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Herman Lundborg, the director of the Institute of Racial Biology in Uppsala, corresponded with some prominent French eugenicists in the 1920s and 1930s. The historical context of this correspondence is analyzed, and the importance of the national differences as well as of the international eugenic organization's efforts are emphasized.
Preimplantation genetic diagnosis (PGD) is a controversial method: while it prevents genetic disorders it is also said to have a eugenic side. It gives rise to many questions: What are the ethical differences between PGD and prenatal postimplantation diagnosis? Is PGD an ethically justifiable method? The conclusion is that PGD is to be preferred to prenatal diagnosis for couples who are at high risk of giving birth to children with very serious genetical diseases with an early onset.
Starting from race hygienic and eugenic ideas at the end of 19th and at the beginning of the 20th century the development and the execution of the "euthanasia of children" by the Nazis is described. Particularly the carrying out of the killing action is so-called "special children's departments" is dealt with in detail by the use of available investigations. Finally questions about the perpetrator profile and regarding the significance of ethical principles in child and adolescent psychiatry are raised.
Psychiatrists undertaking historical research, poets praising advances in the natural sciences, sociologists speaking the language of medicine and biology: these are only some examples of how various approaches started to flow together around 1900. This convergence was attributable on the one hand to a fear of social disintegration and the consequences of modernization, and on the other hand to a widespread belief in scientific progress. The nineteenth century concept of individual integrity and a right to cultural education was now replaced by collective approaches emphasizing the role of society as a whole (the "masses") and heredity. During the next few decades eugenic approaches to the treatment of "asocial elements" and minorities predominated. Rather than deriving, as claimed, from scientific principles, these approaches were often based on cultural argumentation. The trend was more toward a culturalization of the scientific and medical discourse than toward a biologization of thinking with regard to society. A good many areas in this connection have hardly been researched yet. Interdisciplinary studies would be required to elucidate the relationships between medically defined "health" and socially defined "normality", the intertwinement of disciplines, and the implementation of scientific concepts into social and political models.
ETHICAL ISSUES: When performed for contraception purposes, tubular sterilization for mentally handicapped women poses important ethical issues, including patient's rights, body integrity, and the notion of informed consent. French law guarantees the respect and safety of all patients, but in everyday practice, patient's rights must be upheld by family and healthcare workers searching for the most adapted solutions for each individual situation. PROPOSITIONS: We present here our proposals for everyday practice. Our conclusions are based on an analysis of the notion of handicap as defined by the WHO and on the observed sexual activities of this type of patient. In this context, informed consent involves a number of subjective factors pointing out the difficulty encountered in providing dear comprehensible information. Finally we discuss the ethical issue of tubular sterilization which many consider to be a masked form of eugenism.
Early 20th century race biology takes a special interest in woman as part of the "intra-racial" project of bringing forth healthy and competitive individuals. But there are other motives as well for the race biologist to take an interest in woman. She is believed to develop fewer individual characteristics and is therefore a more typical representative of her race than man. The development level of the race is also presupposed to be discernible by the degree of "gender diformism": a race of higher standing would exhibit a greater difference between the sexes. The anthropologist, anatomist, gynaecologist--or whatever guise the race biologist may adopt-- will, in principle, stress that the relation between the sexes is not a matter of "more or less", but one of differences in kind. In reality, the "more-or-less of comparison is the very cornerstone of the issue. Quantitative differences, directly observed or obtained from statistics, are construed as signs of difference in kind. 18th century medical philosophy and sex-linked anthropology laid the theoretical foundation of the 19th century essentialist conception of woman, which is also that adopted by race biology. Eugenics of social Darwinist inspiration regarded prophylactic health care and social welfare programs with scepticism. A race biology founded on the man-woman dualism could sustain altogether different conclusions. An advanced culture calls for extensive division of labour. An extended childhood renders possible higher development but will also impose higher demands on woman. The protection of the female organism is thus an exigency for any people or race striving to survive and evolve. From society's care for the female organism health care for women and preventive maternity care will emerge. Race biology has been a preeminently German concern, as indicated by the selection of works taken to represent this perspective on woman: Bartels-Ploss' Das Weib, C.H. Stratz' Die Rassenschönheit des Weibes and Oskar Schultze's Das Weib: In anthropologischer und sozialer Betrachtung.
