The social costs of genetic welfare

devote so much of the text to initially amusing but gratuitous and eventually tedious recitations of what the author regards as bizarre therapeutic agents. We hear far too much about such remedies as crocodile dung, dried earthworms, and mummy powder. The overall effect is to trivialize the question why, for example, a practice like bloodletting persisted in use for so long. The reader is invited to smile at past ignorance more than to ask what made such therapies-odd to our eyes-meaningful to healers and sufferers alike. A history of medicine may well entertain students, but it is unlikely to bring them the deeper and more lasting exhilaration of historical understanding. Despite their shortcomings, Andrew Wear's edited collection Medicine in society (1991) and even Erwin Ackerknecht's Short history of medicine (1955; revised edition 1968) offer much sturdier narrative frameworks upon which instructors and students can lean. The New Genetics is very topical. Considerable resources are being expended on a project to map the genetic structure that makes us what we are and the technological achievements seem to increase day by day. But in practical terms, what the technology has produced is not the ability to change human genetic material by sophisticated intervention, but by the rather more basic, and old-fashioned, technique of removing "impaired" material from the genetic pool. This latter approach has become possible as the ability to identify certain gene carriers has improved: this leads to the possibility of either selective abortion or persuading against reproduction. For example, it is now possible to screen a population for cystic fibrosis gene carriers, identify the one in two hundred who carry the gene, and advise them that if they reproduce with someone with a similar genetic make-up one in four of their children is likely to have the disease. But should this be done? And at what economic, psychological and social cost? And if for cystic fibrosis, what about other diseases? These are the real dilemmas of the new genetics. But there is another strand to examining the psychosocial implications of the new genetics and that is the literature-mainly popular-which talks wildly of the possibility of engineering our own futures. This book belongs to that genre. It ignores virtually completely the current problems associated with the possibilities of genetic screening and instead addresses hypothetical futures. But as it deals with speculation it is rather light on evidence; indeed, the book's idea …