This month is the 98th anniversary of Buck v. Bell – the infamous case upholding Virginia’s involuntary sterilization law. The case arose from the flawed finding that a young woman named Carrie Buck was an ”imbecile .”Based on the “science” of eugenics and the belief that intelligence was heredity, the court ruled that its desire to preserve society’s genetic “destiny” was not a violation of due process.
“Three generations of imbeciles are enough.” - Justice Oliver Wendell Holmes
While later decisions have attenuated the force of Buck v Bell, technically, the case remains good law and has never been overturned. Pejorative labels, e.g., “imbeciles,” were routinely appended to sexually loose women and had nothing to do with their intellectual capacity. That Carrie had been raped was of no consequence. Her lawyer, a shill for the Eugenics movement, did not contest her diagnosis, leading Justice Holmes to the infamous holding validating the Virginia Sterilization Law.
Controlling our genetic destiny has long been a hankering of the “educated” class since Darwinian evolution caught the fancy of the elite. The term eugenics was coined by Darwin’s cousin, Francis Galton, in 1883 – and became a movement subscribed to by the ostensibly enlightened.
“Many intellectuals and political leaders (e.g., Alexander Graham Bell, Winston Churchill, John Maynard Keynes, and Woodrow Wilson) accepted the notion that modern societies, as a matter of policy, should promote the improvement of the human race through various forms of governmental intervention. While initially this desire was manifested as the promotion of selective breeding, it ultimately contributed to the intellectual underpinnings of state-sponsored discrimination, forced sterilization, and genocide.” [1]
By the 1920s, an organized eugenics movement took root in America, bolstering the beginnings of the nascent Nazi movement. Mainstream members of the American medical community joined the bandwagon. One notable proponent, Dr. Oliver Wendell Holmes, Sr., the Dean of Harvard Medical School and Justice Holmes Jr’s father, was noted for his misogynistic efforts to stymy the early women’s medical movement and his dismissal of the first three black medical students from Harvard Medical School. Dr. Holmes’ views might have gotten lost to the obscurity of science history but for the infamous decision in Buck v. Bell by his son.
Falsely labeling Carrie, her mother, and her daughter as “imbeciles” was certainly defamatory, but the most serious aspect of the case to me is that the basis of the holding was the unsubstantiated and unproven conviction that their intelligence was hereditary.
“Genetics was corrupted in the 1920s by the confusion of folk knowledge with scientific inference….. The fairly obvious lesson to be learned is that where science appears to validate folk beliefs, it needs to be subjected to considerably higher standards of scrutiny than ordinary science.”
By 1925 a rising movement coalesced countering the Eugenics movement, “pointing out that despite all their exhaustive family pedigrees, they failed to really understand the nature of the trait they thought they were studying – the hereditary status of ostensibly low intelligence.” When Buck was decided in 1927 that should have been known and considered, at any rate, by 1935, the tide had turned – and funding for Eugenics dried up.
A science by any other name
Recent advances in reproductive technology, including advances in germline genetic modification via CRISPR, may re-introduce the eugenics envisioned in yesteryear. We now have two methods of designing permanently, i.e., hereditarily configured humans. One involves selection of the “favored” or “prime” embryo(s) for implantation from among the many produced by IVF. The second involves germline genetic engineering via DNA manipulation using CRISPR and its progeny. Each approach has heritable effects – with yet unknown consequences, which, at least for now, are not reversible.
There are several differences between the two approaches. Polygenic scoring (PGS) [2] is available for parents utilizing IVF, a commercial enterprise that enjoys little governmental regulation or oversight. Initially, the process was used to select the embryo with the greatest chance of surviving implantation and gestation, then expanded to deselect embryos with genetically driven diseases. But now, theoretically, these polygenic risk scores can be used to select embryos presenting the greatest chance of fulfilling parental dreams– offspring genetically destined to be the most beautiful, the brainiest, or the brawniest. Some companies have already advertised various commodities for intelligence, and the capacity to select a brawny or beauty is not far off. These corporate promises are far from assurances, as even selecting the healthiest child only forecasts likely levels of risk for diseases whose phenotypic manifestation often depends on environmental and extragenetic factors. But fool’s gold or genetic folly still has followers.
