Caring for people with disability and human growth: evolutionary perspectives and contribution to psychological wellbeing.

From an evolutionary point of view, organisms with mutations resulting in maladaptation are an unavoidable result of genetic variability, and they do not usually survive natural selection. Thus, they do not produce benefits for the species. I contend that this is different in humans at two levels. First, the existence of people with disability has been essential for human growth as a species. Human ancestors' evolving cognitive and social abilities were boosted by caring for vulnerable members of the species, including premature offspring and people with disability. Therefore, caregiving was an essential trait of the evolution of humans, intertwined with the development of bipedalism, the hand, face, vocal apparatus, and brain. Second, caring for disability is also a source of growth at a personal level. Even though most scientific literature focuses on the stress and burden caused by caring for people with disability, there is solid evidence to accept caregiving as a source of happiness and flourishing for human beings. Hence, disability still has an essential role in improving human life nowadays. Contrary to this evidence, influential utilitarian bioethicists promote the elimination of disability from modern societies. Following the arguments presented here, this will lead to the withering of society. In conclusion, disability should be acknowledged as an essential source of growth for the human species.

The Wrong of Eugenic Sterilization.

I defend a novel account of the wrong of subjecting people to non-consensual sterilization (NCS), particularly in the context of the state-sponsored eugenics programmes once prevalent in the United States. What makes the eugenicist practice of NCS distinctively wrong, I claim, is its dehumanizing core: the fact that it is tantamount to treating people as nonhuman animals, thereby expressing the degrading social meaning that they have the value of animals. The practice of NCS is prima facie seriously wrong partly, but crucially, on these grounds. I consider and reject accounts of the wrong of NCS that make no reference to its animalizing character, such as that it violates victims' (procreative) autonomy, amounts to treating them merely as a means, inflicts psychological harm on them, or constitutes an affront to their human dignity. My discussion suggests that the critical vocabulary of bioethics should be expanded beyond talk of rights violations, benefits and harms, and equal treatment-and that the language of dehumanization is indispensable to bioethicists.

Antisemitism and Dermatology in Nazi Germany and Beyond.

Antisemitism, the hatred of or prejudice against Jews, was a core component of the Nazi regime's ideology. We review the chronology of events against the Jews and Jewish physicians in Germany and their conquered territories from 1933 to 1945. The complicit role that German physicians played in these events and the devastating impact on Jewish dermatologists and our specialty will be recounted. Finally, we will address the antisemitism in the United States during that same approximate period and now.

Policy and laboratory practice: How quality control procedures for genetic testing perpetuate biological essentialism and discrimination against transgender, gender diverse, and intersex people.

Transgender, gender diverse, and intersex (TGDI) individuals face significant health disparities due to individual and systemic experiences of discrimination, impacting their access to healthcare. While clinical genetic testing has become increasingly accessible to the general population, the field of clinical genetics perpetuates a narrative of biological essentialism, which creates barriers for TGDI patients. Biological essentialism upholds that sex is a binary, fixed, and innate characteristic, a misconception that has been historically weaponized against the TGDI community in both individual experiences of discrimination and anti-trans legislation, among other systemic forms of oppression. Rejecting this discriminatory framework requires careful consideration of, and changes to, long-established practices that often go unquestioned, such as quality control metrics in genetic testing, in order to improve TGDI patients' outcomes and access to genetic services. The sex-check, comparing an individuals reported sex against their sex chromosomes, is an example of how laboratory genetics practices reinforce the narrative that sex is determined purely by chromosomal composition. Additionally, the sex-check "outs" TGDI people in clinical settings, creating a discriminatory and unsafe environment for these patients. Alternative quality control procedures and inclusive practices, such as clearer delineation of sex and gender on test requisition forms, are proposed to improve TGDI patient experiences. Genetic counselors and other clinical providers have a responsibility to address historical discrimination and advocate for changes to laboratory practice, so as to create affirming experiences for TGDI patients.

History of Eugenics in Otorhinolaryngology: Ernst Rüdin and the International Eugenics Network.

