Prenatal Diagnosis, Economics and Eugenics
by Christian Munthe
Presented at: The 3rd World Congress of The International Association
of Bioethics, San Fransisco, 22-24 November, 1996.
Abstract
Prenatal diagnosis has often been argued for by pointing out that it may
save money for society by preventing the birth of defective and costly
children. This argument has similarities with economic arguments put forward
in favour of various eugenic policies in the past. One example of this
is Sweden, where the eugenic programs that proceeded from the 1930's until
the middle of the 1970's included eugenic abortion with sterilisation as
an obligatory follow-up procedure, prohibition of marriage and compulsory
sterilisation of the mentally retarded. The paper presents arguments in
favour of using prenatal diagnosis put forward by Swedish specialists on
this procedure when it was introduced in Sweden during the 1970's. The
ethical basis of these arguments is analysed with respect to similarities
with and differences to arguments put forward in favour of eugenic policies
in the past. Two lines of interpretation of the economic argument are described,
one offensive and one defensive. It is argued that the economic argument
put forward by specialists on prenatal diagnosis should be understood as
defensive while economic arguments for eugenic programs need to be offensive
in order to be relevant. However, defensive economic arguments leaves room
for worries about prenatal diagnosis being an instrument for eugenic purposes
in that they express tolerance of offensive economic objectives among policy
makers. This calls for increased activism among specialists for safe-guarding
prenatal diagnosis from being used in policies where the autonomy of patients
is forced to yield for economic objectives.
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