I’ve written about the dangers of allowing parents to select children with preferred traits, the harbinger of the classed children of Brave New World Fame, using this algorithmic approach, along with the ethics and legalities.
Even bioethicist Julien Savelescu, who once asserted it was a parental duty to select the “best” child, creating the duty of procreative beneficence, has backtracked, in no small measure, because IVF itself presents dangers, both to mother and embryo. He now believes that only parents requiring IVF to enable childbearing can engage in the “design a kid” scenario.
The flaws of selecting for the “best” (or healthiest) child have a downside: deselecting some of our greatest minds from being born. Imagine a world without Stephen Hawkings, the cosmologist who suffered motor neuron disease (MND), or Paul Dirac, who unified quantum physics and discovered anti-matter and philosopher Derrick Parfit, felt to be on the autism spectrum, to name a few.
The second approach to creating the “perfect” child – is more tailored to specific or isolated characteristics. This can be accomplished using CRISPR by modifying the germline genetics of specific traits, thereby ensuring that these traits are inherited by the progeny of the genetically enhanced, a feat already achieved by the notorious He Jiankui. [3] As with PGS, we cannot be certain of off-site or multiple effects of tinkering with a specific gene. Shutting off a seemingly deleterious gene might deprive the child of beneficial effects that the same gene confers, a phenomenon known as antagonistic pleiotropy.
Another devastating consequence of genotypic selection to achieve the traits society favors is diminishing the genetic diversity necessary for a species to survive. Currently, effective policing gene-wide analysis to prevent this practice doesn’t exist – perhaps to individual satisfaction, but to society’s detriment.
Echoes of Eden: The Genomically Engineered Human
CRISPR and related DNA-editing tools may be less hazardous than PGS, as only one gene is manipulated at a time; however, that gene will be altered permanently, along with any off-target effects it confers, with currently no mechanism to reverse it.
Luckily, scientific CRISPR societies are policing themselves.
“Leading trade organizations representing the makers of cell and gene therapies are calling for a 10-year international moratorium on the use of CRISPR and other DNA-editing tools to create genetically modified children”. - STAT
The message being sent is that alterations of egg, sperm, or embryo genomes are simply unacceptable in the mainstream scientific community. The International Society has advanced unequivocal guidelines for Cell & Gene Therapy, the American Society for Gene & Cell Therapy, and the Alliance for Regenerative Medicine. The declaration outlines scientific shortcomings, including safety concerns and the unclear medical need, both now and in the foreseeable future. It includes a moratorium – meaning an outright ban for a decade, joining previously articulated positions of the NIH.
Although there is no legal or regulatory force attached to the statement, it serves as a statutory basis for launching a negligence suit if something goes wrong, and it surely serves as a “shaming” mechanism that impacts funding. Additionally, 106 countries have various forms of declarations that forbid or curtail germ-line modifications, although eleven countries permit research.
We’re not far away from the societies depicted by Gattaca or Brave New World. Vigilance and humility should be the order of the day. Just imagine if Buck v. Bell ordered the sterilization of the two generations of schizophrenics, Nobel Laureate John Nash and his son (who went on to earn a PhD in mathematics).
[1] U.S. Scientists' Role in the Eugenics Movement (1907–1939): A Contemporary Biologist's Perspective Zebrafish. DOI: 10.1089/zeb.2008.0576
[2] A polygenic risk score (PGS) tallies the estimated effects for certain traits based on a gene-wide assessment. The PGS, also known as the polygenic index or genome-wide score, is used to predict the phenotypic (or observable) result of genetic expression.
[3] He Jiankui is the Chinese scientist who genetically engineered two children (twins) to delete the gene for HIV, receiving international condemnation and a three-year prison sentence. He is currently back in the lab, continuing genetic experiments.
