Modern Day Eugenics

Only eighteen babies with Down Syndrome were born in Denmark in 2019 [1]. Denmark provides all pregnant people access to non-invasive prenatal genetic testing during their first trimester to screen for genetic conditions. Because the screening is performed early in pregnancy, the results are actionable. Parents may choose to abort a fetus with a disability like Down Syndrome, and most of them do. The parents of babies born with Down Syndrome in Denmark generally declined prenatal screenings or received a false negative result; they did not know their baby had a disability before birth. It is rare for parents to choose to bring a child with a known disability into the world. Why? 
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Why does society teach us that disabled people live lower quality lives—that their existence is sad, pitiful, a charitable cause worthy of our spare change? Why do we think disabled lives are not worth living? Why do we think disability must be fixed and eliminated? 
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Our societal obsession with ability—physical and mental—helps us scratch the surface of these questions. In the United States and many other countries worldwide, we live in cultures that judge our worth by our productivity and accomplishments. When celebrated abilities mean everything, people with disabilities mean nothing. This is ableism—discrimination against disabled people. 
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As bioengineers, ableism is an evil we must learn to recognize in ourselves and our environments. It is too easy to get caught up in the narrative that disabilities need "fixing"—that we need to repair disabled bodies to make them walk or hear or see. We must question if the technologies we create—the exoskeletons, the prosthetics, the cochlear implants—help people or force them to conform to societal standards of normalcy [2]. We must remember that fixing disability eliminates disability, and that is exactly what eugenicists tried to do.

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The eugenics era of the nineteenth and twentieth centuries tried to prevent poor people, disabled people, Black people, immigrants, and other oppressed groups from existing. We have to ask ourselves: if parents choose to terminate Down Syndrome pregnancies, do prenatal genetic testing practices reach the same end by a different means? Do implants and robotics attempt to erase disability by restoring the functional abilities valued by society? Will gene-editing technology enable parents to deselect for disability in a new way? Bioengineers must keep these questions of social responsibility in the forefront of their minds. Bioengineers will design the healthcare of the future, and we must learn from the past to promote an inclusive future. 

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References

1. Mayor, Susan. “Denmark Halves Down's Births by Non-Invasive Screening in Early Pregnancy.” British Medical Journal, vol. 334, no. 7607, British Medical Association, 2007, pp. 1291–1291, https://doi.org/10.1136/bmj.39251.369815.DB.

2. Brashear, Regan Pretlow, et al. Fixed : The Science/Fiction of Human Enhancement. New Day Films, 2013.