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History of Medical Enhancement Technologies

Under a grant from the ELSI Project of the National Institutes of Health, Sheila M. Rothman, Ph.D., and David J. Rothman, Ph.D., have completed a study of the history of medical enhancement technologies in the 20th century. The Rothmans contend that historians have too often placed the history of genetic enhancement in the frame of eugenic engineering, with its singular concepts of race and race improvement, and its deleterious impact, both in the United States (the forced sterilization of retarded persons) and in Nazi Germany (the forced killing of so-called terminally ill persons, ethnic minorities, and Jews).

While this grim past must be recalled, its focus on the state as the central force coercing weak and helpless citizens makes it only marginally relevant to contemporary issues. The Rothmans are using a second and, they believe, more relevant frame. It is of individuals eagerly, even desperately, seeking enhancements, physicians readily acceding to their requests, and pharmaceutical companies and the media diligently promoting their application and use. This was certainly true in the 1920-1945 period when hormones, including estrogen and testosterone, were discovered, synthesized, and then prescribed for a variety of reasons. It continues to be true today when one examines the use of growth hormones, psychopharmacology, and plastic surgery. The dynamic here is not of interventions imposed, but interventions embraced-and it is this dynamic that is likely to reappear as genetic enhancement become feasible. What will this mean to the society as well as to the practice of medicine is at the core of the Rothmans' project.

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