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Subject: LITE, ETHI: Book review
From: Hans Goerl <GENETHICS@delphi.com>
Date: Wed, 3 Sep 1997 22:06:52 -0400

This is the first in what we hope will be a series of book reviews published
on HUM-MOLGEN.  It seems particularly relevant in the light of very recent
public dicussions of 20th century eugenic sterilization practices in Sweden,
Norway and Austria.

Arthur Bergen, LITE editor
Hans Goerl, ETHI editor

"Creating Born Criminals : Biological Theories of Crime and Eugenics"
Author: Nicole Hahn Rafter
List: $36.95
Publisher: Univ of Illinois Pr (Trd)
ISBN: 0252022378

Review by David W. Moskowitz

In her latest book,  "Creating Born Criminals" , Dr. Nicole Hahn Rafter
carefully instructs the reader, who she assumes (quite correctly, in my
case) knows nothing about criminology, eugenics, or the early twentieth
century literature on moral imbeciles. The result is an exhilarating insight
 into how the best and the brightest in America came to embrace eugenics out
of altruistic, professionally incontestable reasons. The fallacy of eugenics
 suddenly becomes eminently understandable in human terms.

Beginning with the title of her thoroughly researched book, Professor
Rafter gets to the very heart of the matter: how much of behavior,
especially criminal behavior,  is due to nature (genetics), and how much to
nurture (environment)? Is there such an entity as a "born criminal", and, if
 so, who "creates" him or her? Did a nascent profession "create the monster
to justify its own existenceS, as Dr. Rafter strongly suggests,  or does
nature (read God, genes, or the like) actually produce stone cold criminals
for society to puzzle over?

The current consensus appears to be that both genetics and environment are
inextricably linked in producing any outcome of biological interest,
including antisocial or criminal behavior. I share with  professionals like
Dr. Rafter the bias (hope, really) that criminal behavior  could never
result from a fully loving and wise environment. It is probably relevant to
this discussion that novelty seeking behavior in mice may relate  to the
dopamine circuitry of the limbic system. With the discovery of each new
Mendelian disease gene, however, it is becoming painfully apparent how
little we know of genetic environmental interactions in even the simplest of
 cases, when only a single gene is involved. We are  still barely looking
through a glass darkly at the much more complex polygenic and environmental
interactions which presumably result in criminal behavior.

Given our current state of ignorance about a topic which every adult in the
civilized world is asked by their elected representatives to have a firm
opinion on (namely crime), it is remarkable, although perhaps not
surprising, to see the degree of professional certainty about this topic at
the turn of the century.  Professor Rafter reminds us of a not too distant
past (the fifty year span from the 1870s until the 1920s) when it became
dogma within the United States penal profession that poor mental performance
 was highly correlated with poor moral performance, and that the most
scientific and effective method to rid society of criminal behavior was to
limit sexual reproduction of born criminals. Dr. Rafter shows us exactly how
this rather bizarre conclusion was reached.

This book is recommended for anyone who, like myself, knows that eugenics is
 "bad," but doesn't understand how intelligent, professionally ambitious,
"good" people could have embraced it.  Dr. Rafter's book highlights the
importance for any profession related to genetics to, first of all,
acknowledge its own limitations. In addition to the Hippocratic injunction
of nonmaleficence("primum non nocereS), humility should perhaps be the oath
of any genetics investigator. In the spirit of Nathaniel Hawthorne, in  "The
 Scarlet Letter", every genetics investigator should be required in some way
to "Be true, be true, be true; show freely to the world, if not your worst,
at least some aspect by which your worst may be inferred.S

Dr. Rafter further reminds us of the social danger of concentrating
scientific resources and power in the hands of a few, admittedly gifted,
individuals. In the current climate of research cutbacks, the danger is at
least as great as it was a century ago. Those lucky few who still belong to
the "club" of funded genetics investigators would of course never dream of
criticizing the hand that feeds them.

To an outsider like myself, the "club" seems to be getting even smaller and
more unanimous. It is disquieting, for example, that the Consensus Statement
on Informed Consent for Genetic Research on Stored Tissue Samples (JAMA
274[22]:11995) has already become law, at least in so far as NIH grants are
concerned. (Having to get informed consent before using archived DNA
specimens obviously limits the playing field to those with a large enough
research team to do so; this effectively eliminates any "mom and pop" labs
from the competition). Last summer's salvos from the Human Genome Center
against the IVF Institute for daring to offer BRCA1 testing are somewhat
chilling, as if knowledge should be withheld from the "hoi poloi" until
those in command at the NIH say otherwise. There has also been discussion
recently of a "National Genetics Board " to limit the availability of
genetic testing to only those people participating in NIH sponsored clinical
 trials; this move would cut out commercial upstarts like the IVF Institute

Professor Rafter makes abundantly clear in her excellent book that if the
last century's tragic experience with eugenics taught us anything, it is the
danger of hubris, and the saving power of a fully informed democracy.  All
those engaged in setting the future tone of medicine would benefit greatly
from this eminently clear retelling of the recent past.

David W. Moskowitz, MD, MA, FACPSt. Louis,  Missouri. e-mail:

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