Haddow, Gill

English

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     Edinburgh Research Explorer                                      Heredity and Hope: The Case for Genetic Screening.Citation for published version:Haddow, G 2010, 'Heredity and Hope: The Case for Genetic Screening.' Technology and culture, vol 51, no.2, pp. 532-533., 10.1353/tech.0.0443Digital Object Identifier (DOI):10.1353/tech.0.0443Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher final version (usually the publisher pdf)Published In:Technology and culturePublisher Rights Statement:Copyright © 2010 Johns Hopkins University Press. This article first appeared in Technology and culture, 51:2(2010), 532-533. Reprinted with permission by Johns Hopkins University Press.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 20. Feb. 2015T E C H N O L O G Y A N D C U L T U R EAPRIL2010VOL. 51532Heredity and Hope: The Case for Genetic Screening.By Ruth Schwartz Cowan. Cambridge, Mass.: Harvard University Press, 2008.Pp. 292. $27.95.Since Crick and Watson discovered the DNA sequence in 1953 the geneticenterprise has gained increasing momentum to include the mapping of anindividual’s entire genome and the construction of entire populations’ ge-netic data collections. The hope is that overall human mortality and mor-bidity can be improved by unlocking the secrets of our genetic codes, whichcontribute to the health that we and our kin enjoy. By understanding themechanisms and determinants of genetic inheritance, one can predict thepredilection of an individual or a group to inherit diseases that have a genet-ic component. Essentially, this is a rationale for genetic screening and test-ing. Screen-ing is more often directed at the population level and may in-clude carrier and adult screening, whereas genetic testing refers to a host oftechniques focused more on the individual level such as prenatal diagnosisand newborn screening, but the terms are often used interchangeably.Genetics both as a scientific technology and a medical system is thoughtby some to have a dark past, a history associated with eugenics (ironicallymeaning “the beautiful inheritance”), whose early proponents hoped to“improve the race” through ethically dubious practices such as involuntarysterilization and restrictions on reproduction. Yet Ruth Schwartz Cowan inher book Heredity and Hope persuasively argues that one should not make a“genealogical fallacy” by confusing the motives of the founding fathers ofmedical genetics with the motives of the early eugenicists. The former hadmotives that were applaudable—to alleviate human suffering; the motives ofthe latter were condemnable because they sought to elevate certain subsec-tions of the human race over others.Hence, Cowan asks opponents of today’sgenetic screening not to make the mistake of assuming that the genetic tech-niques and procedures now offered to pregnant women are an extension ofthe eugenics movement as was practiced in the early twentieth century.Heredity and Hope is separated into several parts. Cowan begins in theearly twentieth century with a detailed account of the eugenics movementin the United States, Germany, and Scandinavia, where eugenicists hadsome influence on public policy. Then she outlines how the eugenics move-ment related to medical geneticists working at the same time, before mov-ing on to discuss the history of prenatal diagnosis and adult screening,focusing on specific conditions that were developed after the 1960s: new-born screening for phenylketonuria (PKU), fetal testing for Tay-Sachs dis-ease, carrier screening for sickle-cell anemia, and finally mandated adultscreening for thalassemia in Cyprus.The detail of Cowan’s analysis and historical exposition is second tonone, and rarely is such a heated and controversial topic dealt with in such16_51.2bkrevs 490–542:12_50.1bkrevs 202–  4/15/10  4:34 PM  Page 532B O O K R E V I E W S533a clear and forthright way. Although I was a little unsure about why Cowanfocused on these disorders in particular, I take the point that Tay-Sachsscreening was successful because it was supported at the grassroots, whereassickle-cell anemia screening failed because of opposition from the blackcommunity. This led me to wonder if there was a further point about pub-lic support and opposition for genetic screening that was being made. Per-haps if Cowan had focused on other single-gene disorders this would havebeen instructive and added to her argument. Cowan also makes the pointthat genetic screening, particularly prenatal diagnosis, opens up choice; thatis, parents can choose to have a healthy child rather than not to have a childat all. Yet we know from recent studies in the United States that some par-ents simply refuse to have genetic tests—they choose not to choose.Cowan offers very good arguments that we should not object to geneticscreening because of its (loose) association with eugenics. Further, herbook undoubtedly fills a void by providing a much-needed historical over-view of the evolution of genetics. Such a void perhaps reflects a general lackof interest, awareness, or willingness by social scientists to engage with theeugenic past. They should read this book. You should read this book. Loveit or hate it; either way this book should not be ignored.GILL HADDOWGill Haddow is senior research fellow and lecturer at the Economic and Social Research Coun-cil, INNOGEN Centre, University of Edinburgh.16_51.2bkrevs 490–542:12_50.1bkrevs 202–  4/15/10  4:34 PM  Page 533

Heredity and Hope: The Case for Genetic Screening.