Introduction The early geneticist and psychiatrist Ernst Rüdin (1874-1952) became one of the key figures in the eugenics movement and in the German health system of the Nazi era. His connections in the international eugenics network have played an important role in the history of eugenics. Objective To discuss the connections between Ernst Rüdin's scientific group in Munich and Otmar von Verschuer's group in Frankfurt during the Nazi era. Methods Otorhinolaryngological materials from Ernst Rüdin's former private library are presented, and they show Rüdin's deep involvement in the international eugenics network. These materials provide insights into early medical genetics in otorhinolaryngology. Results One result of the present study is that eugenics groups from Munich, Frankfurt, and New York certainly influenced one another in the field of otorhinolaryngology. Karlheinz Idelberger and Josef Mengele were two scientists who performed hereditary research on orofacial clefts. Later, Mengele became deeply involved in Nazi medical crimes. His former work on orofacial clefts clearly had, to some extent, an influence on subsequent studies. Conclusion An international eugenics network already existed before 1933. However, it becomes clear that the weaknesses of many early genetic studies did not enable its authors to draw firm scientific conclusions, suggesting that scientists lacked an accurate concept of the genetic causes of most illnesses.

Views of Genetic Testing for Autism Among Autism Self-Advocates: A Qualitative Study.

BACKGROUND: Autism self-advocates' views regarding genetic tests for autism are important, but critical questions about their perspectives arise. METHODS: We interviewed 11 autism self-advocates, recruited through autism self-advocacy websites, for 1 h each. RESULTS: Interviewees viewed genetic testing and its potential pros and cons through the lens of their own indiviudal perceived challenges, needs and struggles, especially concerning stigma and discrimination, lack of accommodations and misunderstandings from society about autism, their particular needs for services, and being blamed by others and by themselves for autistic traits. Their views of genetic testing tended not to be binary, but rather depended on how the genetic test results would be used. Interviewees perceived pros of genetic testing both in general and with regard to themselves (e.g., by providing "scientific proof" of autism as a diagnosis and possibly increasing availability of services). But they also perceived disadvantages and limitations of testing (e.g., possible eugenic applications). Participants distinguished between what they felt would be best for themselves and for the autistic community as a whole. When asked if they would undergo testing for themselves, if offered, interviewees added several considerations (e.g., undergoing testing because they support science in general). Interviewees were divided whether a genetic diagnosis would or should reduce self-blame, and several were wary of testing unless treatment, prevention or societal attitudes changed. Weighing these competing pros and cons could be difficult. CONCLUSIONS: This study, the first to use in-depth qualitative interviews to assess views of autism self-advocates regarding genetic testing, highlights key complexities. Respondents felt that such testing is neither wholly good or bad in itself, but rather may be acceptable depending on how it is used, and should be employed in beneficial, not harmful ways. These findings have important implications for practice, education of multiple stakeholders, research, and policy.

Thorny entanglements: feminism, eugenics and the Abortion Law Reform Association's (ALRA) campaign for safe, accessible abortion in Britain, 1936-1967.

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women's social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists' campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act's eugenics clause, sometimes verbatim. This essay analyses ALRA's role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to 'voluntary motherhood' in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities.

Revisiting Emil Kraepelin's eugenic arguments.

It is widely recognized that Emil Kraepelin explicitly advocated for eugenic ideas in his academic works. Given the renewed interest in related concepts such as self-domestication and neo-Lamarckism in different contexts, this article revisits his eugenic arguments by scrutinizing a section of his seminal work, the 8th edition of his textbook published in 1909. Our analysis reveals that Kraepelin's arguments consisted of multiple theories and ideas prevalent at the time (i.e. self-domestication hypothesis, neo-Lamarckism, degeneration theory, social Darwinism, racism and ethnic nationalism), each of which presented individual fundamental claims. Nevertheless, Kraepelin amalgamated them into one combined narrative, which crystallized into an anti-humanistic psychiatry in the next generation. This paper cautions that a similar 'packaging of ideas' might be emerging now.

"At a Glance:" The Role of Diagrammatic Representations in Eugenics Appropriations of the "Infamous Juke Family".

