At 12:51 AM 12/18/02 -0500, Jon Gabriel wrote:

>--- Ronn! Blankenship wrote:
>> > > OTOH, where *does* one� hold the line on health
>> > > costs?
>> >_____
>> > > �Be that "one" the government, an HMO, a private
>> > > insurer, or the individual.
>> >
>> If a young person tests positive for
>> Huntingdon's disease, do we
>> sterilize that person before puberty so they won't
>> pass along the bad genes
>> and then offer them euthanasia when the symptoms
>> start in their 40s?  How
>> about children with hemophilia, cystic fibrosis, or
>> Down's syndrome?  (And
>> how about their parents?)  Mandatory prenatal
>> genetic screening followed by
>> mandatory abortion if the fetus is not "perfect"?
>> And if so, where do we
>> draw the line on what is considered a genetic
>> "disease"?  Homosexuality?  Below-normal
>> intelligence?  Above-normal intelligence?
>>
>> Deborah Harrell wrote:
>
>Now you're talking social engineering (if I understand
>the term correctly), which is quite beyond 'trying to
>reduce medical costs.' [Aside: How much has the
>missile defense program cost thus far?]
>

Re: Social engineering issues

These are all issues which will no doubt be raised and debated to death
in forums way before they reach the point where we will be able to do
anything about them.

Cystic Fibrosis, Huntingdon's, Tay-Sachs, Hemophilia and Down's Syndrome
are considered severe diseases by the medical community.  Since tests
currently exist to detect the possibility of passing on these defects to
one's offspring for all of the above, we can probably assume that if
cures become available (through genetic manipulation) they will be
rapidly offered to the masses.


However, what about the present/immediate future, when tests exist to detect these diseases but there are no treatments, and those with these diseases often require expensive treatment to stay alive and face an early death regardless of treatment?



I think the key word here is "offered".  Most of the theories I see
raised on this subject, IMO, seem paranoid.  They make it sound like our
culture will force cures down the throats of people who need them.  If a
_communicable_ disease threatens large population groups then we can
logically expect to see vaccines and cures become mandatory by law.
Such a law would be established to protect large populations from
infection.  But, when a disease affects small, specific groups and is
non-communicable except from parent to child through genetics, then IMO
such mandatory laws are highly unlikely to be enacted.

AFAIK, Homosexuality and Low/High IQ's are not recognized in the medical
community as diseases.


True. I threw those in for discussion since _some_ people have treated them as diseases either in RL or in SF.



Mental retardation is, but I'm not sure the
causes are usually genetic.  Isn't the brain damage most frequently
caused by oxygen deprivation as a result of drug/alcohol use during
pregnancy or complications during birth?

Try 'curing' homosexuality with genetic manipulation and see how far you
get.  I have strong doubts that such a program would ever get off the
ground due to the incredible uproar it would produce.


However, *if* it turned out to have a genetic basis, I can imagine that a lot of parents today, if their child tested positive, would want the child cured. Or would consider an abortion, if there were no cure available.



Arguments for and against can be argued ad infinitum without resolution.


I didn't intend to lead this discussion into that irresolvable argument. I was saying that there are some people who have already made up their minds on this issue, and some of them may believe that anything is better than living life with same-sex attraction (those who commit suicide) or having a child who will grow up to be SSA.



Deborah Harrell wrote:
><serious>
>As someone who does have a spontaneous mutation that,
>if passed on, has a 50/50 chance of causing mental
>retardation, various cancers and behavioral deficits,
>this is not an academic issue for me.  At the time
>that I would have considered starting a family with
>the right man, there were no prenatal tests available;
>after a great deal of painful consideration, I chose
>not to have children.

Jon Gabriel wrote:
I've never seen statistics on this, but I would expect that yours would
be the most common choice.  I know a couple who went through in-vitro
four times to make sure they didn't pass on a genetic defect.


How much did they spend on those procedures? Can every couple in their situation afford them?




--Ronn! :)

I always knew that I would see the first man on the Moon.
I never dreamed that I would see the last.
--Dr. Jerry Pournelle


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