Eugenics in France

, first theorist of eugenics. In France, in particular, eugenics is a taboo subject, described as "shameful, long stigmatized after World War II," according to historian Anne Carol, and "anathematized in French historiography," according to historian Valentine Hoffbeck. This field of research was opened by Jacques Léonard, a historian specializing in medicine and health, who officially led a postgraduate program (D.E.A.) in 1984 dedicated to the origins of eugenics in France at the University of Rennes-II. Previously, it was approached through the lens of political science. , whose thesis focuses on French eugenics, highlights the difficulties posed by this subject, particularly in terms of anachronism (reinterpreting the past in light of knowledge about the Nazi genocide). According to Anne Carol, the strong involvement of doctors in this movement represents a French specificity compared to the development of eugenics in other countries, particularly the United Kingdom, where statisticians mainly drove its defense. At first glance, the association between "eugenics" and "medical" seems contradictory—the former referring to the physical elimination of individuals, and the latter to care, healing, ethics, and the duty of assistance. The concept encompasses any influence on "human selection," whether through genetic or environmental factors. In 1904, he characterized eugenics as "the science that deals with all influences that improve the innate qualities of a race." It is imperative to discern between the "positive" form of eugenics, which prioritizes the selection of "superior" individuals, and the "negative" form, which involves the physical removal of those deemed to be "dysgenic." Terminology 's writings developing the notion of eugenics in France. A terminological challenge emerges when exploring the history of eugenics in France. The English word "eugenics," first translated into French in 1886, has been introduced to the French language in two forms, both channelled by the racist theorist Georges Vacher de Lapouge. The first, "eugénique," was used to denote individuals who exhibited above-average intellectual abilities, while the second, "eugénisme," Before 1914, the term eugénisme was seldom used in French. over eugénique or eugénisme. Pediatricians could thus conceal their eugenic objectives. In his doctoral thesis in medicine, Dr. Louis Simon proposed the term eugénétique. The ideology of eugenics traditionally draws from the ideology of Thomas Malthus (Malthusianism), who believed that the poor were responsible for their plight because they reproduced despite lacking the material means to support themselves. Additionally, it draws from interpretations of Charles Darwin's theories, known as social Darwinism, which argue that only the strongest and best-adapted individuals survive. The third current is a neo-Malthusian, pacifist, and libertarian eugenics influenced by feminism and particularly promoted by educator Paul Robin. Ethicist Gwen Terrenoire identifies five ideological currents: a medical current led by Adolphe Pinard, a neo-Malthusian current promoted by Paul Robin and continued by Édouard Toulouse, an interventionist current advocating sterilizations and marriage controls promoted by the during the 1930s, and a biocratic current led by Alexis Carrel. , whose interpretation of the texts and statements gave rise to neo-Lamarckism, an ideology that had a profound influence on the history of eugenics in France. Taguieff's observations reveal that certain currents within these movements were characterized by mutual exclusivity. In contrast to the predominantly Darwinian approach found in Anglo-Saxon eugenics, French ideology exhibited a stronger inclination towards Lamarckian principles. This neo-Lamarckism, which emerged as a response to the prevailing hereditary theories of the era, This distinctive approach marked a notable distinction between French eugenics and other European movements within the same period. Historian and sociologist Alain Drouard examined the neo-Malthusian eugenics current more closely, highlighting significant overlaps between neo-Malthusianism and negative eugenics, as well as continuity in the associative commitments of proponents of both ideologies. == History ==

France's implementation of eugenic principles within its legal framework was comparatively modest when evaluated against other nations. For instance, France did not adopt legislation authorizing voluntary or compulsory sterilization for mental disability or criminality, a practice that was prevalent in numerous Western countries. According to Taguieff, the adoption of eugenics in France might be perceived as a non-introduction, given its distinct historical and social context. The contrast with Britain and, more notably, the United States is particularly salient: France did not witness a comparable eugenics movement that influenced significantly its political policies. Origins of French eugenics before Francis Galton According to , a distinct form of eugenics emerged in France that was distinct from Galton's thought. This eugenics addressed unrelated issues and emerged as a by-product of the evolution of medicine itself. The primary motivation behind this development was to combat "human degeneration" and regulate unions and procreation. According to Anne Carol, the earliest contributions to French eugenics can be traced back to the 17th century. During this period, treatises on the "art of procreation" began to be published, primarily intended for parents in private. These treatises contain extensive lists of factors believed to contribute to "good offspring" and introduce the concept of "degeneration" of the human species. Beginning in the late 18th century, treatises began to address legislators, proposing collective measures in the "public interest." For example, Charles-Augustin Vandermonde's Essay on the Way to Perfect the Human Species (1756) is an illustration of this phenomenon. In 1801, Robert Le Jeune published his Essay on Megalanthropogenesis, a neologism of his creation. In this essay, he advocated for forming a human elite under state guidance through marriage incentives. In that same year, physician P. Mahon articulated his opposition to the union of individuals afflicted with "contagious or hereditary" ailments, Another source of concern lay in the French colonial empire, where racialists like Guillaume Poncet de la Grave (1725–1803) led active campaigns against interracial marriages between Black men and French women, claiming this would expose French blood to "corruption" and produce "disfigured" children. File:Essai sur la manière de perfectionner l'espèce humaine - Charles-Augustin Vandermonde.jpg|''Essai sur la manière de perfectionner l'espèce humaine'' by Charles-Augustin Vandermonde, 1756. File:Essai sur la mégalanthropogénésie Louis-Joseph-Marie Robert.jpg|Essay on megalanthropogenesis by Louis-Joseph-Marie Robert, 1801. File:Arthur de Gobineau, Essai sur l'inégalité des races humaines (original).jpg|Essay on the inequality of human races by Arthur de Gobineau, 1853-1855. File:Traité des dégénérescences - Bénédict Augustin Morel.jpg|Traité des dégénérescences by Bénédict Morel, 1857. During the first half of the nineteenth century, pre-eugenic manuals placed significant emphasis on the concept of love within couples, positing that this emotional bond was instrumental in yielding offspring who were both aesthetically pleasing and robust. Arthur de Gobineau's influential Essay on the Inequality of Human Races (1853–1855) introduced a racial dimension to this discourse, establishing classifications and unveiling what Catherine Bachelard-Jobard, a legal scholar, has termed "conceptual articulations characteristic of eugenics." The notion of human degeneration was revived by psychiatrist Bénédict Morel in his 1857 Treatise on Degeneration, which advocated for the establishment of public health programs to prevent it. His alienist disciples expanded on this notion within their field. In 1863, Dr. Rey published Degeneration of the Human Species and its Regeneration, recommending the elimination of sick progenitors and incentives for "regenerative" unions. The theory of degeneration gained significant traction among journalists, politicians, and the general public, Medicine was positioned as the sole bulwark against these so-called deviations. , photographed here in 1865 at the age of 35 by Nadar, three years after her preface to Charles Darwin's work, is considered to be the author of one of the first eugenics texts published in France. One of the earliest French texts that can be considered truly eugenic is Clémence Royer's preface to Charles Darwin's work in 1862, in which she expressed a desire to eliminate the weak and infirm. Dally introduced the legal concept of moral responsibility and proposed the establishment of asylums to confine incurable deviants for life. The innate or acquired nature of criminality fueled debates of the time, which gradually radicalized toward preventing criminals from being born and reproducing due to the "ineffectiveness" of imprisonment. The objective of reducing infant mortality constituted a significant concern, thereby enabling medical professionals to intervene during pregnancy and subsequently with very young children. This led to the conceptualization of puericulture, initially formulated as a medical science focused on the hygienic upbringing of young children, which was introduced by A. Caron in 1865 to reduce the number of "degenerate" children. A third source contributing to eugenics lay in venereology, as the desire to prevent the spread of syphilis inspired proposals for premarital screening tests. After France's defeat by Germany in 1870, military medicine entered these debates, promoting a hygienist discourse. According to Anne Carol, individuals advancing these convergent arguments regarded eugenics as the ultimate solution to the problems they raised. The advances in horticulture and animal breeding likely influenced these ideas. In this context Jacques Léonard asserts that "Galton's eugenics did not fall on virgin soil in France." William H. Schneider, the emeritus professor of history, perceives it as a response to social concerns regarding degeneration and the decline of the population. This perspective is informed by slower population growth compared to Germany following the defeat in the Franco-Prussian War of 1870. During the 1890s, these ideas were influenced by the rise of nationalist anti-Semitism, and from the 1900s, the principles of Mendelian genetics were incorporated. A central tenet of this movement was the pursuit of control over human reproduction, marking a departure from the laissez-faire In 1884, Alfred Naquet achieved legal recognition of eugenics as a valid grounds for divorce, presenting it as a health concern that threatened loved ones (e.g., drunkenness, madness). Between 1886 and 1888, the