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Greek Theories on Eugenics David J Galton St Bartholomew's Hospital, London

Greek Theories on Eugenics David J Galton St Bartholomew's Hospital, London

Journal ofMedical Ethics 1998;24:263-267 J Med Ethics: first published as 10.1136/jme.24.4.263 on 1 August 1998. Downloaded from

Greek theories on David J Galton St Bartholomew's Hospital,

Abstract tion by donor, therapy or gene manipulation With the recent developments in the Human of germ-line cells.3 This definition does not Mapping Project and the new technologies that are include any terms related to the acceptability or developingfrom it there is a renewal ofconcern about otherwise of the means to achieve these ends, ie eugenic applications. (b1822, whether some methods should be made compul- dl911), who developed the subject ofeugenics, sory by the state, or left entirely to the personal suggested that the ancient had contributed choice of the individual. A major problem for the very little to social theories ofeugenics. In fact the future will be where to draw the fine line between Greeks had a profound interest in methods of state control and personal choice for the many supplying their city states with thefinest possible genetic issues that will arise with the application of progeny. This paper therefore reviews the works of the new DNA technology. This is particularly so (The and Politics) and as some ofthe genetic issues related to multifacto- (The Politics and The Athenian ) rial disease are complex and may go beyond the which have a direct bearing on eugenic techniques understanding of some citizens who may be and relates them to methods used in the present involved in such decisions. century.

Galton's work on eugenics makes very little ref- copyright. (7ournal ofMedical Ethics 1998;24:263-267) erence to Greek social theories of eugenics and Keywords: Eugenics; ancient Greeks; Plato; Aristotle; contemporary methods current standard works on eugenics4 make no ref- erence to the Greek contribution. For example Galton states in a letter, that he had read "Plato's Introduction Republic and for eugenic passages; but they Eugenics (Gk eu- good, well; Gk gen- genesis, don't amount to much beyond the purification of creation), a term proposed by Francis Galton, was the city by sending off all the degenerates to form http://jme.bmj.com/ defined as "the science of improving the inherited what is termed a colony!".' It is not clear where stock, not only by judicious matings, but by all Galton obtained this idea of colonisation as a other influences ...".' With the recent develop- eugenic measure; it does not appear to occur any- ments in the Human Genome Mapping Project where in Plato's works. In early his- the scope for eugenics has enormously increased tory (from the eighth to sixth centuries BC) because of the development of a very powerful establishing colonies was a way of coping with technology for the manipulation of DNA. A mul- population expansion and of establishing trading on September 23, 2021 by guest. Protected titude of gene sequences and genetic markers are Galton may have been now becoming available to predict risks of contacts overseas. Perhaps developing such common conditions as cancer, recalling , Book IV, where Polymnes- ischaemic heart disease, diabetes mellitus and tus, a man ofhigh repute in , had a defective hypertension; and in some cases it is possible to son with a speech impediment named Battus treat such disorders by (ie replace- ( stammerer); and Battus was dispatched ment of the LDL-receptor gene in patients with by the citizens with sanctions from the Delphic homozygous familial hypercholesterolaemia).2 oracle to found a colony in Libya.6 However, Gene manipulation of germ-line cells is currently Herodotus does not say anything explicitly to sug- in use for animal models ofhuman disease and no gest that the was a motive for sending doubt will soon become available for the supply of him to lead a colony. On the other hand Plato's donor organs for purposes of human transplanta- works do reveal a profound interest in eugenics as tion surgery. A wider definition of eugenics might a means of supplying the city state with the finest therefore be "the use of science applied to the possible progeny. This was of vital significance for quantitative and qualitative improvement of the the future ofthe city, which needed to supply men human genome"; and this would cover methods of for its army which was continually at war with regulating population numbers as well as improv- other city states. The purpose of this paper is to ing genome quality by selective artificial insemina- describe prevailing ancient Greek views on 264 Greek theories on eugenics J Med Ethics: first published as 10.1136/jme.24.4.263 on 1 August 1998. Downloaded from eugenic methods to improve the quality of their The newborn children were to be taken from progeny. their mothers and reared in special nurseries in a separate quarter of the city. life was to be discouraged as it provided a distraction from the Plato's Republic' business of governing, of defending or extending This work was probably written before 368 BC the city