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A Companion to GenethicsA Companion to GenethicsA Cooperative SpeciesA Mind So RareA Natural History of RapeAcquiring GenomesAdapting MindsAgeing, Health and CareAlas, Poor DarwinAn Introduction to Evolutionary EthicsAncient Bodies, Modern LivesAnimal ArchitectsAping MankindAre We Hardwired?Bang!BehavingBeyond EvolutionBeyond GeneticsBlood MattersBody BazaarBoneBrain Evolution and CognitionBrain StormBrave New BrainBrave New WorldsChoosing ChildrenCloneCloningConceptual Issues in Evolutionary BiologyConsciousness EvolvingContemporary Debates in Philosophy of BiologyControlling Our DestiniesCooperation and Its EvolutionCreatures of AccidentDarwin Loves YouDarwin's Brave New WorldDarwin's Gift to Science and ReligionDarwin's UniverseDarwin's WormsDarwinian ConservatismDarwinian PsychiatryDarwinism and its DiscontentsDarwinism as ReligionDebating DesignDecoding DarknessDefenders of the TruthDo We Still Need Doctors?Doubting Darwin?Early WarningEngineering the Human GermlineEnhancing EvolutionEnoughEntwined LivesEthical Issues in Human CloningEthical Issues in the New GeneticsEvil GenesEvolutionEvolutionEvolution and Human BehaviorEvolution and Human BehaviorEvolution and Human Sexual BehaviorEvolution and LearningEvolution and ReligionEvolution and the Human MindEvolution in MindEvolution, Gender, and RapeEvolution: The Modern SynthesisEvolutionary Ethics and Contemporary BiologyEvolutionary Origins of MoralityEvolutionary PsychiatryEvolutionary PsychologyEvolutionary Psychology and ViolenceEvolutionary Psychology as Maladapted PsychologyExploding the Gene MythFaces of Huntington'sFlesh of My FleshFrom Chance to ChoiceFrom Darwin to HitlerGenesGenes in ConflictGenes on the CouchGenes, Environment, and PsychopathologyGenes, Environment, and PsychopathologyGenes, Women, EqualityGenetic Nature/CultureGenetic PoliticsGenetic ProspectsGenetic ProspectsGenetic SecretsGenetics of Criminal and Antisocial BehaviourGenetics of Mental DisordersGenetics of Original SinGenetics of Original SinGenomeGenomeGenome: Updated EditionGenomes and What to Make of ThemGlowing GenesHow Women Got Their Curves and Other Just-So StoriesHuman CloningHuman Evolution, Reproduction, and MoralityImproving Nature?In Our Own ImageIn Pursuit of the GeneIn the Name of GodIngenious GenesInheritanceInside the Human GenomeInside the O'BriensIntegrating Evolution and DevelopmentIntelligence, Race, and GeneticsIs Human Nature Obsolete?Language OriginsLess Than HumanLiberal EugenicsLiving with Our GenesMaking Genes, Making WavesMaking Sense of EvolutionMan As The PrayerMean GenesMenMood GenesMoral OriginsMothers and OthersNature Via NurtureNever Let Me GoNot By Genes AloneOf Flies, Mice, and MenOn the Origin of StoriesOrigin of MindOrigins of Human NatureOrigins of PsychopathologyOur Posthuman FuturePhilosophy of BiologyPlaying God?Playing God?Portraits of Huntington'sPrimates and PhilosophersPromiscuityPsychiatric Genetics and GenomicsPsychologyQuality of Life and Human DifferenceRe-creating MedicineRedesigning HumansResearch Advances in Genetics and GenomicsResponsible GeneticsResponsible GeneticsScience, Seeds and CyborgsSex and WarSociological Perspectives on the New GeneticsStrange BedfellowsStrange BehaviorSubjects of the WorldSubordination and DefeatThe Age of EmpathyThe Agile GeneThe Ape and the Sushi MasterThe Biotech CenturyThe Blank SlateThe Book of LifeThe Bridge to HumanityThe Case Against PerfectionThe Case for PerfectionThe Case of the Female OrgasmThe Century of the GeneThe Common ThreadThe Concept of the Gene in Development and EvolutionThe Debated MindThe Double-Edged HelixThe Epidemiology of SchizophreniaThe Ethics of Human CloningThe Evolution of CooperationThe Evolution of MindThe Evolution of MindThe Evolved ApprenticeThe Evolving WorldThe Fact of EvolutionThe Folly of FoolsThe Future of Human NatureThe God GeneThe Immortal Life of Henrietta LacksThe Impact of the GeneThe Innate MindThe Innate MindThe Innate Mind: Volume 3The Limits and Lies of Human Genetic ResearchThe Lives of the BrainThe Maladapted MindThe Meme MachineThe Misunderstood GeneThe Moral, Social, and Commercial Imperatives of Genetic Testing and ScreeningThe Most Dangerous AnimalThe New Genetic MedicineThe Nurture AssumptionThe Origin and Evolution of CulturesThe Origins of FairnessThe Paradoxical PrimateThe Perfect BabyThe Robot's RebellionThe Shape of ThoughtThe Shattered SelfThe Stem Cell ControversyThe Story WithinThe Stuff of LifeThe Talking ApeThe Temperamental ThreadThe Terrible GiftThe Theory of OptionsThe Top 10 Myths About EvolutionThe Triple HelixThe Triumph of SociobiologyThe Woman Who Walked into the SeaTwinsUnderstanding CloningUnderstanding the GenomeUnnatural SelectionUnto OthersUp From DragonsWar Against the WeakWhat Genes Can't DoWhat It Means to Be 98 Percent ChimpanzeeWho Owns YouWhose View of Life?Why Evolution Is TrueWhy Think? WondergenesWrestling with Behavioral GeneticsYour Genetic Destiny
