The front door to eugenics is closed. Hitler’s Lebensborn project, the most infamous attempt in this century to produce “good babies,” cast a chilling pall over the frontal assault, the direct route.1 While we have witnessed the development of sperm banks, in vitro fertilization, and artificial insemination, only a small fringe will take the public stage and argue for eugenic aims. Shockley and a few others have espoused a kind of selective breeding of the “good” genetic (“eu-genic”) stock, but wouldbe human breeders remain a tiny node on the periphery of the current genetic revolution. They are likely to remain so. The romantic imagery of Romeo and Juliet is deeply rooted, and shopping at a sperm bank is not something we are likely to see in 1994, or the year 2000. Rather more indirectly, our late twentieth-century Romeo and Juliet will still take their chances of making a good baby, but if they can get a boost from the new technology to insure that they won’t have a “defective” baby, a personal head-on confrontation of the eugenic issue need never occur. But what of the social policy concern of disease prevention? Here, I believe, a subtle and subliminally compelling idea is starting to penetrate the collective conscience, namely, that the “defective fetus” can be eliminated. This book has been aimed at stimulating a general public debate, rather than advocating a single or specific policy. Insofar as I have public policy suggestions, they are made in the spirit of advancing that debate. Accordingly, there is a need to clarify the central issues converging on the horizon. Indeed, it is the convergence that I mean to emphasize. As isolated issues, they hardly present grounds for a eugenic concern. For example, there is nothing particularly disturbing about the search for genetic markers for susceptibility to a disease. Indeed, it can be applauded as providing one more piece of weaponry in medicine’s arsenal against

disease. However, when placed in a larger framework of related developments, the picture is less benign.