## 1. Short history of eugenics




Philosophers have contemplated the meaning and
value of eugenics at least since Plato recommended a state-run program
of mating intended to strengthen the guardian class in
his *Republic*. However, the modern version of eugenics had
its start with the 19th century cousin of Charles
Darwin, British scientist Francis Galton (1883). Galton was interested
in "improving human stock" through scientific management of
mating. His explicit goal was to create better humans. His ideas were
taken up widely in the early part of the 20th century
by seemingly well-intended, and ideologically diverse, scientists and
policy makers, particularly in the United States, Britain, and the
Scandinavian countries. Notable eugenicists included Alexander Graham
Bell and Margaret Sanger. (For an excellent history of eugenics, see
Kevles 1985.)




Eugenicists had two-fold aims: to encourage people
with various desirable traits, e.g., health, intelligence, character,
to reproduce together to create good births (what is known as
"positive" eugenics), and to end certain diseases and
disabilities by discouraging or preventing those with characteristics
considered undesirable from reproducing (what is known as
"negative" eugenics). In the United States, programs to
encourage positive eugenics involved the creation of "Fitter
Family Fairs" in which families competed for prizes at local
county fairs, much in the way that livestock is judged for conformation
and physical dexterity (Stern 2002). Negative eugenics took the form of
encouraged or forced sterilizations of men and, particularly, women
deemed unfit to reproduce (in the language of the day, this included
individuals who were "poor, mentally insane, feeble-minded,
idiots, drunken" and more). Much of eugenics ideology was
reductionistic in nature, with many eugenicists assuming that social
and behavioral conditions, such as poverty, vagrancy, or prostitution,
were inherited as genetic traits rather than shared as common social
situations. Nonetheless proponents of eugenic policies were aware of
the interplay between biology and the environment, even if they were
not very concerned with differentiating the various contributory
factors (Dyck 2014). Social problems such as alcoholism or diseases
related to mental health were understood to have a genetic component
that could lead to difficulties in taking appropriate care of children
(For an interesting discussion of the relevant social moral
epistemology, see Buchanan 2007).




Racist, sexist, ableist, xenophobic, and classist
assumptions pervaded the discourse. In the US, for instance, alarm
calls were raised about the lower birth rates among white Protestant
Americans compared to the large immigrant Catholic populations of
Italian and Irish descent. German scientists and policymakers visited
the United States to learn from their methods, and when the Nazis came
to power in Germany, they began eugenic policies of their own. Early
German policies called for the killing of people in institutions whose
physical or mental illnesses were deemed incurable. Such individuals
were considered to have "lives unworthy of life"
(*lebensunwertes Leben*). The Nazis
also encouraged selective breeding for Aryan traits (e.g., athletic,
blond, blue-eyed). This policy quickly expanded to include bans on
marriage between particular groups, forced sterilization, and then
internment in concentration camps for individuals belonging to groups
deemed inferior (i.e., people who were disabled, homosexual, diagnosed
with psychiatric conditions, communists, considered to be Roma/gypsies,
and/or Jewish). The purported aim was to promote the
"health" of the German population by controlling those who
were "unhealthy." Prisoners faced extremely hard labor,
medical experimentation that was torturous and designed to test the
limits of the human body (Lifton 1986) and daily degradation and abuse.
Eventually, the Nazis escalated their eugenic program to the
"final solution" of death camps, ultimately killing more
than six million Jewish people in the name of promoting Germany's
health.




Following the end of WWII, the term
"eugenic" was so closely associated with the horrific
programs of Nazi Germany that eugenics societies across the world
changed their names (e.g., the American Eugenics Society became the
Society for the Study of Social Biology) and tempered their aims. Yet
many of the same practices and beliefs continued under a different
guise, from immigration policies, to forced sterilization, to
population control (Kevles 1985; MacLaren 1990; Kline 2001; Broberg and
Roll-Hansen 2005; Lombardo 2008; Paul, Stenhouse, and Spencer 2018;
Willson 2018). In the United States, involuntary eugenic sterilizations
of "feeble-minded" women in a variety of states didn't
officially end until the late 1970s and may continue covertly in some
state institutions. California had the highest rate of forced
sterilizations, which were widely performed on prison inmates, people
in mental institutions, and women considered to be bad mothers. Such
sterilizations were motivated by both perceived individual and social
goods but were grounded on deep-seated prejudice as well as scientific
inaccuracies (Kluchin 2009; Stern 2015). Concepts of
"feeble-mindedness" were historically entangled in deeply
problematic ways with ideas of race, class, and gender (Stubblefield
2007). California has now joined Virginia and North Carolina in passing
legislation to compensate forced sterilization victims.




Later, attempts to promote positive eugenics were
renewed with the creation of the Repository for Germinal Choice, a
sperm bank created in 1978 with the idea of collecting sperm from Nobel
laureates, others deemed "geniuses" and Olympic level
athletes. Artificial insemination and IVF would thus allow women to
choose to reproduce with men presumed to have high-quality genes,
without needing to form relationships with them. Although most Nobel
prizewinners proved reluctant to donate to the sperm bank, the general
idea took off. Today, advances in egg freezing have also permitted the
creation of egg banks and print and online ads in college newspapers
regularly request sperm or eggs from donors who meet certain
qualifications for health, intelligence, athleticism, and/or
attractiveness. Individuals or couples who require gamete donation to
reproduce can shop around for a donor who meets their desired criteria
(see the entry on the
 donation and sale of human eggs and sperm). 
 Importantly, these practices are not only examples of
positive eugenics but also of negative eugenics. Racist, classist, and
ableist prejudices underlie these practices in ways that promote
negative eugenics by preventing or discouraging some women from
reproducing (Roberts 1997; Daar 2018). 




The widespread practice of prenatal genetic
testing (traditionally through chorionic villus sampling or
amniocentesis in the second trimester of pregnancy, but now more
routinely done through non-invasive blood tests in the first trimester,
at least as a first screen), similarly presents the opportunity for
individuals or couples to identify genes or genetic markers for traits
they prefer for their future children not to have. If prenatal testing
identifies an undesired gene variant, prospective parents may choose to
abort the fetus, often with the plan to later attempt a new pregnancy.
Studies suggest that approximately 80 to 90% of parents terminate
pregnancies identified with certain disorders (Rothschild 2005,
Blakeley et al 2019). With the advent of preimplantation genetic
testing, prospective parents can choose to use IVF, and then test
early cells of the created embryos to identify embryos with genomic
variants they favor or those prefer to avoid. In this way, they
preclude the potential need for abortion by choosing to implant only
embryos that contain the desired genes.




The aim of these practices certainly appears
eugenic, though without an obviously coercive structure, and presumably
directed at benefiting the individual family rather than the state. The
profession of genetic counseling, started in the 1990s, provides
prospective parents with detailed information about the meaning of the
tests, and the opportunity for discussion of test results. In part due
to concerns about eugenic overtones, genetic counseling is built on a
policy of "non-directiveness" to ensure that the
reproductive autonomy of prospective parents is respected. That tenet
of genetic counseling has been challenged by scholars on grounds that
it is impossible (Clarke 2017) and that it is undesirable (Davis 2010;
Dietz and Reynolds 2021).




Finally, while past testing methods allowed
identification of chromosomal abnormalities such as Trisomy 13, Trisomy
18, Trisomy 21 (Down Syndrome), and monogenic disorders such as
Huntington's disease, next generation sequencing (NGS) technologies now
permit an unparalleled wealth of information about fetuses' and
embryos' genomes. Although these technologies are not yet
used routinely, their utility is being assessed in clinical trials.
Should this expanded genomic information be available on prenatal
testing panels? Or for all prospective parents who request prenatal
testing? What about other additions that might be of interest to
particular parents, even if the genetic linkages to the particular
traits are less direct or even only mildly predictive: diabetes,
obesity, or psychiatric conditions such as bipolar disorder or
schizophrenia?




