[Paleopsych] CSM: Eugenics stir emotions in Germany

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Eugenics stir emotions in Germany
http://www.csmonitor.com/2004/0722/p11s01-stgn.htm
from the July 22, 2004 edition -
[Thanks to Ole Peter for finding this article.]

        Discussion of any type of genetic engineering is particularly
                   sensitive given the country's Nazi past.

       By John Bohannon | Contributor to The Christian Science Monitor

      BERLIN - Because of its dark history in Germany, genetic tinkering
     with human reproduction is a matter of hot debate here - hotter than
           in any other country in Europe and, perhaps, the world.

         Lately, the temperature has jumped even higher, specifically
    concerning whether would-be parents should be allowed to use a medical
        procedure that, doctors say, eliminates the risk of hereditary
                   diseases being transmitted to offspring.

     The procedure, called pre-implantation genetic diagnostics (PGD), is
    forbidden in Germany but has been used in fertility clinics elsewhere
                         since its invention in 1989.

      The latest firestorm erupted last month at a Berlin conference on
    human reproduction, when researchers released a survey indicating that
          4 in 5 Germans approve of PGD to prevent genetic diseases.

     Charges of bias in the survey - and countercharges of thwarting the
     public's will - have been flying ever since. Feelings on the matter
    run so deeply that one politician, who defends the law that bans PGD,
     characterized the import of the debate this way: "If we break [this
                law], then we break the basis of our society."

      The technique in question, doctors say, can prevent diseases that
    otherwise persist in families for generations. Muscular dystrophy and
    cystic fibrosis, two terminal conditions for which medical science has
      not found a cure, are among the diseases that can be prevented via
                                PGD, they say.

    The doctor's role, something like that of a bouncer guarding a select
         nightclub, is to ensure that a fertilized egg containing the
            troublesome mutation never gains entrance to the womb.

     Though it takes the fun out of conception, the most efficient method
     is to collect eggs from the mother and inject each with a sperm cell
    from the father. After three days' growth, a fertilized embryo is big
     enough so that doctors can remove a single cell for analysis without
                           harming its development.

    At this point, doctors can test the cells to see which of the embryos,
      if any, has inherited the mutation. Embryos that test positive are
        discarded, and the rest are implanted in the womb. As with all
      in-vitro fertilizations involving multiple embryos, women are much
                    more likely to bear twins or triplets.

    But the likelihood of passing on the genetic disease, doctors say, is
                                 nearly zero.

    PGD has been illegal in Germany since 1990, when the German parliament
                      passed the Embryo Protection Law.

      "There was a feeling that such new technologies required a strong
    national law because of fears of eugenics," says Heribert Kentenich, a
              member of Germany's national Board of Physicians.

     Any manipulation of human embryos in Germany must pass a formidable
    legal gantlet, he says, "because a human embryo is considered a human
                     being, and so it has human dignity."

    The importance of protecting "human dignity" has been enshrined in the
            first paragraph of the German constitution since 1949.

     One reason for this, of course, is historical. During World War II,
    the medical establishment was a Nazi stronghold, overseeing the forced
      sterilization of thousands of German citizens, not to mention far
            worse experiments carried out in concentration camps.

    It's a history that has made Germany cautious about technologies that
                    have any potential for eugenic abuse.

       Emerging medical technologies, though, have made it increasingly
     difficult to decide what is and is not "human." While Germany holds
     PGD at arm's length, the rest of Europe, North America, and much of
                            Asia have embraced it.

     Consequently, German couples routinely travel abroad for "fertility
     tourism," visiting countries such as the Czech Republic where PGD is
                         inexpensive and unregulated.

     Dr. Kentenich is one who believes it's time to lift the ban, and he
          has been urging the government to reconsider its position.

     Last year he helped organize the first large-scale survey on public
      attitudes toward PGD - the very survey that touched off the recent
    furor when its results were unveiled here last month at the meeting of
          the European Society of Human Reproduction and Embryology.

         The findings seem to fly in the face of the consensus among
    politicians. A parliamentary commission reexamined the legality of PGD
      in 2002 - and unanimously decided to keep PGD strictly forbidden.

       Most politicians believed the public was behind them, says René
     Röspel, a parliament member from the ruling Social Democratic Party
                      (SPD) who chaired the commission.

       "The majority of the public who took part in the discussion were
    against PGD," says Mr. Röspel although he acknowledges that the group
            might not have been "representative" of German public.

       "I don't believe the results [of the new survey]," says Wolfgang
        Wodarg, another SPD member of the commission. "If you present
    questions in a certain way, you can make it seem Germans are in favor
             of the death penalty, which they certainly are not."

      Even if the survey is accurate, Röspel says it does not sway him.

     "I understand the desire of parents to prevent horrible diseases in
     their children," he says, but when it comes to deciding when PGD is
    permissible, "I do not believe it is possible to decide which diseases
                            are horrible enough."

    If PGD is allowed for one disease, "parents will say, 'But what about
         this disease?' And that's where the slippery slope begins."

       Mr. Wodarg, for his part, is already disturbed that many German
     clinics abort fetuses to prevent Down's syndrome and, in some cases,
                  harelip, which poses no threat to health.

     Adds Röspel: "Modern medicine allows people with handicaps to enjoy
           long lives, so manipulating genetics is not the answer."

     On the streets of Berlin, Germans voice a range of opinion - echoing
            the debate between fertility doctors and politicians.

    "You can't give parents these choices, because if it becomes possible
    they'll want to control children's features, even sexual orientation,"
                        says Sabine Künzel, a lawyer.

     At the other extreme, Oliver Redner, a high school physics teacher,
                            favors legalizing PGD.

         "Of course you need legal constraints, but I'm not afraid of
      eugenics," he says. "And if 80 percent of Germans really do agree,
         then the law should be changed. That's how democracy works.