collectivism whereas the New Genetics is Focused on the

Ethos of Individualism The fourth argument used to separate the new genetics from the old eugenics posits that the old eugenics was oriented around the ideology of nationhood, the ethos of collecti- vism and the promotion of social rights. The new genetics, however, is focused on the ethos of individualism and the protection of individual rights. Wikler describes the differ- ence between the old eugenics and the new genetics as a conflict between social rights and individual rights.25 Based on a belief that the gene pool is a public asset and hence, the belief in the heroic ideal that individual liberties should be sacrificed for the benefit of the nation and future generations, the focus of the old eugenics was to improve the health, vitality and temperament of the collective. In contrast, based on a more liberal, individualist ideology, the focus of the new genetics is on promoting the right of individ- uals to information about genetic risk. However, as much as genetic counsellors maintain that their primary role is to assist individuals in making autonomous and informed

22Oliver 1990. 23King 1999. 24Rothman 1994. 25Wikler 1999.

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choices, individual decisions invariably affect others, and the cumulative effect of many individual decisions must ultimately have social consequences. Hence, although genetic testing may rightly be perceived as offering individuals the opportunity to avoid reproduc- tive risk, it may equally be perceived as an instrument for improving public genetic health and reducing the fiscal burden of genetic disease. Indeed, the recent interest in promoting genetic screening programmes to enhance public genetic health signals a revival of the collective ethos of the old eugenics.26

It is worth examining some of the points of convergence and divergence between the policies and practices of medical genetics, public health and eugenics. During their forma- tive years, eugenic programmes and public health policies were separate because of their different beliefs about the aetiology of disease. Eugenic campaigners maintained that disease was inherited through the germ-plasm (what we now call genes), whereas public health specialists insisted that disease was acquired from germs (what we now call infectious agents). Hence, the solution to better collective health for eugenic enthu- siasts was to improve the gene pool of the population by altering patterns of reproduc- tion, whereas the solution for improved aggregate health for public health specialists was to improve the environment through measures such as sanitation, water purification, pasteurisation, quarantine, vaccination, insect control and pollution management.

Eugenic campaigns and public health policies were further separated by their different success rates with public health policies generally enjoying a much higher success rate. To offer a clear example, one of the most effective weapons against infectious disease has been public vaccination, and one of the great success stories in public vaccination is the eradication of smallpox, which killed sixty million people in eighteenth-century Europe.27

The old eugenic policies could never achieve a comparable level of success in attaining their goal of eliminating genetic disease, nor the social pathologies of anti-social beha- viour, because they were based on the fundamental error of reducing complex human behaviour to hereditary and reducing multifactorial disease to single genes.

With gradual advances in scientific knowledge, this gulf between eugenicists, geneti- cists and public health specialists has been reduced. A consensus has now been reached that virtually all disease is contingent on a complex interaction between genes and the environment and that all behavioural traits are a product of nature and nurture. Social, cultural and environmental differences can explain why fully penetrant disease genes differ in severity and time of onset, and polymorphisms in the genes coding for antibodies can explain why a minority will always escape the infections that affect the majority.

Despite their different understandings of the aetiology of disease and their difference in strategy and success rate, eugenic, genetic and public health policies share a common dependence on the co-operation of individuals. All three depend on the co-operation of individuals who share a commitment towards reducing the morbidity and mortality of disease and all three depend on the co-operation of individuals who share a sense of civic responsibility towards achieving collective health outcomes. All require expressions of altruism and a willingness to sacrifice individual rights to promote the common good of improved aggregate health. The success rate of vaccination

26Khoury et al. in Khoury et al. (eds) 2000. 27Roses 1992.

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programmes, for example, is based on the principal of reciprocal benefit. Each individual benefits from all other individuals agreeing to being vaccinated.