An analysis of the publications of the Zurich anthropologists, Adolph Hans Schultz (1891-1976) and Otto Schlaginhaufen (1879-1973) from 1915 to 1925 revealed that both were interested in various subjects and worked on different materials but used the same quantitative method of their teacher, Rudolf Martin (1864-1925). Thus, this method is likely to be the supporting element of the Zurich school of anthropology. The 1915-1925 period describes the earliest stage in Schultz's scientific career and his first years in America, prior to his expeditions to Panama, Siam, and Borneo which presumably led to a change in his object selection. Eugenics became an interdisciplinary guideline of research furthered by the Zurich school of anthropology. Schlaginhaufen as head of the Department of Anthropology and a foundation for anthropological research had a direct influence on other research groups within his university.
In this article, the author examines the campaign leading up to the passage of the Sexual Sterilization Act in Alberta in 1928. The author asserts that the passage of this Act was the result of the influence of a few elite individuals, particularly those involved with the United Farm Women of Alberta social reform movement, and may not have been reflective of widespread favourable public sentiment. While there were serious misgivings regarding the passage of the Sexual Sterilization Act, the legislation was ultimately successful because of the pressing problems of inadequate mental facilities and budgetary constraints. The author discusses the legislation's eventual repeal in 1972 due to public denunciation of eugenic measures, concerns about liability, and the threat posed to individual liberties. This article was the winner of the William Morrow Essay Contest in 1999.
When the National Socialist state was created in 1933, an exodus of anti-Nazi elite began. However, some researchers who were forced to leave Germany approved Nazi eugenic politics, even as Jews. One of them was the psychiatrist Franz Josef Kallmann, a researcher on schizophrenia, who demanded an even more radical sterilization policy than the Nazis. He co-operated closely with the German Research Foundation for Psychiatry in Munich and its leader, Ernst Rüdin. From Rüdin he received help in leaving Germany and finding a job in USA, and Rüdin's assistant, Theo Lang, delivered data-material from Munich to New York. After 1945 Rüdin got a denazification certificate from Kallmann who already co-operated again with Lang.
Rapid advances in the field of genetics in recent years have caused some commentators to suggest the emergence of a "genetic revolution." Such advances have been both praised as the "future of medicine" and condemned for encouraging the acceptance in society of laissez-faire eugenics. Yet the effect of technological advances flowing from the science of genetics appear somewhat overstated as few products of the genetic revolution, particularly in the areas of gene therapy and genetic testing, have managed to satisfy scientists' expectations to date. Furthermore, misdirected regulation of such advances can exacerbate the social, legal, and ethical problems associated with genetics, particularly in the context of health care, where issues of human cloning and the use of premature genetic testing technologies dominate current public debate. In this article, the author criticizes the hyperbolic rhetoric surrounding the genetic revolution and calls for a more balanced and informed approach to the development of genetic policies and regulations. Such an approach should include substantial interdisciplinary debate and an active role on the part of government in the identification and communication of accurate information relating to the effects of recent technological advances in the field of genetics.
We surveyed genetics professionals, patients, and the public about rights to information, to requested services, and to parenthood, posing difficult cases found in practice. In all, 2906 genetics professionals (63%), 499 primary care physicians (59%), 476 North American genetics patients (67%), 394 French patients (51%), 593 German patients (65%), and 988 members of the American public (99%) returned anonymous questionnaires. Results suggest a trend toward increased respect for patient autonomy since an earlier survey in 1985; in most nations more would perform prenatal diagnosis for a couple with 4 daughters who desire a son. A minority (35% in U.S., 14% elsewhere) would perform PND for a deaf couple who want a deaf child, but most (94% in U.S., 62% elsewhere) would do prenatal paternity testing in the absence of rape or incest. About half (51%) would support a woman with fragile X who wants children. The trend to respect patient autonomy was greatest in the U.S. and was least evident in China and India. In general, responses to these cases illustrate a shift away from population or eugenic concerns to a model of genetics focused on the individual.
The activities of German doctors during the Nazi regime are well known and documented. They include efforts at eugenic sterilization and euthanasia, gruesome medical experimentation, and contributions to genocide. The German medical profession embraced the Nazi ideology of racial superiority. Nazi doctors enthusiastically perverted traditional medical mores of viewing each patient as a full individual towards a misguided sense of protecting the racial well-being of the nation from the perceived threat of certain groups of people. Similarly, some 20th-century American physicians engaged in activities prompted by a misguided sense of patients' worth as individuals. This essay will examine the ethical problems of Nazi medicine and ethical missteps in the United States in the context of challenges for contemporary physicians, particularly the way in which we refer to our patients.