racist theorist Georges Vacher de Lapouge introduced the terms "eugenic" and "eugenics" into French in his publications, which were featured in the ''Revue d'anthropologie. The neo-Malthusian movement was significantly influenced by Paul Robin, who established the "League for Human Regeneration" in 1896, along with the journal Régénération. In that same year, Maurice Barrès also employed the term "eugenics" in his Cahiers''. At the beginning of the 20th century, concerns regarding eugenics in France were initially provoked by discourse concerning the nation's declining population. This discourse was subsequently reinforced by prominent demographers. Eugenicists expressed concern that marital decisions might be influenced by factors such as commercial interests and financial status, rather than by love and physical attraction. In 1901, retired medical professor J. Servier proposed in the ''Archives d'anthropologie criminelle that criminals undergo castration to eliminate "degenerate procreators." In 1902, Paul Robin shocked attendees at a family assistance congress by suggesting the sterilization of parents who "burden humanity with degenerates." Eugenic law proposals met with limited success, particularly the proposed therapeutic abortion for "bad heredity" submitted in 1909. The authors lauded romantic unions between "strong and beautiful" men and women, aligning with a prevailing ethos of eugenics and the glorification of physical beauty. This work is part of a broader series of publications that equated the breeding of humans with the breeding of animals, particularly horses. Examples include L'élevage humain by in 1917 and Le haras humain'' by Charles Binet-Sanglé in 1918. French Society of Eugenics The inaugural international eugenics congress, convened in London in 1912, attracted a French delegation of 40 individuals, predominantly medical professionals, who constituted the "founding core" of the (SFE). Upon their return to France, several participants were convinced of the necessity to organize their forces. The official establishment of the SFE transpired on 29 January 1913, De Plauzoles was alarmed by the supposed higher reproduction rate of the "lower classes." Most of the pioneering members of the SFE were "strongly anticlerical, and for some, violently anti-Christian." Richet, along with other eugenics theorists, opposed the concept of Christian charity. Two conflicting perspectives emerge: one advocating for public and authoritarian intervention, and the other promoting private and incentive-based action. The SFE proposes a preventive and "scientific" approach to address social issues. Given the horrors associated with sterilization practices in other countries, proponents of French eugenics generally favor measures involving the spatial separation of criminals, the "insane," and alcoholics. The discourse encompasses a range of contentious subjects, including the castration of criminals, the "reproductive duty" of men considered superior, and recommendations to deploy the least fit individuals, including those with physical and mental disabilities, to the front lines during World War I, a practice euphemistically referred to as "purging" the French population. The French Society of Eugenics encountered limited success due to a lack of financial resources. Association for sexological studies A sexological movement, supported by its association, scholarly society, and publication, aimed to "rationalize social and sexual life through science" and was created in the 1930s on the initiative of psychiatrist Édouard Toulouse, an active member of the French Society of Eugenics. Toulouse sought to limit procreation among "mentally deficient" individuals. Despite the support of prominent figures, including members of the French psychoanalytic movement (Paul Schiff and Marie Bonaparte), the association had very little impact. He attributes the cause of this to the economic crisis. According to Alexandre Moatti, the eugenics of the 1930s foreshadowed transhumanism, particularly through the writings of engineer Jean Coutrot in 1937, and those of Alexis Carrel in 1935. The use of IQ tests increased significantly during this period. Renowned eugenicist Dr. René Martial, a lecturer at the Institute of Hygiene at the Paris Faculty of Medicine, furthered his eugenic theories by incorporating Mendelian genetics. These theories influenced racist policies, leading to significant advancements in the study of "many developments on the French race, miscegenation, and the 'unassimilable' Jews." This foundation adopted a cautious approach, opting to discontinue the proposed establishment of a "genetics and eugenics" section in the fall of 1942. Nevertheless, it engaged in a collaborative endeavor with the prevailing regime, investigating the "genetic qualities" of immigrant families residing in the Paris suburbs during the deportations to Drancy. The preamble to the law noted that "for the first time, a measure of eugenics appears in French legislation: the medical examination certificate before marriage." Mortality in psychiatric institutions A relatively obscure fact is that thousands of people interned in French psychiatric asylums died of starvation under the Vichy regime due to food restrictions. This excess mortality affected between 40,000 and 50,000 people across France: 40,000 according to Max Lafont and ; while according to Claude Quétel and Olivier Bonnet, their number is closer to 50,000. The majority of these