state by conquest. Any children born when the author was in his fourth to fifth decade. defective would be "hidden away" in some appro- It is a blueprint for the organisation of an ideal priate manner. This may actually be a euphemism and with regard to eugenics adopts the for .8 However neither infanticide nor policy of ensuring "judicious matings". Plato exposure as practised in and other Greek thought it vital to society that the correct arrange- cities was recommended by Plato for his republic. ments should be made for such matings. He pro- Women should be allowed to bear children from posed that marriage for the guardian classes the ages of 20 - 40 years, and men reproduce from (guardians were the premier of Athenian 25 - 55 years, when the bodily and mental powers citizens, selected by their natural capacities and are at their best. Unofficial unions which pro- attainments to govern the state) be abolished and duced children would be considered as a civil (and that provision be made for men and women of the divine) offence and appropriate punishments same natural capacities to mate. He drew an anal- instituted. Men should only have relations with ogy with the of sporting dogs women of a marriagable age if the rulers had and horses in order to obtain the desired stock. paired them together. Incestuous unions between The members of the guardian classes should only parents and children were to be forbidden; but be allowed to breed in their prime, for men, after there were no sanctions against brother-sister reaching the age of 25 years, for women 20 years. unions. Brother-sister marriages were not uncom- Inferior members ofthe guardian classes should mon in Egypt and the Greeks had probably not be discouraged from reproducing. Only the best of noticed the increased frequency of defective copyright. chil- the offspring should be kept in the guardian class dren resulting from consanguineous marriages. and the inferior children should be relegated to The main aim of brother-sister as practised the civilian classes (farmers or craftsmen). These by the royal of Egypt was to keep the were the general principles; and in practical terms throne within the family. It appears clear from they could be implemented by the of a portraits of the of Egypt, the most marriage festival, bringing together suitable young notorious case of such incest, that some members people in the correct age band. Sacrifices, poetry, suffered from inherited endocrine disorders,9 buthttp://jme.bmj.com/ songs and dance would set the atmosphere for there is no evidence that this was connected by the young couples to "marry" and cohabit during the ancients themselves with the practice of brother- period of the festival for about one month, after sister incest. However, if all the newborn Greek which the marriage would be dissolved and the children were brought up communally in a creche, partners remain celibate until the next festival. real brothers and sisters would not perhaps know The number ofmarriages at each festival would be they were so related; especially as there would be at the ruler's discretion, to keep the population so many different marriage pairs from each on September 23, 2021 by guest. Protected numbers constant, taking into account losses suceeding festival. Finally, men and women of the caused by war or epidemics. Plato was more afraid guardian classes past the child-bearing age could of a decline than a rise in the birth rate and con- form relationships that would fall outside the sidered that the civilian classes could breed with- jurisdiction of the rulers. out restriction so as to keep an average city state with 5,000 citizens (as stated in The Laws). To Plato's Laws'° prevent marriage of the inferior members of the This is the last of Plato' dialogues, written in his guardian classes a lottery system would be set up eighth decade in about 350 BC, but it is highly but so rigged that young men acquitting them- likely that he was at work on The Laws for many selves well in war and other duties would be given years during intervals of writing other texts, since the first opportunities of having a marriage it is his longest work and it may well incorporate partner for the term of the festival to produce material for earlier projects at which he hints, but children whilst the inferior youth would draw lots seems never to have completed. It is a more prac- which "by chance" would not procure a partner tical treatment and extension of the political for them. At the end of the festival the marriages problems raised in The Republic. He attempts to would be dissolved but the superior youths would frame a model constitution and legislation that be able to draw by lot another (and different) might be adopted by a society of average Greeks. partner at the next festival. He by now considers the temporary unions at Galton 265 J Med Ethics: first published as 10.1136/jme.24.4.263 on 1 August 1998. Downloaded from marriage festivals, with a community of wives and travel. He returned to in 336 BC and children, to be impractical. Instead he would leg- founded the Lyceum. In his book Politics he first islate for monogamous marriages with strict chas- criticizes