Moreover, new genome editing technologies are now
being used to modify sperm, eggs, and embryos. Indeed, although genome
editing for reproductive purposes is implicitly or explicitly
prohibited in most countries, in November 2018, Chinese researcher He
Jiankui used it to modify human embryos (Kirksey 2021). He and his team
edited the embryos to disable a genetic pathway that HIV uses to infect
cells. According to reports, three babies have been born from the
edited embryos




These new genomic technologies could provide
prospective parents -and others - with a significant degree of
control over the characteristics of their children and the traits that
should and should not be promoted. Deciding how to deal with
them - as a society, and potentially as individual prospective
parents - is a monumental task that calls for clarity about the
benefits and drawbacks of genomic testing and editing, and requires us
to revisit the meaning of eugenics and the problems associated with
it.




As this short history should make clear, past,
state-run, involuntary eugenic endeavors have been unjust and socially
disastrous. Yet advances in genomic testing and interventions continue
to make possible practices that have eugenic features, albeit framed
differently. Prenatal testing and preimplantation genetic testing, for
instance, are understood to enhance reproductive choice, even as they
are clearly used by prospective parents to determine which individuals
should come into existence. Should they be considered eugenic
practices? Is that necessarily morally troubling? As technological
advances push us to consider what genomic variants we ought to be able
to test for, which to choose prenatally, and which to manipulate we may
need to reassess our current practices, explore their justifications,
and sort through the ways in which they are eugenic and morally
worrisome.


## 2. Arguing for "liberal" eugenics


### 2.1 Distinguishing "old" and "new" eugenics




Advocates of liberal or new eugenics agree that
past eugenic practices were morally wrong and should not be repeated.
However, they contend that the use of current reprogenetic technologies
does not share any of the morally impermissible features of such past
eugenic programs (Silver 1997; Agar 2004; Harris 2007; Savulescu and
Kahane 2009). They argue that current practices do not involve the
morally troubling characteristics of their historical predecessors.
First, reprogenetic technologies and practices
are *individual* in nature rather than
state-sponsored. The intended benefit of any reprogenetic intervention
is individual/private welfare (that of the child-to-be or of the
family), rather than the welfare of the state. Second, they are
premised on individual *liberty*, the freedom of
parents to choose according to their own values and conceptions of the
good life. The state does not mandate contraception, sterilization,
prenatal testing, abortion, or any other form of eugenic intervention
(note: there are potential exceptions in which judges or states have
offered long-term contraception such as Norplant as a condition of
probation related to a criminal offense or for the continued provision
of welfare, see e.g., Dresser 1996). Rather, it allows individuals to
choose among a range of alternatives. Third, recognizing that
individual parents will often desire different things for their
offspring, current reprogenetic technologies and practices
presume *value pluralism*. This means allowing others to
choose in ways that we ourselves would not, in the interest of
preserving a liberal society that is neutral about conceptions of the
good. The aim of a liberal eugenic program is
to *expand* reproductive choices for individuals, in
contrast to the historical eugenic programs that clearly cut off
reproductive options for many.




Of course, this does not mean that no limits can
be imposed on people's choices. Even liberal eugenics advocates
typically presume that *some* restrictions would need
to be in place to ensure that prospective parents could not act in ways
clearly contrary to the interests of their future children, or in ways
that seem clearly vicious. As will be discussed below, disagreements
exist about how and where those limits should be set.




Finally, advocates of current reprogenetic
technologies and practices highlight the difference between the kind
and quality of the science underlying past and current reproductive
policies. Past eugenic programs relied on views of race, intelligence,
and genetics that were, from our current perspective, "hopelessly
wrong" (Agar 2004: 7), while reprogenetic technologies are
grounded on purportedly sound scientific theories and evidence.




For advocates of liberal eugenics, the fundamental
differences between the old and the new practices are reasons to reject
claims about the moral wrongness of current reprogenetic technologies.
In their view, what current and past eugenic practices share is the aim
of improving our offspring, and arguably that is a morally worthy goal.
 


### 2.2 Using reprogenetic technologies




Many theorists argue in favor of permitting
parents to make choices about their future children's genetic make-up.
Such arguments run the gamut from a completely laissez-faire market
system - or "genetic supermarket" - of the sort
considered by Robert Nozick (1974: 315) to a more highly regulated
system, with controls to protect the well-being of future children as
well as socially valued goods (e.g., rough equality, efforts to
eliminate discrimination) that might be put at risk in a completely
free market environment (Buchanan et al 2000). Many also contend that
there is a morally relevant difference between choices aimed at
addressing diseases and those aimed at selecting or enhancing
non-disease traits such as intelligence, self-confidence, height, eye
color, or attractiveness. Further, while some liberal eugenics
advocates contend that reproductive interventions for non-disease
traits are permissible (Agar 2004, Green 2006), some argue that they
are morally obligatory (Harris 2007; Savulescu 2005; Savulescu and
Kahane 2009).


#### 2.2.1 Addressing diseases




Liberal eugenics arguments often start by
recognizing the value of treatment of disease. Disease, typically
defined as a negative departure from species typical functioning
(Boorse 1975; Daniels 1994), can interfere with an individual's
participation in society and/or individual flourishing. Buchanan et al.
(2000) link disease to a reduction of opportunity, and so argue that
provision of medical treatment for disease is a way for the state to
promote equality of opportunity. Parents are obliged to ensure that
their children get medical treatment for diseases and can be charged
with negligence if they fail to do so. This obligation does not obtain
in cases of diseases that result in relatively small negative effects
on participation (e.g., mild asthma) or where the potential benefits of
treatment are still somewhat uncertain or might be outweighed by the
possible harms (e.g., some cancer treatments). Parents whose
conceptions of the good life do not include medical treatment for
serious diseases - as in some religious communities - are not
allowed to impose this view on their children because the children
deserve the opportunity to choose to adopt those views or not when they
are adults. Mandatory life-saving treatment of their childhood diseases
helps to ensure that they survive to make such decisions as adults
(Feinberg 1980). This requirement has been the subject of some debate
(see, e.g., DesAutels, Battin and May 1999).




Buchanan et al. (2000) note that as technology
advances, theories of justice need no longer consider "natural
inequalities" to be given, or outside the scope of distribution.
If equality of opportunity is one of the aims of a society, then,
provision of certain forms of genetic intervention - including
interventions that determine who will be brought into
existence - may become *owed* to future people as
a matter of justice. If parents can decide between implanting an embryo
that carries a genetic marker associated with a serious disease - 
e.g., Tay Sachs - or an embryo without that marker, they would have
a moral obligation to choose the latter, in the name of promoting the
health and well-being of the future child (impersonally, perhaps, given
the non-identity problem).




Liberal eugenics advocates thus move from a
commonly accepted position regarding the obligation to treat serious
diseases in children, to a requirement for people to use genetic
interventions in reproduction (e.g., pre-implantation genetic testing
or genome editing) as a way to avoid transmitting serious diseases to
one's offspring (Savulescu 2001; Agar 2004; Glover 2006; Green
2007; Harris 2007; Savulescu and Kahane 2009).




To be clear, though, most liberal eugenics
proponents do not suggest that all prospective parents would be obliged
to seek reproductive counseling and use IVF in order to fulfill
their parenting or impersonal duties (but see Savulescu and Kahane
2009). Such a requirement would present serious ethical concerns. Given
the prohibitive costs and relatively low success rates of IVF
treatment, this kind of obligation would be overly demanding on
prospective parents, and particularly on women. Arguably, it would also
constitute an infringement on people's procreative liberty.




Similarly, proponents contend that the obligation
to use reprogenetics to avoid transmitting diseases to one's
offspring does not extend to legal mandates on prenatal testing or
abortion (or one day, genome editing). For them, such practices would
be consistent with the old eugenics but not with the new, liberal
version which values reproductive liberty (but see below for challenges
to whether such view can be maintained consistently by at least some
proponents of liberal eugenics).


#### 2.2.2 Addressing non-disease traits




 Liberal eugenics advocates recognize that
many prospective parents may be interested not only in addressing
health-related problems in their offspring but also in selecting or
editing non-disease related genes to improve their children's
wellbeing. Why settle for the likelihood of normal functioning if one
could safely choose other traits that are likely to make a
child's life better?