deaths occurred between 1941 and 1943. Among the artists who perished were , , Séraphine de Senlis, and Camille Claudel. According to science historians and Alexandre Moatti, a robust ideological denial of the inhuman character of eugenics itself enabled prominent figures who promoted this ideology, most notably biologist Jean Rostand, to persist in its defense during the "Trente Glorieuses"; the notion of enhancing the human genetic heritage remained pervasive. Raymond Turpin, a Parisian and active member of the French Society of Eugenics before the war, was one of the French geneticists responsible for the discovery of the cause of Down syndrome. In 1956, Turpin expressed concern about the survival rates of handicapped babies: During the 1970s, a logic informed by scientific progress and eugenics, which sought to "track chromosomal anomalies as errors of nature requiring correction," gradually gained traction in France. Concurrently, various far-right political movements continued to assert their affiliation with Alexis Carrel. The reality of Nazi eugenics remains largely unknown in France, though it is frequently cited in bioethics debates. == Analyses of the political failure of eugenic theory in France ==

Eugenics theorists largely failed in their attempts to establish their ideas politically and implement them under the Third Republic. Humanist doctors opposed their eugenicist counterparts, and French doctors adhered to the tradition of liberal medical practice and rejected interventionism. Depopulation According to the philosopher , the ease with which eugenics was implemented in other countries can be attributed to different social fears. In the United States, eugenics was linked to immigration, while in England, it was associated with the working classes. In France, however, the primary concern was the health and development of children, which was more compatible with a hygienist intervention policy than with eugenics. Schneider and Taguieff posit that the prevailing concern regarding depopulation represented the primary impediment to the adoption of eugenics measures. In addition, Carol's research underscores how the depopulation that ensued in the aftermath of World War I engendered a societal environment that proved to be incongruent with the pursuit of sterilization and abortion policies. Pierre-André Taguieff observes that the failure of eugenics is pervasive in all Latin Catholic countries, where Catholicism generally condemns birth control and non-reproductive sexual acts. French doctors align with Catholic values that prioritize family, morality, and social virtues. The emergence of eugenics discourse at the close of the 19th century posed a challenge to Christian moral doctrine, as the Church feared that science would supersede it. In May 1930, the Christian Marriage Association convened a national congress in Marseille, to deliberate on the relationship between the Church and eugenics. The conclusions of this congress affirmed eugenics, but only under the condition that it served to "ensure the multiplication of humanity" (i.e., "pro-life eugenics"), and firmly condemned birth control. This papal condemnation effectively curtailed the potential support that French Catholics might have previously extended to the eugenics ideology. French Catholics similarly rebuffed the eugenic proposal for a prenuptial examination law. Nevertheless, a handful of marginal figures, including Alexis Carrel, endeavored to harmonize their faith with eugenic convictions. Catholic representatives persisted in their opposition to any manifestation of eugenics and birth selection in France, predicated on the tenet of the sanctity of human life. == Main theorists of historical eugenics ==

Pierre-André Taguieff and science historian identify two primary proponents of historical eugenic ideology in France: Charles Richet and Alexis Carrel. He introduced a doctrine that integrated elements of Darwinism, socialism, and Aryanism, a term denoting racial prejudice. In this work, he advocated for the selective reproduction of certain physical traits, such as those exhibited by the Aryan, dolichocephalic, and blonde populations. He theorized that this "elite" group would serve to "perpetuate the race," Vacher de Lapouge regarded eugenics as the sole means to avert potential interracial conflicts. Adolphe Pinard Adolphe Pinard, a founding vice-president of the SFE, emerged as a prominent proponent of a "positive" and natalist eugenic ideology. He reinterpreted the concept of puericulture (childcare) as part of an "ambitious project of medical control over procreation," to exert influence over the child from the moment of conception. Pinard, who concurrently held the position of deputy, undertook the initiative of assembling a cadre of SFE-affiliated medical professionals to develop a certification program, the objective of which was to empower these individuals with substantial regulatory authority over marital unions and the selection of prospective parents. The proposed legislation, introduced by Pinard in 1926, was never deliberated in the Chamber of Deputies. Charles Binet-Sanglé , from a photograph of Cauville. In ''L'Art de mourir'', Charles Binet-Sanglé advanced a defense of suicide and proposed a technique for its execution. Specifically, he advocated for the use of gassing on individuals deemed to be "deformed," following a period of persuasion regarding their perceived social harm. Influenced by American ideas, he