HIST 460/560, Winter 2007
Reading and Discussion Questions, Week 5
Diane Paul, “Eugenic Origins of Medical Genetics”
1. What do you consider the major differences and similarities between
eugenics and genetic counseling? How does Paul describe the chronological
development and basic concerns of each in the U.S.? How did they overlap?
2. What impact did evolving technologies of prenatal testing for genetic
disease and deformity–such as amniocentesis–have? What about
the legalization of abortion?
3. Paul argues that eugenicists were more concerned with eliminating
mental than physical disabilities? Do you think that the movement toward
genetic counseling changed that emphasis or not?
4. When Paul suggests that the presumption of rational reproductive
decision-making is questionable, what does she mean? Are the would-be
parents who use genetic tests to select for deafness or dwarfism (described
in the article by Sanghavi) acting rationally?
5. Do you think that progress in genetic science and technology has
made all Americans into eugenicists? Has it increased the power that
women have over their fertility? Has it eliminated the need for eugenics?
6. In your view, is reproduction purely a private matter or does it
have social dimensions? If it is purely a private matter, what (if anything)
does that suggest about how individuals exercise reproductive freedom
in a market society with dramatic socio-economic disparities? If it has
social dimensions, what (if anything) does that suggest about the direction
of public policy related to fertility and family-making in a democratic
society that champions equality?
7. What do you think have been the fundamental principles governing
reproductive decision-making in modern U.S. history? What do you think
they should be?
8. “Reproductive choice and ‘public health’ models
of genetic services do not easily cohere.” (p 150) What does the
author mean by this?
Erik Parens and Adrienne Asch, “The Disability
Rights Critique of Prenatal Genetic Testing”
1. Why do the advocates of disability rights worry about prenatal genetic
2. The critique of prenatal genetic testing presented by Parens and
Asch included two components: 1) testing is morally problematic, and
2) testing is based on misinformation. Explain each.
3. How does this critique try to reconcile the principle of reproductive
freedom with the moral dilemmas associated with selective abortion?
4. What is the “expressivist argument” detailed on p. 13?
5. Do you think that the availability of prenatal genetic tests has
encouraged people to believe that they can control the “quality” of
the children they conceive? Is this good or bad for parents and children?
6. What is the commodification of children and why is that a problem?
7. How do you respond to the claim that disability is largely socially
structured, and that challenges for children and adults with disabilities
have more to do with the social organization of access and opportunity
than with the disabling traits themselves? Do you think that disability
can ever be “neutral”? What would it take to convince would-be
parents that having a child with a disability is no more difficult, on
balance, than having a child without one, or that the child will have
a life just as fulfilling and complete as his/her non-disabled peers?
8. What’s the difference between descriptive claims about normal
(and abnormal) traits and evaluative claims about persons?
9. Some people utilize prenatal genetic testing to select against disease
and disability. Others use prenatal genetic testing to select for desirable
traits. Do you feel differently about these? Would you govern them differently?
10. Parens and Asch conclude their article by defining people with disabilities
as the most recent group to join the civil rights revolution in the United
States. How are questions of prenatal genetic testing like and unlike
other civil rights claims?
11. After reading this article, what public policies or professional
practices related to prenatal genetic testing would you change?
Ann Baily, “Why I Had Amniocentesis”
1. Baily writes that her decision to have amniocentesis grew out of
her belief that “abortion is not morally problematic in itself.” What
does she mean?
2. How does Baily relate her own decision about amniocentesis to the “expressivist
argument” formulated by Parens and Asch? Why does Baily worry about
using the “expressivist argument” to criticize prenatal genetic