Two reasons are given for the use of reprogenetic
technologies in this way. First, according to some liberal eugenics
proponents, non-disease traits such as intelligence, memory, sex, hair
or skin color, height, or beauty affect people's wellbeing
(Savulescu 2001; Harris 2005; Green 2007). Sometimes their effect on
wellbeing is at least as significant as that of some diseases. If
so then, using reprogenetic technologies to select or edit some of
those traits would be morally permissible.




Second, as mentioned earlier, liberal eugenics
advocates place significant value in reproductive freedom, and they
contend that reprogenetic technologies can advance people's
reproductive choices in meaningful ways (Roberston 1994; Buchanan et
al. 2000; Savulescu 2001; Agar 2004; Harris 2007; Green 2007; Buchanan
2011). If selecting or enhancing non-disease traits contributes to
people's reproductive projects, then provided that their actions
do not clearly and seriously harm others, they should be able to use
reprogenetic technologies with such aims.




Liberal eugenics proponents recognize that the
permissibility to use reprogenetic technologies for non-disease traits
raises significant moral concerns. For instance, obsessively focused
prospective parents might design their children in ways that are
overbearing or narrowly focused on a particular goal of the parents
(Kass 2003; Sandel 2007). To avoid this problem, liberal eugenics
advocates propose various limits on genetic interventions for
non-disease traits. There is widespread agreement that interventions
should not harm the future child (by creating a life so miserable as to
be not worth living, as might be the subject of a wrongful life suit).
Beyond that, variations include, for instance: (1) only interventions
on traits that will benefit the future children no matter what life
plan they decide to pursue and that do not reinforce problematic social
norms (Agar 2004), (2) only interventions that preserve a child's right
to an open future (Davis 2010), or (3) only interventions that preserve
open futures and protect some central core of our human nature (Glover
2006), or (4) only interventions that rational people agree can be
understood to be in the best interest of the child (Green 2007).




How might one harm a child through choosing
genetic traits? Perhaps by selecting for traits that clearly cause
significant suffering and a typically short life span (e.g., Tay-Sachs
disease, Lesch-Nyhan syndrome). Such constraints may seem unnecessary,
given that most parents do not intentionally desire painful states for
their children and would not seek to engineer them in this way. Also,
relatively few genetic conditions will be so inherently debilitating as
to make life so obviously miserable that would prevent one to consider
that life is, on balance, a benefit.




Some of the other constraints are more contentious
because they involve decisions about lives that would be worth living
but have different features. For instance, it can be difficult to
determine how one might ensure a child's capacity to choose from a
variety of life plans, or what traits would be necessary to protect a
child's right to an open future.




Davis (2010) and Agar (2004) both use deafness as
a case for clarification, as such a case calls attention to the
contentious nature of these decisions. They both take hearing to be a
core human capacity, or a trait that is necessary for a wide variety of
life plans. Hence, they argue, engineering a child to be deaf will
limit that child's future options. This is not, of course, to say that
deaf individuals cannot live rewarding lives in which they flourish.
Indeed, Agar recognizes that in some circumstances, lacking a capacity
like hearing will only lead to a small difference in relative freedom,
and if so, then we might not have a "general requirement to
replace genetic arrangements linked with deafness" (2004: 105).
On his view, prospective parents could engineer a child to be hearing
because it would increase her real freedom but could not engineer a
child to be deaf. Weighing in on the now widely analyzed case of two
Deaf women (the capital "D" marks membership in the
linguistic-cultural group of the Deaf; a small "d" only
signifies the physical state of the body) who sought out a deaf sperm
donor in hopes of having a deaf child (Spriggs 2002; Mundy 2002), Agar
argues that they reduced their child's real freedom by attempting to
ensure that the child would be deaf. (Although this case did not
involve reprogenetic technologies, one can easily imagine the use of
such technologies to ensure the birth of a child who would be deaf.)
Davis, too, acknowledges the claims of Deaf culture, and the reasons
parents might prefer to have a child more like themselves, but argues
that deliberately trying to conceive a child who will have relatively
limited options - limited, in her view, not just due to enduring
discrimination and social constraints, but also to bodily
deficits - is morally impermissible.




Constraints on parental reproductive decisions
about what traits to choose can also be seen as conflicting with
reproductive freedom and parental autonomy. For instance, Green
(2007) rejects the "right to an open future" language in
part because he thinks parents must be allowed to do things that are
more for their own interests than for the sake of their children, even
when doing so affects how the children develop. Following William
Ruddick (2007), he thinks of parents as both guardians and
gardeners - protecting their children so that they can grow as they
will, but also *shaping* how they grow in line with
the parents' hopes. Because he thinks "parental love almost
always prevails" (Green, 2007: 114) - when we are faced with
an actual child of ours, we will (typically) love the child, regardless
of the child's traits - he finds it morally acceptable that
parents might want to choose traits for their children that do not
strictly speaking preserve an open future. If parents want a child with
a good shot at an athletic career, for instance, why not allow them to
engineer for athleticism or great vision? Doing
so *might* narrow other life opportunities, but not to
the extent that the child couldn't choose how her life goes. Her future
would still be open enough. Green emphasizes parental reproductive
autonomy, and the continuum between shaping the future possibilities
for our existing children through parental values, education, religion,
and more, and doing so through genetic interventions. His central
recommendation is that genetic interventions should be aimed at what
is *reasonably* in the child's best interests (2007:
216), recognizing that the parents' own interests are also relevant. By
"reasonably" he means that it is not enough for parents
to *think* that something is in their child's best
interests; their judgment must accord with that of most other informed
members of society (2007: 216). Once that condition is satisfied,
parents would be permitted to choose, according to their own tastes and
preferences, within a wide range of options of relatively
"all-purpose" traits (2007: 218). Just who the
"informed" members of society are, is of course, a matter
of some contention (for discussion, see Hayry 2010).




In sum, theorists who argue for the permissibility
of using reprogenetic technologies and practices for disease and
non-disease traits seek to preserve parental reproductive autonomy and
to expand rather than reduce parental options. At the same time, they
emphasize the need to increase the future child's options, so long as
doing so does not reinforce unjust social prejudices or threaten deeply
held core values. One problem with this thesis, to be explored more in
depth below in the section on critiques, is the appropriate scope of
its central claims. Some critics (e.g., Asch 2000; Saxton 2000; Sparrow
2005), for instance, suggest that it fails to recognize that many of
the presumptions about social prejudice could be extended to prejudice
against people with certain diseases and disabilities, many of whom
live relatively well with traits or characteristics that genetic
enhancers may well desire to eliminate or attempt to improve upon. If
we ought not collude with and exacerbate the social prejudices of
sexism and racism through our reproductive genetic choices, why is
doing the same for ableist norms permissible?


#### 2.2.3 Morally permissible or obligatory?




But are parental choices regarding non-disease
traits simply morally permissible or are they morally obligatory? While
advocates of liberal eugenics agree on the obligation to address
disease-related genomic variants, they disagree regarding whether the
use of reprogenetic technologies for non-disease traits is a matter of
moral permissibility or obligation. For some proponents, it is morally
permissible, but not obligatory, for parents to use (with some
constraints) reprogenetic technologies to select or edit non-disease
traits (Agar 2004; Green 2007). They reject the moral obligatoriness of
these practices for several reasons. First, there is the difficulty of
determining just what counts as an improvement (beyond addressing
serious disease). For instance, Agar (2004) questions whether it is
obviously better for a child to be highly intelligent (roughly
approximated by a likely IQ of 160). Might some parents reasonably
choose a more moderate level of intelligence for a child, presuming the
child will have greater social opportunities in the latter case?
Perhaps the overall freedom of the child of moderate intelligence will
be greater than that of the child with high intelligence, even though
on that one dimension the child's capacities are comparatively
lower. Second, while one might consider it reasonable to incur risks of
reprogenetic intervention to treat or prevent diseases, it is by no
means clear that the risk-benefit balance would be appropriate when
dealing with non-medical traits. Third, many recognize the
importance and value of diversity (Green 2007). Given the many ways in
which parents can attempt to improve the lives of their children, it is
not clear why there would be a moral obligation to choose some
non-disease traits over others rather than simply allowing parents to
choose what they wish. Additionally, even if many people agree on the
value of some non-disease characteristic and it becomes so common that
its possession is practically required for equal participation in
society, we might want to resist the temptation to make that
intervention *obligatory*. For example, Agar (2004: 85)
suggests this might happen with the trait "being somewhat happier
than is now normal" if treatment tied to 5-HTTLPR, a genetic
marker associated with upbeat temperament, became common. The
now-typical temperament is not a disease, but a mere variety within the
capacious normal range of functioning and would likely remain so even
in a future society of 5-HTTLPR-enhanced people.
A *liberal* eugenics cannot mandate any one view of
the good life for its citizens.




