The Specter of Eugenics
ONE of the often noted anomalies of our society is its capacity to develop extraordinary new technologies while failing to find ways to perform elementary services in a minimally decent fashion. Nowhere is this truer, or more painful, than in medical care. Hospitals visit tawdry indignities on patients even while their bills reach unimaginable levels; medical services are increasingly bureaucratized and depersonalized; competent doctors, nurses, and paraprofessionals are in short supply and not where they are most needed. In these circumstances a new theme has emerged to dominate the discussion of the moral and social responsibilities of medicine. It is not how to humanize medicine but how to re-engineer the human race.
The occasion for this preoccupation-which has affected the curricula of medical and law schools, led to the creation of new institutes and to proposed legislation in Congress,* and produced a stream of sociological, moral, and philosophical reflection-is the advent of “biomedicine,” a package of dazzling biological discoveries and new medical techniques. Biomedicine, we are told, is the harbinger, or portent, of the day when man will be able to say of himself, meaning it entirely, that, at last, he is his own greatest creation, and has got the weight of that other Creation off his back. Existentialist philosophers have accustomed us during the past generation to phrases like “man invents himself.” But they have meant these dark utterances metaphorically, metaphysically. Biomedicine, it would appear, gives them a literal meaning. If what is said about it is true, mankind is on the verge of being able to make itself, in a quite physical sense, its own principal artifact.
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