title: Eugenics and genetic testing.
abstract: Pressures to lower health-care costs remain an important stimulus to eugenic approaches. Prenatal diagnosis followed by abortion of affected fetuses has replaced sterilization as the major eugenic technique. Voluntary acceptance has replaced coercion, but subtle pressures undermine personal autonomy. The failure of the old eugenics to accurately predict who will have affected offspring virtually disappears when prenatal diagnosis is used to predict Mendelian disorders. However, when prenatal diagnosis is used to detect inherited susceptibilities to adult-onset, common, complex disorders, considerable uncertainty is inherent in the prediction. Intolerance and the resurgence of genetic determinism are current pressures for a eugenic approach. The increasing use of carrier screening (to identify those at risk of having affected offspring) and of prenatal diagnosis could itself generate intolerance for those who refuse the procedures. Genetic determinism deflects society from social action that would reduce the burden of disease far more than even the maximum use of eugenics.
authors.forename: N A
authors.initials: NA
authors.lastname: Holtzman
mesh_terms: D000025:Abortion, Eugenic; D003068:Coercion; D037001:Directive Counseling; D005053:Eugenics / Q000379:methods; D006580:Genetic Carrier Screening; D005817:Genetic Counseling; D030342:Genetic Diseases, Inborn / Q000517:prevention & control; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D037141:Mandatory Programs; D026684:Personal Autonomy; D011296:Prenatal Diagnosis; D035141:Voluntary Programs