Other proponents (Harris, 2002, 2007; Savulescu
2005; Savulescu and Kahane 2009) recognize the potential benefits of
genetic enhancement, and forthrightly argue in favor of moral
obligations to pursue them. Some such enhancements might be relatively
minor, while others might be radical enough to eventually create a new
species (Glover 2006).




Early work by Savulescu (2001), for instance,
argues that parents have an obligation to produce the best children
possible. This obligation cannot be owed to any particular child (given
the non-identity problem), but is an impersonal obligation, to make the
world a better place. If parents are using pre-implantation genetic
diagnosis, they should always choose the embryo with the best chances
at the best life. Non-disease traits, as mentioned earlier, can have
significant effects on how well people's lives go. Savulescu
imagines that the rational parent could make no other decision but to
avoid the negative linkages and promote the positive ones, where
possible.




But this obligation is a moral one. Thus, the
state need not (indeed, should not) legally coerce parents to select or
edit their offspring to produce the best children they can have
(Savulescu 2001). To the contrary, the state must balance the benefits
of potential enforcement against its existing obligations to protect
reproductive liberties. Nonetheless, the state might have good reason
to encourage parents to take such action, through education and
persuasive public health campaigns (not unlike anti-smoking campaigns).
On this stronger view, others, too, would be right to express
disapproval (Savulescu and Kahane 2009)




A similar position is advocated by Harris (2007).
Although the arguments are about a moral obligation, these liberal
eugenics advocates recognize that other competing priorities (e.g.,
autonomy of parents, welfare of other siblings, harm to others) could
potentially trump this obligation.




For other liberal eugenics advocates the moral
obligation to select or edit non-disease traits is grounded on social
benefits. For instance, Buchanan (2011) is broadly optimistic
about biomedical enhancement technologies - seeing them as not
significantly unlike other enhancing societal innovations, such as
literacy, numeracy and agriculture - and argues in favor of
funding research and development into a broad array of enhancements.
Doing so will be socially good: good for economic growth to avoid
problems of illiteracy, sickness, etc. that can accompany, for
instance, lower intelligence and merely typical immune systems.




Other theorists likewise offer social benefit
justifications for genetic enhancement. Elster (2011) advocates a
principle of general procreative beneficence, changing the last part of
Savulescu's PPB to an obligation to produce the best child, of those
possible, "whose life will maximize the expected overall value in
the world." (2011: 483). Rather than focus on individual welfare,
he recommends a system of obligations that starts from general social
goods. Parents considering reproduction are then bound by a maximizing
duty to the world.




Although Savulescu highlights the well-being of
the individual in his work on procreative beneficence, in more recent
work, the obligation to produce the best seems to have shifted from an
obligation to improve the world by privately producing the best
individuals, to an obligation to improve the world by producing
individuals who will help to solve social problems. For instance, in
their book *Unfit for the Future* (2012), Persson and Savulescu
argue that we are obligated to fund and explore *moral
bioenhancement* (2012: 2) - the idea that we could
genetically or pharmacologically enhance our moral motivation, to
reduce selfishness and aggression, and increase our sense of fairness,
altruism, and our willingness to cooperate (see also Douglas 2008).
Given the massive threats to human well-being presented by global
climate change and the abundance of weapons of mass
destruction - and the fact that solutions to these large-scale
problems will require collective action to prevent future
problems - Persson and Savulescu claim that traditional methods of
moral change (e.g., education, public campaigns) are unlikely to be
effective. If we care about the planet - and we should - then
we are obligated to invest in moral bioenhancement research, and
presumably ensure that if successful, it gets wide uptake (Persson and
Savulescu 2012). Buchanan (2011) is sympathetic, noting that critics
who worry about whether we will use this technology wisely may be
short-sighted.




This suggestion
about *moral* bioenhancement has sparked criticism
focused on threats to human freedom (Harris 2011; Simkulet 2013), the
meaning of being virtuous (Kabasenche 2013; Levin 2021), the complexity
of human moral psychology (Zarpentine 2011), and the complexities of
human biology (Wiseman 2016, Levin 2021).


## 3. Criticisms of "liberal" eugenics




Given the historical horrors associated with
eugenics, it should be unsurprising that criticisms of liberal eugenics
- whether regarding permission or obligation - are numerous and
varied. Proponents have tried to address some of those criticisms in
more or less convincing ways. In this section, we discuss some of the
most significant criticisms that have been presented against liberal
eugenics.




Some critics point out the difficulty of making
meaningful comparisons about what is the "best" life (de
Melo Martin 2004; Parker 2007). Other theorists - attentive
to pervasive unjust discrimination in respect to sexism, racism,
classism, and heterosexism - emphasize the broadly negative
consequences of promoting or allowing liberal eugenic policies, given
the aggregation of many individual choices, and the slippery slope to
an older style of coercive eugenics (Duster 1990; Sparrow 2011a). When
some parents insist that eliminating a trait will increase their
child's relative freedom and the group of people who live with that
trait point to the ways in which that choice contributes to and
reinforces social prejudice against their group (Lane and Grodin 1997;
Saxton 2000; Asch 2000; Kaposy 2018), how are we to proceed with the
regulation of "liberal" eugenics? Other critics call
attention to the problematic conceptions of disability that underlie
many of the arguments as well as the negative effects liberal eugenics
is likely to have on existing people with disabilities (Asch 1999;
Saxton 2000; Amundson 2005). Still other critics highlight potential
damage to some core values, such as our conception of ourselves
(Habermas 2003), what it means to be human (Sandel 2007; Kass 2003),
and the parent-child relationship. When parents attempt to design their
children, critics argue, they demonstrate a lack of humility in the
face of nature, and more specifically, an attempt to control where they
should instead appreciate what is given (Sandel 2007; Kass 2003).


### 3.1 The comparison problem




The reproductive choices that prospective parents are encouraged
- or morally required - to make regarding their offspring are
choices about selecting or enhancing their children or selecting the
best they can have. All involve comparisons about traits that
contribute to better or worse lives. But deciding which traits are
positive, and of those, which are better than others, is a task far
from simple. Critics point to the difficulty of ranking the expected
well-being of future possible lives, given 1) disagreements about what
traits are positive and negative, and the need to contextualize such
traits in a particular environmental or societal context or family
situation, and 2) the reality that most embryos will have a complex
mixture of positive and negative traits making meaningful pairwise
comparisons very difficult (de Melo Martin 2004; 2017; Parker
2007).




Savulescu and Kahane have tried to reply to these
concerns in various ways. For instance, they have argued that critics
are overstating their case and that we do this kind of ranking all the
time when we make decisions about bringing up and educating our
children. Ordinary morality, they argue, already asks parents to make
these comparisons (Savulescu and Kahane 2009).




But it is far from obvious that this is the case
(de Melo-Martin 2017). Clearly, common morality requires that
prospective parents care about their children's wellbeing, not
that they maximize it. Moreover, in ordinary life, parents are not
required to choose between child A and child B in virtue of which one
is more likely to have the best life. Rather, when prospective parents
make decisions that are likely to have an impact on their
children's welfare, such decisions involve comparisons between
the life of a child if one does A or if one does B (e.g., if one
promotes music training or sports).




Savulescu and Kahane (2009) also contend that in
complex cases where different forms of life might be equally good or
that are likely to contain incomparable forms of well-being,
prospective parents choosing the child whose life can be expected to go
best are free to choose any of the available options.




