The New Eugenics in Medicine

A growing body of contemporary research and reporting exposes how old ideas can find new life when repurposed within modern systems of medicine, technology, and public policy. Over the last decade, several trends have converged:

• The rise of polygenic scoring for embryos and adults;
• Rapid growth in commercial direct-to-consumer genetic testing;
• Artificial intelligence (AI)-driven "risk stratification" tools in healthcare and insurance;
• The proliferation of biobanks disproportionately populated by individuals from privileged backgrounds; and
• The reemergence of academic interest in "optimal reproduction," "biological improvement," and "population efficiency."

While these movements hold extraordinary possibilities for treating illness and ameliorating suffering, they also have the potential to be used to enhance certain traits and delete others -- ones that are simply disliked by those in power. Individually, each development has scientific merit and, in many cases, real potential to prevent disease and improve care.

Collectively, however, they raise questions that are both familiar and deeply unsettling.

Echoes of the Past

The U.S. and many other countries have long histories of medicalized discrimination under the banner of "improving the population." During the early and...