The case of the Juke family is one of the most notable episodes of the history of eugenics in the USA. The Jukes were initially brought to the fore in the 1870s by a famous investigation that aimed at estimating the interplay of heredity and environment in determining the problems of poverty and crime. This inquiry triggered a harsh confrontation between two polar interpretations of the study, an "environmentalist" one and a "hereditarian" one. It was with the later reassessment of the case made by the Eugenics American Office (ERO) in the 1910s that the controversy was considered closed with the victory of the eugenicists' hereditarian stance. As a result, the family was made a living proof of the alleged hereditary nature of crime and pauperism and a case study in support of the eugenicists' plea for the sterilization of people deemed the bearers of hereditary defectiveness. In this article, I explore the role played by pedigrees and other diagrammatic representations in the eugenicists' appropriation of the meaning of the case of the Juke family and the role played by this appropriation in asserting the superiority of the ERO's method of work over rival approaches.

Our values and our historical understanding of psychiatrists.

Many people like to perceive themselves as better than previous generations: more knowledgeable, moral, tolerant and humane. Values associated with these aspects of ourselves may affect how we understand our professional forebears. In the early 20th century, some psychiatrists adopted new biomedical theories, including focal sepsis and eugenics, which resulted in inestimable harm. Detrimental clinical practices arose and were perpetuated in the context of societal values, medical ethics and other forces within and outside the medical profession. Historical understanding of the processes by which these things took place may help inform debate concerning current and future challenges of providing psychiatric care. The methods by which psychiatrists consider their predecessors may also have a bearing on how psychiatrists of the future will perceive us, the psychiatrists of the 2020s.

Em benefício dos filhos de amanhã: participação feminina na eugenia brasileira, 1918-1936 / To benefit tomorrow's children: female participation in Brazilian eugenics, 1918-1936

Resumo O texto analisa a participação feminina na eugenia brasileira e os discursos médicos acerca dos papéis e funções sociais dos sexos na primeira metade do século XX. A partir da análise da produção de duas mulheres, Ítala Silva de Oliveira e Eunice Penna Kehl, o objetivo principal é argumentar que determinadas mulheres se engajaram efetivamente no movimento eugênico, trabalhando em prol da aproximação feminina com a eugenia. Tal análise permite explorar uma dimensão pedagógica e de popularização da eugenia por meio da tentativa de formação de uma consciência higiênica e eugênica nas mulheres.

Abstract This text analyzes female participation in Brazilian eugenics and medical discourse on the roles and social functions of the sexes during the first half of the twentieth century. In examining the production of two women, Ítala Silva de Oliveira and Eunice Penna Kehl, we maintain that certain women were effectively engaged in the eugenics movement and worked to bring women closer to eugenics. This analysis makes it possible to explore a pedagogical dimension of eugenics and of the popularization of this movement by attempting to form a hygienist and eugenist consciousness among women.

History of Eugenics in Otorhinolaryngology: Ernst Rüdin and the International Eugenics Network

Abstract Introduction The early geneticist and psychiatrist Ernst Rüdin (1874-1952) became one of the key figures in the eugenics movement and in the German health system of the Nazi era. His connections in the international eugenics network have played an important role in the history of eugenics. Objective To discuss the connections between Ernst Rüdin's scientific group in Munich and Otmar von Verschuer's group in Frankfurt during the Nazi era. Methods Otorhinolaryngological materials from Ernst Rüdin's former private library are presented, and they show Rüdin's deep involvement in the international eugenics network. These materials provide insights into early medical genetics in otorhinolaryngology. Results One result of the present study is that eugenics groups from Munich, Frankfurt, and New York certainly influenced one another in the field of otorhinolaryngology. Karlheinz Idelberger and Josef Mengele were two scientists who performed hereditary research on orofacial clefts. Later, Mengele became deeply involved in Nazi medical crimes. His former work on orofacial clefts clearly had, to some extent, an influence on subsequent studies. Conclusion An international eugenics network already existed before 1933. However, it becomes clear that the weaknesses of many early genetic studies did not enable its authors to draw firm scientific conclusions, suggesting that scientists lacked an accurate concept of the genetic causes of most illnesses.