While this response suggests some greater
flexibility in their view than might be apparent from the language of
obligation, they do not always seem consistent in advocating for this
flexibility (Sparrow 2007). Moreover, how will
we *know* when different forms of life are equally
good or when the associated well-being is incomparable?




Rather than giving a substantive account of
well-being (they argue that their account is compatible with several
theories of wellbeing such as hedonism, desire-fulfillment accounts,
and objective list theories), Savulescu and Kahane simply assert
confidence that we will be able to find an agreeable one. They offer
simple examples to illustrate their view. Mild asthma, though only a
minor impediment to well-being, is nonetheless not acceptable to choose
if we have the information and an alternative embryo without the mild
asthma. Deafness is clearly a detriment to well-being - at least in
this society - and so should not be selected. They are careful to
add that their view can appreciate deafness and recognize that it is
clearly *compatible with* a good, even flourishing
life. But a life without asthma or deafness, they submit, would
*clearly* be better. Our obligation is to produce the best, not
just a life compatible with flourishing. They thus see the need for two
steps: finding a reasonable theoretical model of well-being, and then
investigating whether a particular trait or condition is, on balance, a
detriment to overall well-being on that view.




Despite their confidence, there is reason to think
there will be significant disagreement in both steps. A theory of
well-being that is acceptable to most might be so abstract as to fail
to offer any significant help, and then the matter of determining how
traits or conditions in question are related to expected
well-being - such that we can do a comparison and select the
best - will be even more difficult (Parker 2007). Parents who see
value in a wide variety of ways of being in the world - both for
the individual, and for society as a whole - may welcome children
who have traits that are not standardly considered advantageous.
Consider, for instance, positive accounts about raising children with
Down syndrome (Berube 1998; Estreich 2011; Kaposy 2018), and even
profound cognitive and physical disability (Kittay 1999). Indeed, as
Sparrow (2007) has pointed out, on any of the accounts of wellbeing
that Savulescu and Kahane consider, their proposal to choose the best
child will turn out to have either counterintuitive or incoherent
results. For instance, prospective parents who have a hedonist
conception of wellbeing would be justified in choosing -indeed
obligated to do so - the child whose brain chemistry is more likely to
cause feelings of pleasure. Similarly, on a desire-fulfillment account,
parents would have reasons to choose children who will grow up to have
less ambition or curiosity as their preferences will be more likely
satisfied, and thus would have better lives.


### 3.2 The promoting injustice problem




One of the most serious challenges to liberal
eugenics is the concern that promoting -and more so
requiring - these practices will contribute to social
injustices. Indeed, the past use of eugenic policies provides
good reasons for these worries.




The use of reprogenetic technologies to select or
edit embryos can contribute to social injustices in various ways. For
instance, given the significant costs of these technologies, its use is
likely to increase inequalities between people who have the finances to
afford them, and those who do not. The wealthy already have advantages;
if we allow them to select or edit their offspring for improvements
 - so that they are smarter, faster, stronger, with less need to
sleep, etc. - those children will be ever more competitive, and
liable to increase the divide between rich and poor. (Lee Silver
explores this dystopian possibility with the GenRich and the Naturals
in his *Remaking Eden*, 1997, though he still supports the use
of these technologies.)




Proponents of liberal eugenics have offer several
responses to this concern. Some contend that these technologies will
eventually become widely available and thus, that the critics'
worries are overstated. For example, Green (2007) notes that all
innovations have a period of diffusion, during which early adopters pay
higher prices and take some risks for the potential of leading the way
forward, and then, if the technology is successful, prices drop and the
wider public gains access through the market. Similarly, Buchanan
(2011) compares genetic intervention to literacy, numeracy, and
agriculture, and argues that these innovations too were only available
to a few at the start, but then became broadly accessible.




For others this problem would be avoided by
ensuring that the technologies are available to everyone, at least for
traits that offer significant advantages (Buchanan 2011). Traits that
only offer positional advantages - being taller than, perhaps
faster than - would then be self-defeating (Buchanan et al. 2000)
if available to all, and the allure might fade. Other
traits - perhaps enhanced concentration, memory, or
immunity - might be advantageous regardless of how many people have
them. Providing funding to improve accessibility would then be
necessary in order to ensure fairness.




Of course, whether these responses assuage
concerns about increasing inequality depends on their feasibility. We
have at least some reasons not to be very hopeful in such regard. 
After all, technologies such as IVF have been around for several
decades, and though more people now have access to them, they are far
from being cheap technologies, accessible to everyone who wishes to use
them. Also, given the many serious problems our society faces,
prioritizing access to these technologies rather than using resources
for something else that would be more cost-effective would require
justification.




Another way in which the use of reprogenetic
technologies to select or edit embryos can contribute to social
injustices is related not to access but to the kinds of values that are
likely to guide parental choices. Critics highlight the troubling
aggregate effect of individual choices, particularly when they are
often ill-informed or relatively biased (de Melo Martin 2004; Goering
2000). They call attention to the deeply entrenched social injustices
that pervade many societies, and that would typically inform individual
free choices. Tremain (2006) discusses this effect in relation to
disability. Russell (2010) argues that taking race to be a morally
neutral feature (as Harris does) is only a "veiled attempt"
to distinguish contemporary from historical eugenics practices. Perhaps
race should be morally neutral, but it is not commonly treated as such,
and opening up "choice" for people who harbor explicit or
implicit biases related to race allows for those biases to shape the
next generation. Oliver (2010) likewise highlights the trick of
labeling gender a morally neutral category in a world filled with
sexism, and also rightly emphasizes the levels of surveillance and
control over women that are likely to follow the implementation of
liberal eugenics. The unintended negative effects on pregnant women of
increased attention to prenatal testing and surveillance of pregnancy
generally are explored in Katz Rothman (1986), Rapp (1999), and Kukla
(2008), but tend to be ignored by liberal eugenics advocates (Oliver
2010; de Melo-Martin 2017). (See also the entry on 
 pregnancy, birth and medicine).




Liberal eugenics proponents are generally
sympathetic to these concerns -indeed, some of them, have
explored directly issues related to collective action problems (Anomaly
2020) - and have tried to respond to them. Some argue for constraints
on the types of traits that parents should be allowed to select or edit
(Agar 2004; Green 2007). Some characteristics, e.g., homosexuality,
dark skin, will only be harmful to the individual in a morally
defective social environment. What is needed in such a case, proponents
argue, is to change attitudes and social practices instead of
people's genomes. For instance, Agar acknowledges that it would
be preferable to eliminate racism (2004: 155), but given how entrenched
it is in many societies, he considers whether we might want to allow
some genetic interventions (e.g., engineering lighter skin tone) that
could help individuals avoid suffering from it. On this view, the use
of reprogenetic technologies to select or edit certain traits could be
helpful at least in the short term, as it would help reduce some
near-term suffering, and the social solutions are distant and rather
unlikely. Ultimately, however, he claims that we should not allow this
kind of genetic engineering - not simply because it seems to
collude with a morally defective social environment, but because it
reinforces and perhaps exacerbates that environment (it undermines work
toward changing the morally defective social environment) (2004:
156-157). Liberal states remain neutral about what constitutes
the good life, but impose certain restrictions (laws, policies) and
offer education or aid (public health campaigns, food stamps) in the
name of ensuring that citizens are safe, relatively stable, and have
equal opportunity to pursue their goals.




Critics, however, fear that regulations put in
place by advocates - whether in the form of laws, restrictions of
the use of federal or state funds, or mere recommendations or
guidelines from medical societies - will not be sufficient to avoid
the negative consequences of eugenic practices (Duster 1990; Sparrow
2011a). They point out the many ways that a collection of individual
choices, pressured by unjust social norms and assumptions, may lead to
results not wholly unlike those of the old eugenics programs.




Green (2007) also recommends against interventions
that would reinforce or increase discrimination, economic inequality,
or racism (2007: 216-226), but he does so with some reservations.
Parents understandably might want to reduce social burdens on their
children through genetic interventions, he believes, and if we make
doing so illegal, they will likely go elsewhere or underground to get
what they want. He also - optimistically - suggests that
stereotypes and fashions ebb and flow and may be self-corrective (2007:
227). Groups who have experienced significant discrimination over many
generations will understandably reject such optimism. Indeed, the
insufficient progress made against these social ills and the historical
evidence arguably calls for all of us to be skeptical of this
optimism.




