Eugenics: still a fool's errand
Louise Perry’s recent article in The Spectator cautions against “The quiet return of eugenics,” a threat she locates in preimplantation genetic testing for polygenic disorders. The technology is billed as a way for parents undergoing IVF to select which embryo to implant based on information about each embryo’s genetic risk factors and traits. These reports, she says, give parents “a very full picture of the adult that embryo could become”––from their child’s risk of developing different diseases to their “likely physical and psychological traits.”
Clinics attempting to sell genetic selection pitch the technique in ways that encourage parents to overlook their ethical qualms about the technology, by framing the lowering of genetic “risks” as being in the best interest of the future child. As Perry notes, this aligns well with some parents’ efforts to make their children’s future more secure and less risky: “... think of what’s on offer: the opportunity to offer your children the best possible chance in life. Why would the kind of upper-middle-class parents who think nothing of spending vast sums on their children’s education not opt for polygenic screening?”
Perry’s point is that this technology sounds a lot like eugenics––and it does. Some proponents who embrace the selection of the “smartest” embryos have gone so far as to call it “hipster eugenics.” But Perry misses the opportunity to show that the science behind these tests doesn’t live up to their claims –much like early 20th century eugenics. While Perry rightly questions whether this kind of technology is beneficial to society, noting its potential to further entrench social inequalities, she does not scrutinize the scientific claims that purveyors of polygenic risks testing put forward ––or make mention of the researchers questioning the science behind the tests.
As Pete Shanks pointed out in Biopolitical Times last year, the American College of Medical Genetics has cautioned against the use of polygenic risk scores (PRS) in commercial settings, calling the technique an “inexact science.” The 2023 ACMG statement cautions against clinical use, emphasizing that a low risk score does not preclude development of a particular disease. It further notes that the accuracy of PRS is severely limited––in part because the genomic data sets upon which they rely are mostly from people of European ancestry, and in part because the development of disease and of complex traits is shaped by far more than genetics. As Philip Ball explained in a 2021 article, “gene variants an individual carries don’t guarantee which traits they will develop. And environmental factors such as upbringing and diet, as well as unpredictable quirks of embryo development, also have a role. We’re products of (genetic) nature, nurture, chance and an interplay between all three… An individual with a high PRS for skin cancer might never develop it, while someone who scores low might do so. Someone with a genetic profile that predicts a modest IQ might turn out to be brilliant.”
Some disability rights scholars and activists have questioned the entire premise of preimplantation genetic testing for polygenic risk, or PGT-P. Selecting the “smartest” or “healthiest” embryo relies on constructed categories that have often served to discriminate against and devalue the lives of people with disabilities. Technologies that continue ableist myths of superiority will only reduce already inadequate social and structural support for people with disabilities.
Perry points to the promise of PGT-P for resolving issues like asthma. While consumers might indeed find this a compelling idea, it too repeats a mistake of eugenics reinforced by a medicalized culture. It frames problems like asthma as individual diseases that can be eradicated through costly (and inaccurate) genetic selection practices available only to a select few, rather than focusing on addressing the social and environmental factors that make asthma more common, especially for racial and ethnic minority populations.
Perry is right that the stakes of PGT-P are high––and regulating these tests is an urgent necessity. A recent survey in the United States indicates that 72% of U.S. adults support the use of PGT-P to screen embryos for disease, with a little over a third expressing support for its use to screen embryos for behavioral traits. The study also showed, however, that most participants expressed concern about the potential perils to society that PGT-P could bring. And when study respondents were told up front about concerns related to equity, coercion, and accuracy, support for PGT-P plummeted, and uncertainty about the technique soared.
While concerning, this survey shows that public opinion on PGT-P is not yet fully formed. Companies are already pitching the public on taking the “Gattaca route” to ensuring their child's future. That makes it even more urgent to bring the eugenic threats these technologies pose to the forefront of public conversations, and to act now to curtail those risks.