Plato's views and then proposes his own. tity outside of that. Provision for this should be He thinks that the community of wives and initially made by arranging sports and dance festi- children for the guardian class is impractical and if vals so the young people of the city could meet anything is better suited to the civilian classes. If each other. If a man of 25 years or more finds a the latter have wives and children in common they suitable partner he should submit his case to the will be less closely united by bonds of affection curator of laws, and if the match is found suitable, and family ties and perhaps remain more obedient should in all cases marry her before the age of 30 to the ruling elite and be less likely to rebel. Also, - 35 years. A girl could marry from the age of 16 - would mothers in the guardian class voluntarily 20 years. With regard to fitness for marriage a man give up their children to be reared in a communal should primarily court a for the city's nursery? If some of their inferior children are rel- good and not just because she takes his fancy. The egated to the lower classes and eventually find out origin of the bride and her family should be care- their true parents, this may lead to quarrels and fully scrutinised. The wealth or poverty of the recriminations and perhaps would provide more a bride's family should not play a large part in his source of disorder in society. choice. He also criticises Plato's view that the birth rate If any fit young men did not, or refused to should be left unrestricted for the lower classes. If marry, up to the age of 35 years they then should this leads to over-population, the attendant evils of pay an annual fine of 100 drachmas ifbelonging to poverty, crime and revolution would most likely the wealthiest class; 70 drachmas if to the second; follow. In Aristotle's view the birth rate should be 60 if to the third and 30 drachmas if to the fourth regulated even more stringently than was done in class. The fines so collected would be dedicated to c 330 BC. He quotes in support of this idea that the Temple of . Phaedon of , an early legislator, recom- Married couples should make it their first con- mended that land allotments for families and the copyright. cern to present the city with the best and finest number of citizens should be kept equal to one progeny. They should therefore be under the another, implying a tight regulation of the birth supervision of a board of matrons, appointed by rate. the magistrates, to superintend the conduct of the married couples. For example, expectant mothers Raw material should assemble daily for a minimum period of 20 Aristotle's own views agree in principle with http://jme.bmj.com/ minutes at the Temple of Ilithyia (a goddess iden- Plato's that conditions should be managed to tified with or Hera) to provide sacrifices ensure the highest possible state of health for the and rites to the Goddess of Matrimony. Their city's newborn children. The quality and quantity period of supervision by the board should last ten of their population depends on this and is the first years and the board would provide advice and concern ofthe city state. The population is the raw guidance on all problems connected with child- material on which the statesman works. Aristotle

birth (for example, if couples were infertile, or would therefore legislate for the following propos- on September 23, 2021 by guest. Protected producing too many children). Infertile couples als. Strict monogamous marriages should be insti- could have their marriages dissolved but the rela- tuted, with women marrying at about 18 years and tives of both parties were to have a voice in the men at 37 years, when he considers both sexes to terms of the separation. Finally, an official register be at their prime. Pregnant women must take care ofbirths and deaths should be kept and made eas- of their bodies with regular exercise each day by ily accessible by the recording of its details on walking to the Temple of Ilithyia to worship at the whitened walls. Such a record would be required altar of the gods presiding over childbirth. for the proper observance of the laws fixing the Expectant mothers should be given nourishing ages for marriage, service or qualifica- food and remain as tranquil as possible since the tions for various official posts. embryo derives its nature from the mother, rather Regarding Plato's other political dialogues, The as plants do from the soil in which they grow. Statesman" deals with the different forms of Laws should be introduced to oppose an unre- government and the nature ofpolitical science but stricted birth rate, but no children should suffer makes no reference to eugenics. exposure just to limit the population. If couples are having too many children must be Aristotle's Politics12 procured before the embryo has reached the stage Aristotle initially studied with Plato at the of "sensitive life". Infanticide should be practised Academy from 367-348 BC, but then left to for any children born with deformities. 266 Greek theories on eugenics J Med Ethics: first published as 10.1136/jme.24.4.263 on 1 August 1998. Downloaded from