advocated for the establishment of a voluntary eugenic aristocracy. For Carrel, confronting the issue entailed the implementation of a form of "salvational eugenics," which entailed the state's interventionist role, guided by the principles of medicine and biology. Carrel was among the first to introduce transhumanist concepts such as "biocracy" and "androtechnics," advocating for the elimination of tens of thousands of individuals considered to be detrimental to humanity's future through forced sterilization or euthanasia. In this book, Sutter criticized Nazi ideology, asserted the disappearance of eugenics as a scientific methodology, and its survival as an ideology, while avoiding the term "race" and preferring "population." Patrick Tort's interpretation of this text is that it firmly established the notion of distinguishing between desirable eugenics and criminal eugenics, the latter of which is associated with Nazi atrocities. == Since the 1990s ==

The discourse surrounding eugenics underwent a resurgence in the 1990s, coinciding with significant advancements in molecular biology and biotechnology. A substantial portion of this discourse revolves around divergent interpretations of the term "eugenics." According to the definition of eugenics as a practice aimed at optimizing the human genetic heritage, none of the contemporary biotechnologies can be classified as such. In contrast, Henri Atlan reserves the term "eugenics" for practices before 1945. The debate also encompasses the question of the unity and continuity between the historical, authoritarian form of eugenics and modern medical practices. Perruche case The is a protracted legal proceeding involving Nicolas Perruche, a child born in 1989 with severe disabilities resulting from rubella contracted by his mother. This case has ignited a discourse surrounding the notion of "prejudice of being born," ableism, and eugenics. The Perruche ruling established that a disabled child could be subject to prejudice due to their birth and be deemed a medical error. This ruling has been interpreted by some authors as a form of encouragement regarding abortion. In particular, it has been suggested that specialists in prenatal diagnosis may be prompted to recommend medical termination of pregnancy "at the slightest doubt regarding the normality of the child." Ban on forced sterilizations The question of the possibility of sterilizing people with mental disabilities has repeatedly arisen in France, In 1994, the European Union prohibited any irreversible harm to the reproductive organs of individuals, a prohibition that was incorporated into the French Civil Code during the same period. However, the (APF) denounced the lack of a clear ban on these practices in 1996 and 1997, stating that "each adjustment with ethics is ultimately a further step toward de facto eugenics. The recent history of eugenics should nonetheless make us vigilant." A survey conducted in Gironde reveals that, in the 1990s, one in three mentally disabled women underwent sterilization, with a further two in three residing in specialized care facilities. In 1997, the satirical newspaper Charlie Hebdo reported, citing researcher Nicole Dietrich, that 15,000 women in French institutions for mentally disabled individuals had been sterilized under duress, either at the request of their families or on the initiative of the institution's medical staff. Nevertheless, it remains feasible for parents to undergo this procedure in a foreign nation where it is permissible. A new form of eugenics? and the use of liberal eugenics. The concept of a novel form of eugenics, occasionally referred to as "liberal eugenics," is predicated on the autonomy of parents to elect to deliver a child, or not, if said child is identified as potentially disabled or ill before birth. According to the French philosopher Jean Gayon, this "new eugenics" emerges from the convergence of advancements in prenatal screening techniques and the decriminalization of abortion, which enables pregnant French women to terminate their pregnancy if a "serious, proven or presumed anomaly" is detected in the fetus. Ethics professor Gregory Katz-Bénichou posits that "the nascent orthogenics of the 21st century extends the eugenic theses of previous centuries." He asserts the existence of an uninterrupted lineage between the historical eugenic ideology espoused by Georges Vacher de Lapouge and the preventive medicine of the 21st century, particularly concerning the establishment of a medical boundary between the normal and the pathological. This boundary is often conflated with a moral boundary between what is considered good (normal) and what is regarded as bad (abnormal). This conflation results in the elimination of the abnormal being perceived as morally acceptable. postulates a continuity between the writings of Charles Richet, who advocated for the "elimination of the abnormal," and the arguments justifying medical abortion for disability or illness, despite a difference in intentionality. Noted urologist-surgeon Laurent Alexandre has been a vocal proponent of genetic selection, citing Israel as a paradigm of a "eugenic country" that has successfully eradicated Tay-Sachs disease as an example. Gaïa Lassaube, a sociology PhD student, has critiqued Alexandre's arguments, labeling them as "pseudoscientific," and suggesting that they serve to "liberate a relaxed eugenic discourse." In his column titled "Gifted Women Have Fewer Children," published in ''L'Express'' on 31 January 2018, Laurent Alexandre advocated for easier access to gamete preservation and assisted reproductive technology for women with doctorates. == Legislation ==