Some have denied that social injustice could
result from selecting or editing for particular traits that increase
people's chances at a better life (Savulescu 2001). To the extent
that those traits contribute to inequality, the argument goes, it is
unlikely that they could promote wellbeing (Savulescu 2001, 424). This
claim seems, however, either irrelevant or false (de Melo-Martin 2017).
Prospective parents choosing certain traits for their children could do
so without realizing that they are actually undermining their
children's wellbeing (see Anomaly 2020, a proponent of liberal
eugenics, who explicitly acknowledges coordination problems resulting
from prospective parents' choices - although he does not
discuss choices that might increase sexism or racism). For instance, in
a sexist society where parents systematically select for boys, it might
be the case that the wellbeing of those boys could diminish because of
the effects in society of fewer females. However, parents will realize
this only once the choices contributing to injustice have already been
made. But quite likely the claim is simply false. Consider racists
societies. It is implausible that the selection of fair-skinned
children in such societies would ever contribute to either a decrease
in wellbeing for fair-skinned selected children or a decrease in social
injustices against those with darker skin (Sparrow 2007).




In some cases, liberal eugenics proponents simply
bite the bullet and argue that social injustices should be addressed by
changing the social context rather than by constraining peoples'
reproductive choices (Savulescu 2001; Harris 2007; Savulescu and Kahane
2009). For them, prospective parents have a moral requirement to
create the best child even if doing so results in social
injustice. Savulescu and Kahane, for example, maintain that
restricting access to reprogenetic interventions regarding sex,
sexuality, or skin color, in order to ensure that unjust norms are not
promoted is not justified. Indeed, Savulescu explicitly maintains that
prospective parents have a moral obligation to select the best child,
even if doing so increases social injustices (Savulescu 2001). For
these proponents, society should address the unfair treatment of
various groups, but they believe it should not be done through
regulation of reproductive decision-making. Reproduction should not
become an instrument of social change, at least not mediated or
motivated at a social level.


### 3.3 The inconsistency problem




Recall that proponents of liberal eugenics argue
that insofar as the choice of whether and how to use reprogenetic
technologies is left up to individuals, these practices do not involve
the immoral characteristics of their historical predecessors. Critics
however have been highly skeptical that liberal eugenics proposals can
escape the charge of being problematically eugenic. For instance,
Bennett (2008) notes that an obligation to bring to birth the best
children possible can only be established by placing a lower moral
value on people with disabilities and that this obligation strongly
argues for the introduction of eugenic policies.




Koch (2011) highlights similarities to past
eugenic policies and accuses the central theorists of hubris - even
a "huckster's promise" (p. 199) - in presuming not only
that we will be able to engineer complex traits like intelligence, but
that they can know the appropriate regulatory limits and speak for all
parents. In fact, the title of one of Persson and Savulescu's
book - *Unfit for the Future* (2012) - combined
with its thesis regarding the need for tightened controls on liberal
societies to preserve human security, makes comparisons to eugenicists
ideas about unworthy lives unavoidable. (For a chilling review of
Persson and Savulescu's book, see Munsterhjelm 2011).




Buttressing these concerns, critics have also
called attention to other potentially troubling assumptions in the
theoretical framework of liberal eugenics that undermine claims about
the differences with the old eugenics. Bennett (2008), for instance,
contends that an appeal to impersonal or non-person-affecting harm
cannot get supporters of liberal eugenics out of the non-identity
problem without resorting to troubling social justifications. Insofar
as the liberal eugenic project is not interested in the welfare of
particular people but in producing what liberal eugenicists believe is
the best world possible, it is difficult to see the differences with
the old eugenics which aimed at promoting social and not personal
goods.




So, even though advocates of liberal eugenics
claim to value people equally (while acknowledging that their lives can
go better or worse), this does not square with the idea of some worlds
being *morally* preferable simply because they do not
contain people with even mild disabilities or other presumably
undesirable traits.




Similarly, Sparrow (2011a) points out the profound
tension between the consequentialist justifications favored by liberal
eugenics advocates and their assurances about the preservation of
reproductive liberties. For example, taking Savulescu to task, Sparrow
draws attention to the fact that in order to address concerns about
colluding with unjust social norms - which Savulescu does by
admitting that in certain cases parents ought not choose the
"best" child for their social environment, given sexism,
racism, etc. - Savulescu must revert to attending to social
consequences, rather than individual welfare. But, this would
commit proponents to sacrifice the well-being of individuals for the
sake of social goals (2011a: 35-36). At a minimum, this calls for
some justification about what social goods would trump the reproductive
choices of individual prospective parents and about who should be
making those decisions.




Sparrow also questions the justification for the
assumption that parents ought to have the best
child *they* could have. If we are morally obligated
to produce the best, and if any embryos we can produce are not likely
to rank very high relative to those of others, wouldn't there also be
an obligation to use a donated embryo (or a clone
of *the* embryo that is *the best*)
(Sparrow 2011a)? To be fair, Savulescu argues that other moral reasons
can trump prospective parents' moral obligations to choose the
best child, and some degree of reproductive autonomy will surely fit
there. Nonetheless, the tension between parental choices and
consequentialist demands is difficult to escape. Moreover, as Sparrow
points out, even if advocates of an obligation to enhance - like
Savulescu and Harris - deny any requirement for the government to
coerce individuals to participate in genetic interventions for the sake
of enhancement, governments might still be obligated to implement
policies that are not strictly coercive, e.g., systems of incentives
and targeted health campaigns. Doing so would be a form of
state-sponsored control - even if only through non-coercive
pressure - of reproduction, and thus much more like troubling
old-style eugenics.




Liberal eugenics proponents, particularly those
who argue for a moral obligation to use reprogenetic technologies to
improve our offspring, also have difficulties responding to concerns
about the ways in which societal norms can lead toward homogeneity,
even without state-sponsored programs. Parents who are free to choose
characteristics for their offspring may be inclined to choose
similarly, either because they agree (perhaps wrongly) that those
characteristics are better, or because they worry their child will be
at a substantial disadvantage relative to other children if they choose
what is unpopular (or simply fail to intervene to ensure what is
popular). If so, societal pressures on parental choices will have
effects similar to policies enforced by a state - homogeneity of
traits selected across the population (Duster 1990). 




Indeed, some liberal eugenics proponents, aware of
this concern, are willing to defend restrictions on parental
reproductive freedom (Agar 2004). But here again, such restrictions are
proposed in the name of ensuring a social good. Thus advocates of
liberal eugenics face a dilemma: if parents should be the ones
determining the future well-being of their children, then they will
likely choose in ways that a) some liberals find counter-intuitive,
i.e., choosing a Deaf child, and b) may, through market pressures and
social norms, lead to homogeneity from "tyranny of the
majority" (Sparrow 2011b: 515). If, on the other hand, parents
should not have this leeway, if some restrictions prevent them from
choosing in certain ways, then reproductive decisions about improving
our offspring fall in the hands of the state. While, as mentioned
earlier, most advocates of liberal eugenics express concern about the
problem of aggregate effects of individual choices, they often end up
seeming to dismiss them (Green 2007), presuming that education or other
modes of dealing with the problems will be sufficient (Savulescu 2001),
or just adding a qualification about the need to avoid reinforcing
unjust social norms (Agar 2004), without fully exploring the difficulty
of doing so.


### 3.4 Disability rights critiques




Common among liberal eugenic proponents is the
assumption that disability is a bad state. Selecting or editing against
disability is thus understood as what parents who care about their
children's wellbeing ought to do. In response, the disability
community has presented strong arguments against liberal eugenics. The
disability rights critique of the "new" eugenics takes on
current practices such as prenatal testing and PGT and selective
abortion or destruction of embryos, as well as options such as gene
editing.


#### 3.4.1 The expressivist argument




In what is known as the *expressivist
argument*, disability theorists have argued that screening
embryos or fetuses followed by destruction of the embryos or abortion
of fetuses sends a negative message - "It is better not to
exist than to have a disability" (Saxton 2000), "We do not
want any more like you" (Wendell 1996) - to existing people
with disabilities, particularly those living with disabilities for
which testing is routinely done. The negative message is harmful and
might be considered a form of discrimination.