Other proposed ideal considered marriage partners, and in Book Three of The by Aristotle, ie those of Phaleas of or Republic he states that deception of citizens for the Hippodamus of appear to make no provi- city's welfare is justified for political ends in the sions for eugenics. The actual constitution of same way that doctors may conceal the truth from Sparta appears to include eugenic measures but their patients for their own good, but patients these were mainly directed to a single aspect, should conceal nothing from their doctors (if they namely military prowess.'3 Their practice of child want a correct diagnosis). In practice, of course, exposure and infanticide was mainly aimed at justifying a means for political ends can be at developing a cadre of good soldiers but this led to almost total variance with justification for the a shortage ofmanpower which proved to be one of benefit of the citizen's welfare. Aristotle criticised Sparta's major social weaknesses. A law had even- the social implications of a community of wives tually to be passed to encourage population and children; but both Plato and Aristotle appear growth in which a father of three sons was exempt to have overlooked the possibility ofbrother-sister from military service and a father of four sons was (or half brother-half sister) matings leading to the exempt from all state-imposed obligations, includ- appearance ofdeleterious recessive characters that ing taxes. The actual constitution of had occur at high frequency in the human genome (c measures to regulate the birth rate by segregating 20%). Perhaps the adverse effects of consanguin- women from men. However, Lycurgus, the eous marriages had not been recognised by the supposed legislator for both Sparta and Crete, Greeks or Egyptians, since brother-sister mar- sanctioned sexual intimacy between males as a riages were condoned. means of controlling reproductive rates, the of which Aristotle to Plato and Aristotle both recommended legisla- morality appears question. tion of social methods aimed at promoting judicious matings amongst an elite class, methods Commentary that would be unacceptable today. Contemporary It is of interest that neither Galton nor many con- has more aimed to discourage injudiciouscopyright. temporary commentators4 '5 appear to give credit matings in the population by methods that are to or even mention the Greek contribution to the equally questionable. In the early half of this cen- subject of eugenics. In fact Galton's proposals for tury state introduced compulsory the development of the subject3 go very little fur- ther than the measures proposed by Plato except measures to improve the "inherited stock" of their in society. For example from 1930 onwards 27 states that there was almost no element of coercion in the USA passed sterilisation laws to prevent the former. Galton's main proposals were: (1) http://jme.bmj.com/ Extensive family records should be kept and in various classes of people from having children.'6 competitive examinations for professional posts These included the insane, those suffering from in, for example the civil service, extra marks epilepsy, and the feebleminded. In some states should be awarded for "family merit". The family these laws were applied to habitual criminals and history as well as the personal history of the appli- "moral perverts". Most states did not enforce cant should be taken into account; (2) Early mar- these laws, but in compulsory sterilisa- tions reached a total of 9,930 by 1935. Other riages for women from "gifted" families should be on September 23, 2021 by guest. Protected encouraged by the award of financial endow- countries, including , Switzerland, Ger- ments, analogous perhaps to the use of grants for many, Norway and also passed sterilisa- higher education for promising young adults; (3) tion laws for similar categories of people, and Rules of for gifted individuals ( for exam- between 1935 and 1976 about 60,000 young ple Fellows at the older universities) should be Swedish women deemed mentally defective or abolished; and finally (4) The state should take otherwise handicapped, making them incapable of some form of action (unspecified) against the looking after children, were sterilised. The laws in procreation of the feeble-minded, the insane, and Sweden remained on the statute books until some classes of habitual criminals. 1976.'7 Only in have recent attempts Plato's methods to improve the genetic consti- been made to "breed" for an elite class. The Leb- tution ofthe ruling elite class are far more original ensborn (Spring of Life) state programme of the than those of Aristotle and are in accord with Nazis established homes throughout modern genetic theory. Different choices of part- Germany where SS men and suitable young ners at serial marriage festivals amongst a selected women were encouraged to procreate. 