     Edinburgh Research Explorer                                      Heredity and Hope: The Case for Genetic Screening.Citation for published version:Haddow, G 2010, 'Heredity and Hope: The Case for Genetic Screening.', Technology and culture, vol. 51,no. 2, pp. 532-533. https://doi.org/10.1353/tech.0.0443Digital Object Identifier (DOI):10.1353/tech.0.0443Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher's PDF, also known as Version of recordPublished In:Technology and culturePublisher Rights Statement:Copyright © 2010 Johns Hopkins University Press. This article first appeared in Technology and culture, 51:2(2010), 532-533. Reprinted with permission by Johns Hopkins University Press.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 29. Nov. 2025T E C H N O L O G Y A N D C U L T U R EAPRIL2010VOL. 51532Heredity and Hope: The Case for Genetic Screening.By Ruth Schwartz Cowan. Cambridge, Mass.: Harvard University Press, 2008.Pp. 292. $27.95.Since Crick and Watson discovered the DNA sequence in 1953 the geneticenterprise has gained increasing momentum to include the mapping of anindividual’s entire genome and the construction of entire populations’ ge-netic data collections. The hope is that overall human mortality and mor-bidity can be improved by unlocking the secrets of our genetic codes, whichcontribute to the health that we and our kin enjoy. By understanding themechanisms and determinants of genetic inheritance, one can predict thepredilection of an individual or a group to inherit diseases that have a genet-ic component. Essentially, this is a rationale for genetic screening and test-ing. Screen-ing is more often directed at the population level and may in-clude carrier and adult screening, whereas genetic testing refers to a host oftechniques focused more on the individual level such as prenatal diagnosisand newborn screening, but the terms are often used interchangeably.Genetics both as a scientific technology and a medical system is thoughtby some to have a dark past, a history associated with eugenics (ironicallymeaning “the beautiful inheritance”), whose early proponents hoped to“improve the race” through ethically dubious practices such as involuntarysterilization and restrictions on reproduction. Yet Ruth Schwartz Cowan inher book Heredity and Hope persuasively argues that one should not make a“genealogical fallacy” by confusing the motives of the founding fathers ofmedical genetics with the motives of the early eugenicists. The former hadmotives that were applaudable—to alleviate human suffering; the motives ofthe latter were condemnable because they sought to elevate certain subsec-tions of the human race over others.Hence, Cowan asks opponents of today’sgenetic screening not to make the mistake of assuming that the genetic tech-niques and procedures now offered to pregnant women are an extension ofthe eugenics movement as was practiced in the early twentieth century.Heredity and Hope is separated into several parts. Cowan begins in theearly twentieth century with a detailed account of the eugenics movementin the United States, Germany, and Scandinavia, where eugenicists hadsome influence on public policy. Then she outlines how the eugenics move-ment related to medical geneticists working at the same time, before mov-ing on to discuss the history of prenatal diagnosis and adult screening,focusing on specific conditions that were developed after the 1960s: new-born screening for phenylketonuria (PKU), fetal testing for Tay-Sachs dis-ease, carrier screening for sickle-cell anemia, and finally mandated adultscreening for thalassemia in Cyprus.The detail of Cowan’s analysis and historical exposition is second tonone, and rarely is such a heated and controversial topic dealt with in such16_51.2bkrevs 490–542:12_50.1bkrevs 202–  4/15/10  4:34 PM  Page 532B O O K R E V I E W S533a clear and forthright way. Although I was a little unsure about why Cowanfocused on these disorders in particular, I take the point that Tay-Sachsscreening was successful because it was supported at the grassroots, whereassickle-cell anemia screening failed because of opposition from the blackcommunity. This led me to wonder if there was a further point about pub-lic support and opposition for genetic screening that was being made. Per-haps if Cowan had focused on other single-gene disorders this would havebeen instructive and added to her argument. Cowan also makes the pointthat genetic screening, particularly prenatal diagnosis, opens up choice; thatis, parents can choose to have a healthy child rather than not to have a childat all. Yet we know from recent studies in the United States that some par-ents simply refuse to have genetic tests—they choose not to choose.Cowan offers very good arguments that we should not object to geneticscreening because of its (loose) association with eugenics. Further, herbook undoubtedly fills a void by providing a much-needed historical over-view of the evolution of genetics. Such a void perhaps reflects a general lackof interest, awareness, or willingness by social scientists to engage with theeugenic past. They should read this book. You should read this book. Loveit or hate it; either way this book should not be ignored.GILL HADDOWGill Haddow is senior research fellow and lecturer at the Economic and Social Research Coun-cil, INNOGEN Centre, University of Edinburgh.16_51.2bkrevs 490–542:12_50.1bkrevs 202–  4/15/10  4:34 PM  Page 533

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Heredity and Hope: The Case for Genetic Screening.

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