On the basis of a review of the historiography on thought about hereditary transmission and human genetics in the 20th century in Britain, the United States, Germany, Russia, Sweden, and the Netherlands, a new research perspective is formulated. Concepts of heredity and their use in society have been various and diverse. Definitions of heredity and of the influence of 'nature' and 'nurture' in shaping genetic material have significantly changed. In the new research perspective the focus is directed to the role of a broad range of concepts of heredity in framing debates and practices around health, disease, and behaviour, including but not exclusively the concepts of Mendelian genetics, neo-Lamarckism', and concepts prevalent in eugenic movements. A research programme is outlined that is directed at specific problem fields in health care (e.g. alcoholism), and uses various sources to examine the historical dynamics in medical and public spheres.
While some claim that germ-line engineering is a definite possibility, the law in Israel and in most countries states that it should be avoided. This paper suggests that using GLE in order to 'self-evolve' (when it becomes safe) is not only inevitable but also morally justified. This paper argues that, The great achievements of healthcare during the last century, enabling longer life, have made almost everyone prey to late-onset diseases. The conundrum of healthcare allocation is worsening, partly due to late-onset dysfunctional genes that have escaped the barriers of natural selection, Trying to free future generations from late-onset diseases (such as Alzheimer's for instance) may be considered as 'eugenics' but, if pursued freely and justly, is a noble goal. We will be affecting future generations whether or not we use GLE. By definition, GLE might be reversible; it follows therefore that GLE may not necessarily represent the dramatic change inserted in the germ line forever--as is usually suggested. Reproductive freedom and justice are paramount in this scenario. These values are not necessarily incompatible if the right policies are in place.
The vital role of support services in ensuring the smooth operation of NHS IT networks is outlined by Eugene Conroy CEng, electrical director, Eta Projects, who goes on to provide an overview of the IT upgrade works at The Hammersmith Hospital NHS Trust.
This paper summons to contest some of the bonds that will be severed, probably, by the new eugenics, and may be repaired by narrative-based medicine, two of the most extreme and contradictory challenges to today's--and tomorrow's--medical practice. Accordingly, I intend to frame its development into the unbounded mathesis of biomedicine with the hindsight intention of questioning the foundations both of the ethical basis of the beginning of life medical decisions and of the end of life medical decisions. I will defend that, since clinical experience always embodies existential and anthropological density, and always has moral value, medical decision making seems not to be totally reducible to any algorithm or to the genetization of the live world.
When the National Socialists came to power in 1933 psychiatry experienced a boom in Germany that was undreamed-of. Psychiatry became one of the leading disciplines because it put the theory of racial hygiene into practice, which was closely linked to the National Socialists' ideology. Coercive sterilizations performed in hundreds of thousands cases could only be carried out with the help of many deeply convinced psychiatrists. From the late 1930s on tables started to be turned: psychiatrists were more and more eclipsed by administration officers. Time consuming therapies, which were still favoured by some psychiatrists, were replaced by economy measures. The killing of patients in the years 1940/41 in the so called "Aktion T4" marked a complete change of direction. Psychiatrists' eugenic activities and their propagation of sterilizations during the 1930s were not directly linked to the so called "euthanasia". On the contrary, there was a massive shift from the elimination of diseases to the elimination of patients. This shift caused society to withdraw its formerly strong trust in psychiatry. Because psychiatrists had participated in murdering their clients the clinical practice of psychiatry and psychiatric research became superfluous. As a consequence psychiatry faced the problem how to justify its existence. During the years 1941/42 the futile quest of a psychiatric "project for the future" began. Psychiatrists tried to justify the existence of their profession by research and modernization. An attempt that was doomed to failure.
The "Deutsche Forschungsanstalt für Psychiatrie" (DFA) in Munich, one of the most important research institutes in the field of theoretical and clinical psychiatry was founded in 1917 by Emil Kraepelin. Its financial existence between the World Wars was guaranteed by enormous donations from the jewish American James Loeb. The scientific work done by Walther Spielmeyer (neuropathology), Felix Plaut (serology), Kurt Schneider (clinical psychiatry) and Ernst Rüdin (psychiatric genetics) earned the DFA the reputation as an international center for psychiatry and neurology. During the "Third Reich", Ernst Rüdin cooperated with the national socialist health system. His genetic concepts supported eugenic laws such as compulsory sterilization of psychotic patients. These complex interrelations underscore the DFA's importance for the recent history of medical science in Germany.