8 elite of the population would be expected to lead The policy never became firmly established and to an optimal spread ofabilities for their offspring. there were only 700 employees in all of the He recommends systematic deception in the pur- Lebensborn homes. It probably failed to realise its suit of these aims by rigging the lottery system for full potential because of the overriding demands Galton 267 J Med Ethics: first published as 10.1136/jme.24.4.263 on 1 August 1998. Downloaded from of the resettlement and extermination pro- vene in such cases ifthe mother is clearly unable to grammes. provide economically for the long term care ofher In the USA between 1969-73 many states handicapped child. However, each particular case organised compulsory schemes to screen for sickle for state intervention has to be scrutinised very cell heterozygosity which occurs primarily carefully in view of the gross abuse of such meas- amongst the black population. Carriers, who are ures in the present century. entirely healthy, had problems with obtaining marriage certification, employment and access to Acknowledgements life insurance. For example, carriers of the sickle I am greatly indebted to Professor RW Sharples, cell trait were excluded from positions in the Air Department of Greek and , University Force academy involved with flight training and College London, for providing two critical reviews from flight personnel posts. In the Department of of different versions of the manuscript regarding the Navy employees were screened and heterozy- the accuracy ofthe Greek contents; and to Profes- gote cases excluded from airborne, ranger or flight sor DAG Galton for helpful criticism. crew training. Such procedures could be inter- preted as racist and a means of discriminating David J Galton MD, FRCP, is Professor of Human against the black population by preventing their Metabolism in the Department of Metabolism and promotion to officer class.'9 This could also have Genetics, St Bartholomew's Hospital, London, ECIA an indirect eugenic effect although there is no 7BE, UK. demographic evidence that reproductive rates were affected by this policy. References More recently insurance companies in the UK 1 Galton F. Inquiries into human faculty and its development. Lon- don: J M Dent and Sons, 1943:17. (1997) required the declaration of previous 2 Grossman M, Raper SE, Kozarsky K et al. Successful ex vivo genetic tests for susceptibility to such diseases as gene therapy directed to liver in a patient with familial hyperc- holesterolaemia. Nature Genetics 1994;6:335-41. cancer, heart disease and premature dementias; 3 Galton DJ, Galton CJ. Francis Galton: and eugenics today. copyright. premiums are adjusted according to the health Jtournal ofMedical Ethics 1998;24:99-105. 4 Kevles DJ. In the name of eugenics. Cambridge, Mass: Harvard risks involved.20 Since life insurance is frequently University Press, 1995. tied to mortgages this would tend to have an effect 5 Pearson K. The life, letters, and labours of Francis Galton. Cambridge: Cambridge University Press, 1930:312. of discouraging (by financial pressures) individu- 6 Herodotus. The [translated by Carter H]. Oxford: als possessing an adverse genetic constitution Oxford Unversity Press, 1962. 7 Plato. The republic [translated by Cornford FM]. Oxford: from starting families and therefore could act as a Oxford Unversity Press, 1955. 8 Adam The 1]. covert eugenic measure. J. republic of Plato [vol Cambridge: Cambridge http://jme.bmj.com/ Unversity Press, 1965: 357-60. Currently the trend for eugenics has been very 9 Davis N, Kraay CM. The Hellenistic kingdoms - portrait coins and much away from social coercion by various state history. London: Thames and Hudson, 1973: plates 13-47. 10 Plato. Laws [translated by Taylor AE]. London: J M Dent and institutions to providing more education and free- Sons, 1969. dom for citizens to make their own genetic and 11 Plato. , Theaitetos, sophist, and statesman [translated by Warrington J]. London: J M Dent and Sons, 1961. reproductive choices. For example, mothers can 12 Aristotle. Politics [translated by Warrington J]. London: J M choose to have a disabled child with trisomy 21 Dent and Sons, 1964. even though the state may eventually have to pro- 13 Aristotle. The Athenian constitution [translated by Warrington J]. London: J M Dent and Sons, 1964. on September 23, 2021 by guest. Protected vide for the child's long term care. If there were a 14 Kitcher P. The lives to come. London: , 1996. 15 Weir RF, Lawrence SC, Fales E, eds. and human self genetic "cure" for trisomy 21 the mother could be knowledge. Iowa City: University of Iowa Press, 1994. held responsible for injury to her child for 16 Olson FH. Eugenics. In: Encyclopaedia Britannica [15th ed]. Chicago: HH Benton, 1980. withholding it. If a pregnant mother can take steps 17 Armstrong C. Thousands of women sterilised in Sweden with- to cure a disability affecting her fetus she should out consent. British Medical Journal 1997;315:563. 18 Toland J. AdolfHitler [vol 2]. New York: Doubleday, 1976. do so, or otherwise she could be held responsible 19 Duster T. Backdoor to eugenics. New York: Routledge, 1990. for deliberately injuring her child.21 The only 20 Association of British Insurers. Life insurance and genetics. London: Association of British Insurers, 1997. "cure"5 at present for trisomy 21 is termination of 21 Harris J. Is gene therapy a form of eugenics? 1993;7: pregnancy and perhaps a state body should inter- 178-87.