"A Vigorous Campaign against Abortion": Views of American Leaders of Eugenics v. Supreme Court Distortions.

The Supreme Court decided Box v. Planned Parenthood of Indiana and Kentucky in 2019. Justice Clarence Thomas's opinion in the case claimed there was a direct connection between the legalization of abortion, in the late 20th Century, and the beginnings of the birth control movement a full three quarters of a century earlier. "Many eugenicists," Thomas argued, "supported legalizing abortion."Justice Samuel Alito highlighted similar claims in Dobbs v. Jackson Women's Health, citing a brief entitled "The Eugenic Era Lives on through the Abortion Movement." That brief was an echo of Justice Thomas' misguided attempt at history in the Box opinion. Similar claims reoccur in Judge Matthew Kacsmaryk's opinion in the Texas mifepristone case, Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration.These false claims are the focus of this article. There is no evidence that early leaders of the eugenics movement supported abortion as part of the movement for birth control. It is accurate to describe those leaders as anti-abortion, and their followers as people who condemned abortion for moral, legal, and medical reasons.

'Dysgenic fertility' is an ideological, not a scientific, concept. A Comment on: 'Stability and change in male fertility patterns by cognitive ability across 32 birth cohorts' (2023), by Bratsberg & Rogeberg.

Recently Bratsberg & Rogeberg (2023) presented an analysis in Biology Letters of how cognitive ability is associated with fertility in Norwegian men. Our concern relates to the theoretical framework of this paper. The analysis is framed around the concept of 'dysgenic fertility', which is treated throughout as a scientific theory, but 'dysgenic fertility' is not science, it is an ideological concept.

Toward depathologizing queerness: An analysis of queer oppression in clinical genetics.

Critically examining the way that the field of clinical genetics has impacted queer communities offers the field an opportunity to strengthen our commitment to inclusive high-quality care to all patients, families, and communities. This article reviews the origins of clinical genetics and genetic counseling in the eugenics movement and how this ontology promoted harmful medical practices grounded in assumptions of what is "normal." We critically examine existing clinical genetics practices and how commonly used binary frameworks for gender, sex, and sexuality perpetuate heteronormative, cisnormative, and bioessentialist assumptions. In order to move toward queer inclusivity, the genetic counseling field must first take accountability for past injustices. Restorative justice and trauma-informed approaches offer a way to engage with the queer community and to begin to rectify the history of medical harm. Through our analysis, we advocate for expanding efforts to depathologize queerness, promote bodily autonomy, and provide equitable healthcare for the queer community.

"Not by a Decree of Fate:" Ellen Richards, Euthenics, and the Environment in the Progressive Era.

In 1904, Ellen Richards introduced "euthenics." By 1912, Lewellys Barker, director of medicine and physician-in-chief at Johns Hopkins Hospital, would tell the New York Times that the "task of eugenics" and the "task of euthenics" was the "Task for the Nation." Alongside the emergence of hereditarian eugenics, where fate was firmly rooted in heredity, this article places euthenics into the same Progressive Era demands for the scientific management over environmental issues like life and labor, health and hygiene, sewage and sanitation. I argue that euthenics not only heralded women as leaders in the quest for what Richards and eugenicists termed "racial improvement," but also aimed to make reforms through environmental and educational changes rather than hereditary interventions. Seeking to recuperate the figure of Ellen Richards in the history of science, I place Richards and her euthenics more into the debate over eugenics rather than over the emergence of home economics. Building on the work of Donald Opitz, Staffan Bergwik, and Brigette Van Tiggelen, this article shows, first, how Richards' career threads the needle between the home and the laboratory as sites of science making, not as separate spheres but as overlapping realms, and helps recover how domestic concerns shaped the focus of the life sciences. Second, this article shows how euthenics shaped eugenics by looking at the writings of American eugenicists Charles Davenport, Paul Popenoe, and David Starr Jordan. Third, the article describes how euthenics took root in new academic departments of domestic science, home economics, and departments child welfare and family life in the 1920 and 1930s, most notably the department of euthenics at the Kansas State Agricultural College from 1926 and the Institute of Euthenics at Vassar College after 1923.