This compromise between protecting individual rights and promoting the common good has often been the decisive factor in legal judgments. In the landmark US Supreme Court case Jacobson vs. Massachusetts in 1905, for example, the common good was used as justification for compulsory smallpox vaccination. Twelve years later, in the landmark 1927 case Buck vs. Bell, the US Supreme Court ruled in favour of com- pulsory sterilisation, arguing that the collective right of society to improved genetic health trumps the reproductive rights of individuals. Citing the 1905 Jacobson vs. Massachusetts verdict, Justice Oliver Holmes opined: ‘The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian.’28

A century after Jacobson vs. Massachusetts, compulsory vaccination is still a viable public health policy for managing infectious disease. However, compulsory sterilisation as a route to eradicating genetic disease is an obsolete policy of the old eugenics. As noted by Lynn, with the increased emphasis and awareness of individual rights in contem- porary western liberal society, it is unlikely that the new genetic technologies of pre- conception, pre-implantation and pre-natal testing will become compulsory. It is even less likely that a state policy of mandatory abortion for any foetus with a genetic defect, however defined, would be acceptable.29 Through more insidious channels of ubiquitous societal expectations, however, the new genetics is a public health policy that places the collective good of society above individual rights. As Duster has argued, the new genetics is a continuum of eugenics. The only difference is that the new genetics is a more insidious eugenics that enters through the back door rather than the front door.30 In effect, the new genetics is covert rather than overt eugenics.

The Old Eugenics was Coercive whereas the New Genetics is Voluntary

Defenders of the new genetics argue that the old eugenics was coercive whereas the new genetics is voluntary.31 Embodied in statutes such as marriage restrictions, immigration restriction, sterilisation laws and ultimately in Hitler’s final solution of genocide, the old eugenics was certainly more coercive than the new genetics, but the new genetics is not without coercion, and in some countries, notably China’s recently enacted ‘Law on Maternal and Child Health Care’, a state policy of coercive eugenics persists.32 In western democracies, the coercive element is less visible, and it comes from different authorities, but it is not absent. Under the old eugenics, coercion was administered by the central power of the bureaucratic state. Under the new genetics, coercion comes from more diffuse or decentred powers. Coercion comes from omnipresent social expec- tations, from scientists aiming to justify the benefits of their research and receive research grants, from physicians aiming to maintain their position of medical dominance and avoid wrongful birth or wrongful life suits and from biopharmaceutical companies that

28Quoted in Pernick 1997. 29Lynn 2001. 30Duster 1990. 31Caplan, McGee and Magnus 1999; Wikler 1999. 32Beardsley 1997; Normile 1998.

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aggressively promote the use of genetic tests because of the billion dollar profit potential embodied in these predictive tests. As Hasian opines: ‘Doctors fearing malpractice suits and companies interested in selling tests will join other interested parties in pushing for “voluntary” or even mandatory screening’.33

Although there are elements of coercion in the old eugenics and the new genetics, the source and the intensity of this coercion are very different. Coercion in the new genetics is less visible, leading many social analysts to conclude that the coercive element is greater. Coercion in the new genetics comes when anxious parents fear that a child born with a genetic disease will experience genetic discrimination and social exclusion in insurance, education and employment. If parents fear that insurance will be denied to a child with a genetic disability, or if they fear that welfare services for children with disabilities are inadequate, then they face financial coercion. The extent of this coercive influence has been investigated in a British study, which found that 13 per cent of obstetricians agreed with the statement that ‘the state should not be expected to pay for the special- ised care of a child with a severe handicap where the parents had declined the offer of prenatal testing’.34

In a sincere attempt to avoid the coercive practices of the old eugenics, the founders of genetic counselling developed the principle of non-directive counselling.35 This principle states that counsellors should offer objective information and advice to their clients but ultimately they must encourage their clients to make the final decision about the pre- ferred course of action. Although commendable for attempting to avoid coercion and to make genetic testing voluntary, this concept has been challenged by Clarke, who argues that coercion exists in all genetic counselling.36 According to Clarke, the very fact that a genetic test is offered by counsellors suggests to parents that the test is desir- able, socially responsible and the ‘right’ thing to do.

Finally, the personal characteristics and beliefs of individual counsellors will inevitably influence the advice given and hence, the decision clients make. The counsellor’s age, gender, ethnicity, religion, ideological beliefs, training and unique personal and pro- fessional experience will affect the level and direction of coercion embedded in the advice given to clients.37 Male and female practitioners, for example, may differ in their attitude towards prenatal paternity testing. Catholics may have a different attitude towards the termination of a pregnancy than non-Catholics. African-American counsel- lors may place a greater emphasis on sickle-cell testing or physicians of Mediterranean descent may emphasise the benefits of testing for thalassemia. Liberal-minded counsel- lors might see testing as an individual right. Socialist-minded counsellors might see testing as promoting the collective interest of the state. Ultimately, the coercive and eugenic potential in the professional relationship will vary with the personal profile of the counsellor.