In Your Genetic Destiny,
Aubrey Milunsky sets out some of the most recent information about genetic
medicine. The fundamental premise of
the book is simple: there are many genetic disorders, and prospective parents
should take whatever steps they can to avoid the terrible outcome of having a
baby with a genetic disorder. The book
sets out the scientific information about genetic abnormalities in clear
language, with explanation of cells, chromosomes, DNA and their role in genetic
disorders. In the 27 chapters, Milunsky
covers a wide range of disorders, including Down syndrome, Fragile X syndrome,
mental retardation, allergies, asthma, emphysema, heart disease, obesity, lipid
disorders, abnormalities of heart rhythm, high and low blood pressure,
diabetes, cancer, schizophrenia, depression, bipolar disorder, Alzheimers
Disease, aging, Huntington disease, and polycystic kidney disease. He explains both genetic and environmental
factors as causes of these disorders, and steps one can take to reduce ones
chance of falling prey to them.
This is a relatively long book, at
over 400 pages, and it is somewhat repetitive.
Readers who have some understanding of human biology will probably find
the explanations helpful, and it is possible that readers concerned about
genetic disorders will also find the information in the book helpful. For women and men wondering about the
possible health problems of their children, the book often recommends that they
consult with a genetic counseling and testing service. The real flaw is in the book's uncritical and
somewhat old-fashioned attitude towards some disorders. Milunsky tells the reader that you and your
partner owe it to yourselves and your future offspring to be as fully informed
as possible about your genetic risks and options when considering planned
child-bearing (p. 19). He emphasizes
that the presence of a child or adult with a serious birth defect or genetic
disorder in the home becomes a chronic emotional, physical and economic drain
on the parents (or family) (p. 19).
His language is often morally loaded: he often uses the phrases genetic
defect and flawed genes and he even uses the phrase defective child (p.
7). He discusses the burden of
families caring for children with Down syndrome, but makes no mention of the
rewards of doing so. Many people will
find his attitude toward genetic disorders problematic, because he pays so
little attention to the question of how we label these disorders and the
effects of our labeling. Some may
suspect that the shadow of eugenics falls over Milunskys approach, suggesting
that he takes an intolerant attitude towards people who are different. Disability activists may well find that his
language expresses the judgment that people with genetic disorders have less
valuable lives. Its not certain that
Milunsky himself would explicitly embrace any sort of eugenic program, but
given the history of eugenics in the last century, anyone writing in this area
has to show awareness towards these issues.
His book strikingly fails to show the appropriate sensitivity.
The book also gives very little
discussion of some difficult decisions people may face. For example, people with a family history of
Huntingtons Disease can get genetic testing to find out whether they will get
the disease which normally starts in mid-life and has a typical course of
twenty years. The book reproduces six
pages of guidelines about predictive testing from the World Federation of
Neurology Research Group on Huntingtons Chorea and the International
Huntington Association, which is in the form of a list of more than 80 main
points, but there is no discussion of these, nor any consideration of how
individuals work through such emotionally hard decisions. The chapter on genetic counseling is short
and somewhat perfunctory. The
penultimate chapter on ethical issues in the diagnosis and treatment of genetic
disorders and the use of genetic information covers a wide variety of issues,
but gives little discussion of any particular one. When women are facing questions about whether to have an abortion
because there is a strong likelihood their baby has a genetic disorder, or
whether to preventatively remove their breasts or ovaries because they are at a
high risk for cancer, their values are at the heart of the
decision-making. Milunskys neglect of
these central issues means that Your Genetic Destiny will be of only
limited use to people concerned about their genetic predispositions to medical
© 2002 Christian Perring. All
Ph.D., is Chair of the Philosophy Department at Dowling College, Long Island.
He is editor of Metapsychology Online Review. His main research is on
philosophical issues in psychiatry. He is especially interested in exploring
how philosophers can play a greater role in public life, and he is keen to help
foster communication between philosophers, mental health professionals, and the
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