I have a confession to make: I am a eugenicist.
I am a family physician who provides obstetrical care. I love taking care of moms and babies.
It has insidiously become the Standard of Care to offer to all pregnant women testing that will inform them whether there is an increased risk that their unborn children have certain genetic abnormalities or birth defects. If I do not offer these tests to all pregnant women, I am considered to have provided substandard care, and the wrath of a society that tolerates Nothing But The Best will descend quickly upon me. If I do offer these tests, I am practicing “Good Medicine” — and eugenics.
How did eugenics become Good Medicine again?
I don’t want to practice eugenics. Yet I am compelled to by the Standard of Care; and the Standard of Care is shaped by the existence and marketing of these tests. It’s the old story in our technophilic society: we are constrained to use a technology merely because the technnology exists.
Why were such tests even developed in the first place? Was it only for diagnostic purposes, simply to provide information to prospective parents? Of course not. Clearly these tests were developed to help guide therapy; and because the primary “therapeutic” option is induced abortion of fetuses who are not up to snuff, it seems equally clear that eugenic considerations drove their development. So, the eugenic ideal drives development of eugenic technology, which, marketed and disseminated, drives the Standard of Care, which drives what I do in my office and provides the ammunition for the licensing board — and malpractice lawyers — who are looking over my shoulder.
Thus am I an unwilling eugenicist. Thus am I compelled to do the dirty work for the eugenicists of our society.
(This is not to say that all parents who opt to undergo this testing do so for eugenic purposes. I realize that some do so solely for diagnosis. I am writing here about the development and mandatory offering of such tests.)
Maybe the time has come for a new medical association. Instead of the AMA, perhaps we should inaugurate the HMA: the Hippocratic Medical Association, the members of which will adhere to a different Standard, who will pledge to uphold the ideals behind the Hippocratic Oath. The members of this association would return to the ethos of that Oath which, according to anthropologist Margaret Mead, marked one of the great turning-points in the history of the human race, because, “For the first time in our tradition, there was a complete separation between killing and curing . . . One profession . . were to be dedicated completely to life under all circumstances, regardless of rank, age, or intellect–the life of a slave, the life of the Emperor, the life of a foreign man, the life of a defective child . . .”