33Hasian 1996, p. 152. 34Green 1995. 35Reed 1975. 36Clarke 1991. 37Andrews 2001.

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The Old Eugenics was Flawed Science whereas the New Genetics is Accurate Science

The final argument advanced to separate the new genetics from the old eugenics posits that the old eugenics was flawed science, whereas the new genetics is accurate science. Many geneticists around the globe now discredit the old eugenics as based on scientific errors. It was certainly based on fundamental errors about the role of genetics in deter- mining complex human diseases and human behaviour. It was based, however, on fairly accurate principles of Darwinian evolutionary theory, it employed the new statistical instruments developed by Galton and Pearson together with the new theory of quanti- tative genetics developed by Fisher, and initial pedigree studies followed classical Mende- lian traits such as haemophilia, Huntington’s disease and albinism. The movement was coordinated by leading professional scientists of the day, who formed Eugenics Societies, organised regular conferences on eugenics and published professional journals such as the Eugenical News in New York and the Eugenics Review in London. The American Eugenics Society published Eugenics Quarterly and it was not until 1968 that this journal was renamed Social Biology. In addition, the epicentre of American eugenics research was the prestigious Cold Spring Harbour Laboratory and when the American Society of Human Genetics was founded in 1948, four of the first five presidents were former members of the Board of the American Eugenics Society.38

The major research flaws leading to the demise of the old eugenics include: the assumption of genetic determinism, defined as the belief that all human traits are deter- mined by genes and similarly, the assumption of genetic reductionism, defined as redu- cing complex human traits to the action and expression of genes whilst ignoring the influence of the social, cultural and physical environment. Second, drawing correlations and conclusions about causation from small sample sizes. Third, studying behavioural traits and moral characteristics that required highly subjective value judgements such as feeble-mindedness, altruism, courage and trustworthiness and hence, traits whose social value may differ over time and between cultures. Fourth, misunderstanding the difference between genotype and phenotype and between dominant and recessive mutations. Finally, assuming complex, polygenic and multifactorial traits, such as intelli- gence, are inherited in classical Mendelian fashion as single alleles.

A study by Kerr and colleagues found that professional scientists in the UK discredit the old eugenics as flawed because its target was on complex medical and behavioural traits we now understand as being shaped by an interaction between many genes and an uncertain environment.39 Traits included intelligence, addiction, criminality, insanity, homosexuality and illiteracy. Yet ironically, while behavioural geneticists discredit the old eugenics on this basis, they continue to receive research grants to search for genes responsible for intelligence, addiction, criminality, insanity, sexuality and illiteracy.40

Thus, as a research project, the new genetics is a continuum of many unanswered ques- tions raised by the old eugenicists.

38Paul 1998. 39Kerr, Cunningham-Burley and Amos 1998. 40Hamer and Copeland 1998; Horgan 1993.

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It would be naive to assume that the old eugenics differs from the new genetics because the old eugenics was faulty and the new genetics is faultless, or that the old eugenics was based on science fiction and the new genetics is based on science fact. Indeed, unanticipated risk and irreducible uncertainty is endemic to all science and to argue that the new genetics is not eugenics because the new genetics is error free is arro- gance, ignorance and against the spirit of the scientific method. Contemporary philosophers of science have consistently argued that most science is wrong most of the time, that the only certainty in science is uncertainty, that all scientific results are tentative and provisional, that the scientific method accepts the possibility of error. Finally, they have argued that the scientific method retains the permanent possibility of revision, falsification or refutation.41 This post-positivist philosophy of irreducible uncer- tainty applied to the old eugenics and continues to apply in the new genetics.

A common error in the new genetics is over-estimating the predictive value of genetic tests and misunderstanding the difference between presymptomatic and susceptibility tests. This is the error that may result in new forms of social inequality and genetic discrimination. Employers, insurance assessors, educators, marriage registries, adoption agencies or immigration officials may interpret susceptibility as inevitability and may discriminate against people based on an uncertain probability of developing a future genetic disease.

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