The concept of eugenics was introduced in the French law of 29 July 1994, the first French bioethics law, in the section concerning respect for human bodies (Chapter III, Section I, Article L 511-1). The adoption of this law sparked long debates aimed at defining the concept of eugenics in a way that would prevent its abuses while not hindering biomedical research. The current Penal Code addresses the issue of eugenics in Subtitle II of Title I, Book II, entitled "Crimes Against the Human Species": • Article L 214-1: "The implementation of a eugenic practice aimed at organizing the selection of people is punishable by thirty years of criminal imprisonment and a fine of 7.5 million euros." • Article L 214-3: "This penalty is increased to life imprisonment and a fine of 7.5 million euros when committed in an organized group." The Civil Code, Article 16-4, states that "no one can harm the integrity of the human species. Any eugenic practice aimed at organizing the selection of people is prohibited." European laws (European Bioethics Convention) and texts from supranational organizations (UNESCO) influence French bioethics laws, although they are not legally binding. The National Consultative Ethics Committee (CCNE) is regularly consulted. Although the prohibition of eugenics appears to be solemn and unquestionable, the French position is more ambiguous. French law also provides incentives and legal exceptions to avoid giving birth to children with malformations or presumed disabilities. The legislation under scrutiny prohibits the implementation of collective eugenic selection, yet it does not extend to the prohibition of eugenic ideology or individual eugenic practices. Catherine Bachelard-Jobard posits the hypothesis that the legislation may be aimed at Galtonian and Nazi eugenics, that is, state-planned selection, a scenario that would be difficult to implement in France. She concludes that "The scope of this principle text is ultimately very limited. The legislator articulates a principle that prohibits state eugenics, while permitting all prevailing practices, contingent upon the autonomy of parents and their aspiration to procreate a healthy offspring." The formulation "organization of the selection of people" is strategically employed to forestall any conflation of the practice of medical abortion (IMG) with eugenics. Moreover, the concept of "protection of the genetic heritage of humanity" is devoid of any constitutional significance. == Ethical questions regarding disability or illness ==

(CCNE). The fundamental inquiries concerning contemporary eugenic hazards are contingent upon the establishment of criteria to delineate between what is "normal" and "pathological," A further inquiry pertains to the universal consideration of certain mutated genes within the human species as defective and therefore subject to elimination, given the potential for genetic diseases to confer a situational selective advantage. It is imperative to acknowledge the inherently subjective nature of these definitions (disability, normality, etc.). According to the bioethics study published by the French Council of State in 2009, eugenics "can also be the collective result of a series of converging individual decisions made by future parents, in a society where the search for the 'perfect child,' or at least one free from many serious afflictions, prevails." Doctor in law (CNRS) discusses the creation of criteria for the legitimacy of abortion defined in prenatal screening centers in France, which anthropologist describes as "the broad outlines of a doctrine of tolerable or desirable eugenics." For Gregory Katz-Bénichou, "Everyone will opt for the advantage of eugenic exemption. Theoretically, the choice remains individual, but in practice, it tends to become collective and systematic […]. 21st-century eugenics spreads in a peaceful medico-parental consent, protected by democratic values." potentially leading to practices such as embryo selection and the euthanasia of elderly individuals. Finally, eugenic birth selection based on the search for normality raises the question of its compatibility with the very notion of natural selection, since the regular birth of "abnormal" individuals constitutes the norm in the absence of medical interventions. Another salient question in the French discourse on eugenics is economic. In January 1994, the High Council of Public Health articulated its position on the matter, stating, "A cost-benefit analysis, when it merely contrasts the collective cost of amniocentesis and karyotyping with the cost of caring for disabled children who would not have been screened — and under the assumption that a positive diagnosis is always followed by medical abortion — shows that prenatal diagnostic (DPN) activity is fully justified for the community." Down syndrome carrier, politically involved in the revision of bioethics laws. A social debate has emerged surrounding the ethical implications of screening for Down syndrome in France, with concerns that it could constitute negative eugenics. In his 18 October 1996 progress report, ‘’Screening for Down syndrome using maternal serum markers’’, Jean-François Mattei stated that pregnant women undergoing Down syndrome screening may enter a medical pathway with unclear