The expressivist argument highlights the ways in
which prenatal testing feels threatening to people with disabilities
and their allies/advocates. As Parens and Asch point out,




If one thinks for even a moment about the history
of our society's treatment of people with disabilities, it is not
difficult to appreciate why people identified with the disability
rights movement might regard such testing as dangerous. ... living
with disabling traits need not be detrimental either to an individual's
prospects of leading a worthwhile life, or to the families in which
they grow up, or to society at large. (2000: 4).




The expressivist argument is often defended by
theorists who are staunchly pro-choice about abortion; they typically
defend a woman's legal right to choose abortion for any reason but
present a moral argument against particular reasons for selective
abortion. In making this distinction, they rely on the
"any/particular" distinction proposed by Asch (2000): a
woman who does not want *any* child because she is not
ready to be a mother is different from one who is eager to be a mother
but then rejects this particular fetus or embryo, based on screening. A
different version of the expressivist argument looks beyond the
individual act of testing to focus on the
social *offer* of prenatal testing, particularly in a
society where it has become routinized, to consider the negative
evaluation it expresses about the lives of existing people with
disabilities (Press 2000).




Objections have been raised regarding the meaning
of such "expressions" (see, for instance, Buchanan 1996;
Nelson 2000), and the necessity of the negative message (Baily 2000;
McMahan 2005), as well as the relative moral significance of the
message even if it is negative and expressed (Edwards 2004). Many
theorists emphasize that one can value the person with a disability,
while devaluing the disability (Savulescu 2001; Glover 2006; McMahan
2005). Glover (2006), for instance, is careful to note that we should
be very clear about expressing support for existing people with
disabilities even as we seek prenatal testing or other genetic
interventions.




Such distinction, however, can be difficult to
accept for individuals who experience their disability as a central
part of their identity (for discussion, see Wendell 1996; Saxton 2000;
Edwards 2004). Furthermore, as Holm (2007) notes, even if we could
conceptually separate prenatal testing from the disrespectful and
discriminatory messages about people with disabilities, that does not
mean they aren't deeply intertwined in current screening practices.




Some disability rights advocates reject the
expressivist argument and are more concerned with the fairness and
completeness of the information provided in the context of prenatal
testing than in the practice as a whole (Shakespeare 2006; Klein 2011;
Kaposy 2018). These advocates call attention to the attitudes,
practices, education, and research of professionals involved in
administering prenatal testing and the prejudices rampant in our
society against people with disabilities. They evince a disregard for
the experiences of disability as well as an ignorance of disability
issues. The biases against people with disabilities that underly
decisions about selective abortion threaten the wellbeing of those with
disabilities.




Kaposy's book, *Choosing Down
Syndrome*, for example, presents an extended argument for the
position that people with Down Syndrome can and often do have good
lives, full of the wide variety of joys and sorrows attendant to being
human. As he notes early on, the genetic realities (i.e., what is
available during prenatal testing) of Down Syndrome don't tell
the whole story.




He worries that expanded use of non-invasive first
trimester tests may ultimately increase the number of abortions of
fetuses with Trisomy 21 and with it, further threaten the wellbeing of
people with Down Syndrome. But rather than arguing that people should
*not* selectively abort fetuses with Trisomy 21, pro-choice
Kaposy argues for a more capacious understanding of how good life can
be and why *choosing* to continue pregnancy after such a
diagnosis is perfectly reasonable. Indeed, if more people chose to have
children with Down syndrome this would counter the prevalence of
harmful prejudices. His key concern is that much of the impetus to
abort following a prenatal diagnosis comes from misinformation, faulty
inferences, and biases that people might disavow if they were made
aware of them. He offers his book as a way to increase the
"social fund of knowledge."


#### 3.4.2 The meaning of disability




Part of what concerns disability rights advocates
is the questionable relation between the existence of certain
impairments or bodily anomalies and the availability of equality of
opportunity or well-being (Silvers, Wasserman, and Mahowald 1998;
Amundson 2005; Asch and Wasserman 2005) that seems to be a common
presumption in liberal eugenics theories. Broadly, they worry that many
of these theorists are relatively uninformed about the life experiences
of people with disabilities, or unfairly dismissive of their claims
(Amundson 2005; Goering 2008), and thus rely on an overly negative
evaluation of their quality of life. As such, efforts to promote
"good birth" often undervalue existing people with
disabilities. Additionally, advocates of liberal eugenics, it is
argued, allow one trait to stand in for all of what a potential person
can be (Asch and Wasserman 2005), and underestimate the value of human
diversity that includes non-standard modes of human functioning linked
to disability (Silvers 1998; Garland-Thomson 2012), and the possibility
of "gains" made possible through living with disability
(Baumrin and Murray 2014). (For more discussion, see entries on 
 disability: definitions and models; 
 and 
 feminist perspectives on disability.)




At least some liberal eugenic advocates are aware
of this concern and have explored the possibility that our current
social norms might be "morally defective" in respect to
disability. For instance, Glover defends the permissibility of parental
choice within some limits, but he investigates just what counts as a
disability. He proposes that a disability involves a functional
limitation that "impairs the capacity for human
flourishing" (2006: 9), either by itself or in conjunction with
social disadvantage. Thus, although racism results in social
disadvantage, having dark skin is not itself a disability, because it
has no associated functional limitation. Some conditions previously
considered disabilities - e.g., achondroplasia - need not be
disabilities at all, according to this view (for more on
achondroplasia, see Miller 2006; Davis 2010). Glover understands
"functional limitations" as a contrast to normal human
functioning, a species-based notion that itself involves significant
degrees of variation and the matter of setting (rather than
discovering) boundaries. As such, "normal" is not purely
statistical, but also partly normative (see also Buchanan et al. 2000).
Glover recognizes the conceptual messiness of "normal
functioning" but still prefers it to alternatives. If an
individual prefers a bodily state that might otherwise count as a
functional limitation (his example is Asperger's syndrome), then it
isn't a disability *for her* (2006: 14); it does not
affect her flourishing. He is much less sanguine about blindness and
deafness. Both conditions, he suggests, confer significant functional
limitations, and although they *can* certainly allow
individuals to have lives of great worth and flourishing - he
explores conflicting first-person accounts about going blind and
gaining sight to explore the positive sides of the conditions and the
negative side of normalizing (2006: 15-22) - he concludes
that they are nonetheless disabilities that confer clear disadvantages
(related to navigation, safety, etc.). As such, they are disabilities
that are understandably acceptable to some, but that ought not be
chosen for future children. Such future children, like their parents,
might be able to flourish with the condition, but engineering it means
intentionally impairing at least some capacities commonly relevant to
flourishing. Interestingly, Glover concludes that the Deaf lesbian
couple who sought a deaf sperm donor did nothing wrong in conceiving
their deaf child (the child cannot be harmed by his clearly worthwhile
existence), but he argues they would be wrong in not giving him a
cochlear implant *if* the technology were perfected
(2006: 26).




Glover's attention to the difficulty of defining
disability is helpful, and he emphasizes the importance of taking
seriously the perspectives of people who have lived with the
disabilities in question. But disability scholars push back on this
line of argument by noting the inherent presumptions about what
constitutes flourishing or well-being that underlie the view (Campbell
and Stramondo 2017; see also Schroeder 2018 who articulates a different
view about the relevance of well-being, but with similar practical
conclusions). For instance, what justifies the claim that living in
some disabled bodies is clearly disadvantageous, even if the individual
living that way understandably values her body, and not just as a
necessary reality but as a point of pride (Barnes 2016, esp. Ch 6)?
What epistemic grounds are there for the claim that such a person has
adapted - perhaps admirably, to a lesser condition - rather than
simply enjoys living one of a wide variety of good lives (Amundson
2005, Barnes 2016, Stramondo 2021)?