Addressing the paradox: Health expansion threatening sustainable healthcare.

We need to address the paradox that health expansion threatens sustainable healthcare as anti-aging drugs are on the trail from trial to the market and come together with health enhancement measures changing demography and the health of populations. This poses global, social, and professional problems, and challenges clinical medicine as well as health policy. To handle the emerging challenges, we need to address four crucial issues: (1) injustice (access), (2) sustainability, (3) basic human rights, and (4) eugenics. To do so we need to differentiate between health improvements and health enhancements and reinforce medicine's strongest moral appeal: to reduce suffering.

Guerrilla eugenics: gene drives in heritable human genome editing.

CRISPR-Cas9 genome editing can and has altered human genomes, bringing bioethical debates about this capability to the forefront of philosophical and policy considerations. Here, I consider the underexplored implications of CRISPR-Cas9 gene drives for heritable human genome editing. Modification gene drives applied to heritable human genome editing would introduce a novel form of involuntary eugenic practice that I term guerrilla eugenics. Once introduced into a genome, stealth genetic editing by a gene drive genetic element would occur each subsequent generation irrespective of whether reproductive partners consent to it and irrespective of whether the genetic change confers any benefit. By overriding the ability to 'opt in' to genome editing, gene drives compromise the autonomy of carrier individuals and their reproductive partners to choose to use or avoid genome editing and impose additional burdens on those who hope to 'opt out' of further genome editing. High incidence of an initially rare gene drive in small human communities could occur within 200 years, with evolutionary fixation globally in a timeframe that is thousands of times sooner than achievable by non-drive germline editing. Following any introduction of heritable gene drives into human genomes, practices intended for surveillance or reversal also create fundamental ethical problems. Current policy guidelines do not comment explicitly on gene drives in humans. These considerations motivate an explicit moratorium as being warranted on gene drive development in heritable human genome editing.

Evolved Eugenics and Reinforcement of "Othering": Renewed Ethico-Legal Perspectives of Genome Editing in Reproduction.

This article extends an exploration into renewed ethico-legal perspectives of genome editing technologies, examined from an evolved conceptualization of eugenics in contemporary human reproduction. Whilst the ethico-legal conundrums presented by genome-editing technologies in various aspects of modern medicine have thus far inspired a comprehensive trove of academic scholarship-and notwithstanding the World Health Organization's (WHO) publication of guidelines on human genome editing in 2021-the legislative landscape for these technologies remain relatively unchanged. Accordingly, this paper presents the unresolved problematic questions that still require significant reflection. First, the paper highlights these questions, which primarily center around the tension between reproductive autonomy and the legal governance of reproductive/genome editing technologies by a democratic state. Secondly, the paper interrogates the evolved conceptualization of eugenics, exercised on the part of prospective parents as part of reproductive autonomy. By this, the paper predicates that it indirectly reinforces societal and systemic problems of discrimination and "othering", increasing reproductive inequalities in excluded communities. Thirdly, the paper attempts to offer narratives of intersectionality as a facilitating tool in a continuing dialogue to build belonging, foster a healthy and balanced exercise of reproductive autonomy, and increase reproductive equalities.

Nursing and eugenics in the early 20th century United States.

BACKGROUND: Research has documented how ideas about race, class, ethnicity, ableism, and structural hierarchies determine health outcomes and disparities today. The historical role of nursing practice and education needs further exploration. PURPOSE: This study aims to better understand how some nurses thought about and interacted with eugenics in the early 20th century. METHODS: Historical analysis of primary and secondary sources. DISCUSSION: In the early 20th century, reformers of the day, including some nurses, demonstrated much ambiguity of thinking as they pushed for eugenic improvement of the "human race" while also enhancing environmental changes, such as good nutrition and clean, safe housing. CONCLUSION: Nursing's past relationship with eugenics sheds light on the history and construction of the system leading to health disparities among marginalized groups. Nurses must acknowledge the historical roots and context of their education and practice as we engage in critical conversations about social inequities.