Further, some scholars argue that disability (and
also race) are not simple passive products of reproduction. They are
instead active technologies in reproduction. They are instruments
created and used in particular contexts and in the service of certain
goals and processes (Valentine 2021). Eugenics arguments often
naturalize race and disability as features of bodies, but these
categories can instead be understood as practices, relations, and forms
of social organization (Valentine 2021, Benjamin 2019). On this view,
the idea that disability just is a functional limitation with inherent
disadvantages - disadvantages that can be addressed through
reprogenetics interventions - ignores the fluidity of the
categories and the ways in which larger forces are at play, and it
thereby ignores social problems, and social, structural solutions
(Valentine 2021).


### 3.5 Undermining core values




Given the emphasis that liberal eugenics
proponents place on reproductive freedom, another concern raised by
critics is related to the possibility that the choices prospective
parents will make will undermine some central core of human nature or
of our normal human capacities. For some critics such as Kass (2003)
and Sandel (2007), the human disposition of hubris or mastery that the
project of genetic engineering expresses and promotes, undermines a
central aspect of humanity: our appreciation of the gifted character of
human life, the sense that the way we are is not solely the product of
our own doing. Similarly, Habermas (2003) contends that in transforming
reproduction from a natural process of creation to one of manufacture,
genetic engineering practices will fundamentally alter relationships in
the moral community as well as human freedom and autonomy.




Concern with the effects of reprogenetics on human
nature are also present in proponents of liberal eugenics. For
instance, Glover proposes two potential features of great value in our
current nature: our capacity to rein in our violent and destructive
tendencies, and our capacity to aim for a good life (for Glover, this
is about a balance between happiness and flourishing). These are very
tentatively offered, with many qualifications about possible linkages
to other traits of value, and the likelihood that we might be more
successful in securing containment through non-genetic means. Still,
the suggestion is that if parents might be tempted to select for
genetic markers linked to, for instance, extreme selfishness or
emotional coldness, in an attempt to have their child succeed in
gaining power and riches, doing so would seem to endanger parts of our
nature that we can widely agree are deeply valuable for society as a
whole.




Most advocates of liberal eugenics, however,
dismiss worries about effects on human nature. They contend that we
have likely unjustifiable intuitions that our present nature is worth
preserving (Buchanan 2011) or they argue that a main trait of human
nature is its changeability (Harris 2007). Other advocates claim that
we have a tendency to overvalue the "status quo" and this
leads us to see some core values, e.g. openness to the unbidden,
current longevity parameters, etc., as optimal when in fact we are
simply affected by status quo bias (Green 2007; Bostrom and Ord
2006).




Some critics (Sparrow 2012) have argued that
advocates of liberal eugenics face a problem if they reject the idea
that some conception of human nature or of normal human capacities
matters for debates about genetic improvement. They must accept that
parents' have reasons to choose some traits in spite of repugnant
consequences, or that parents' choices regarding some human
traits must take into account the interests of society. Others contend
that proponents of liberal eugenics simply fail to appreciate the
historicity of the human condition and view human beings as a
collection of parameters that can be optimized in isolation of each
other (Nordmann 2007).




Still other critics (Sandel 2007; Kass 2003)
highlight the ways in which the motivations for the genetic improvement
of our offspring express hubris, a "drive to mastery"
(Sandel 2007: 27) that, left unchecked, threatens not just human
nature, but the meaning of parent-child relationships, from openness to
the "unbidden" and unconditional love to design and
manufacture (Kass 2003); from loving whatever child comes along, to
loving a particular child because of chosen traits (Herissone-Kelly
2007).




Sandel recognizes that many parents already exert
excessive influence on their children's lives, and may fail to love
them unconditionally, but he worries that genetic technologies will
only exasperate that tendency. Even though we might undertake genetic
practices for the benefit of our offspring, in so doing, we make them
into creatures who must be indebted to us for their gifts, and for whom
our love may be conditional on fulfilling our desires. If a parent
designs a child to be a certain way, her investment will increase the
parent's demands. In a similar vein, Kass (2003) notes that
parental hopes will become parental expectations if we allow the
designing of children. The concern about parental expectations and how
choice might affect the unconditional love we envision for parents is
also explored by disability scholars (Kittay and Kittay 2000; Asch and
Wasserman 2005).




Proponents of liberal eugenics respond that much
of what we attempt to do in medicine to create treatments for disease
could itself fit under a "drive to mastery" and might
likewise question our commitment to being "open to the
unbidden" (see Buchanan 2011). Also, if the point is simply that
we must be attentive to our inclinations to hubris - we might get
carried away in thinking we can enhance appropriately - then we
could heed that warning without rejecting the use of genetic
technologies to improve our offspring entirely. Other advocates simply
deny the value of humility (Glover 2006: 113).




Kamm (2005) dismisses Sandel's worries about
mastery and openness to the unbidden but raises a different kind of
worry about the enhancement project, one related to concerns regarding
aggregate effects of individual choice. Her fear is that we may lack
imagination to see how a variety of traits (and different combinations
of traits) can create goods we have yet to envision or experience.
Parents who might wish to design their child to have the good trait of
composing classical music, for instance, would have been unable to
conceive that it would be good to have a child who turns out to be one
of the Beatles, at to have conceived it, would have involved creating
the style before the Beatles did.




Another worry linked to the desire for control
comes from Habermas (2003) who grounds his arguments in a deontological
framework. He argues that by engineering our children in very specific
ways - beyond the treatment of disease - we may undermine their
capacity for self-definition, their sense of being responsible for
themselves (in respect to creating their own identities), and their
freedom (2003: 12-13). He claims that it is not genetic
engineering *per se* that is the problem, but rather
the scope of its use as well as the attitude. In this case, the
wrong attitude is one that is not attentive to likely second person
consent to the changes - would the child have granted approval for
the selected traits? For Habermas, what matters is the attitude of
appreciating the need for the future person's presumed consent, rather
than the idea of making the change merely according to parental
preferences.




Further, he worries that parents who engineer
their children will have expectations of their children "without,
however, providing the addressee [the child] with an opportunity to
take a *revisionist* stand" (2003: 51). Why not?
The genetic program is a mute, and in a sense, unanswerable fact. This
is so because, unlike persons born naturally, someone who is at odds
with genetically fixed intentions is barred from developing, in the
course of a reflectively appropriated and deliberately continued life
history, an attitude toward her talents (and handicaps) which implies a
revised self-understanding and allows for
a *productive* response to the initial situation
(Habermas 2003: 62).




The basis for this claim seems to rest on a
distinction between "the grown and the made" (Habermas,
2003: 52). Being created to be a particular way is
being *made*, and so objectified, a product of the parents.
Being grown, by contrast, recognizes the individual subjectivity of the
new person, who is equal to her parents and not defined by them. This
objection shares much with Kass's (2003) concerns about genetic
despotism - control of one generation by the previous one.




Many liberal eugenics advocates (Glover 2006;
Green 2007; Buchanan 2011) are also dismissive of these concerns. For
them, it is unclear how genetic selection or editing is different from
other activities that presumably are also intended by parents to
"make" their children, such as registering them in school,
sports practice, or piano lessons with the aim of having children who
are likely to became academics, athletes, or musicians. Moreover,
liberal eugenics proponents contend that it is not clear either why the
genetically designed child could *not* be revisionist
in her response to her parents. Designing a child to have features that
make, for example, an athletic career possible (even likely) is not the
same as ensuring such a career, or even an athletic body. Parenting
would not lose its challenges simply because of the origins of the
features of the child in question.




However, critics contend that advocates of liberal
eugenics assume that there are no morally relevant differences in the
means parents take to try to shape their children. Such assumption
seems questionable. For instance, the longer iterative process of
educating a child enforces a kind of communicative engagement in ways
that cannot be part of engineering an embryo (Malmqvist 2011). Indeed,
arguably it is not just the means that are different (de
Melo-Martin 2018). The goals of engineering an embryo
-through selection or editing - and the goals of educating a
child -in various ways - are similar only in appearance.
While genetic selection or editing focuses on a particular trait, the
emphasis of education or training is the whole person, with attention
to the particular child's personality, even if the aspect of
interest -e.g., music or sport excellence - are the
characteristic that parents aim to inculcate in their children.