implications and potentially unbeknownst to them. Unless they explicitly consent to an abortion, the procedure may take on an "eugenic essence, even under the guise of the doctor's desire to do good." When the future mother is adequately informed of the non-obligatory nature of screening and the option of pregnancy termination, this screening for Down syndrome is regarded as not having an eugenic objective. In 2009, two decrees were issued, followed by the 2011 revision of the bioethics law in July. These legal developments led to the incorporation of the obligation for healthcare professionals to inform pregnant women about the existence of Down syndrome screening into French law. This screening is systematically offered in a social context of the growing acceptability of medical abortion, both among healthcare professionals and the general population. Evolution of births of children with Down syndrome The number of births of children with Down syndrome is challenging to estimate due to the fragmented nature of the data. According to F. Goujard, the average number of births decreased from 800 to 900 children in 1990 to an average of 500 to 600 children in 2001, following the adoption of the nuchal translucency and serum markers diagnostic method. This change represented a reduction of approximately one-third in births. According to Gregory Katz-Bénichou, in 1999, 1,335 trisomic fetuses were aborted (95% of those screened), 357 children with Down syndrome were born, including 287 who were not screened, and 70 from couples who chose to give birth to a child diagnosed with Down syndrome (5%). In 2020, individuals with Down syndrome in France, encountering difficulties in locating peers, perceived themselves to be victims of eugenics. Positions taken A variety of associations and public figures have articulated their perspectives on France's policy concerning Down syndrome. The intricacies of this discourse are further compounded by the political and religious commitments of the primary actor, the . This foundation asserts that France is "at the forefront of eugenics" due to its bioethical legislation, which it contends results in "the elimination of an entire population of individuals selected based on their genome," a practice that it deems synonymous with the very definition of eugenics. "It is impossible to avoid the Lejeune Foundation when working on the subject of Down syndrome [...] with its eternal obsession: abortion, prenatal tests [...] the rhetoric of the pro-life far-right, its inappropriate comparisons, frequently made in speeches, to the Nazi Reich’s Aktion T4 program for the elimination of the disabled," says Yann Barte critically in Les Triso, les Catho, Éléonore et moi. Israel Nisand declares that he is "not far from thinking that France is practicing state-sponsored eugenics in this regard." For Jacques Testart, who calls it a "sly and consensual desire for eugenics," it "reveals a growing intolerance among populations towards physical or mental marginalities grouped under the term 'disabilities'." Physician adds that "parents who wish for the birth of these children must, in addition to the suffering associated with the disability, expose themselves to the community's judgment and a form of social cruelty born from the fact that they did not accept the proposal made by science and ratified by law." Short stature , French personality with achondroplasia. In 1996, the French physician Pierre Maroteaux published a scathing critique of eugenics as it pertains to individuals with short stature. In his article, Maroteaux compellingly argued that the prevailing societal attitudes concerning height, weight, and social status have led to a situation where individuals who do not conform to these standards face significant challenges, including the denial of basic rights. In her 1997 thesis, Corinne Assouline observes that the detection of pseudoachondroplasia, a condition marked by very short stature and a distinctive facial appearance without intellectual disability, is accepted in 80% of cases as grounds for medical abortion. This practice gives rise to ethical concerns, as the primary motivations for abortion are aesthetic (morphotype), which could potentially result in "complete eradication." In 2001, philosopher Alain Etchegoyen highlighted the widespread prescription of growth hormones to children with a form of dwarfism, a practice that he argued was influenced by advertising and eugenic drift in France. Congenital deafness Psychoanalyst André Meynard challenges the notion of liberal eugenics about individuals born deaf. He contends that selective abortion and the use of cochlear implants after birth can lead to the gradual extinction of individuals whose first language is sign language. This phenomenon, he argues, can be viewed as a form of eugenics that favors the extinction of non-verbal individuals and the predominance of those who can speak. == Ethical and legal questions by medical technique ==

Since the mid-20th century, there has been an increasing medicalization of pregnancies and births in France. , a vocal critic of the eugenic implications of certain medical techniques, particularly preimplantation genetic diagnosis (PGD), has long warned against the role of doctors and scientists as mere "executors of the normative fantasy." This position contrasts with that of Pierre-André Taguieff, who opposes eugenics based on a divergent definition of the term. Prenatal diagnosis / screening (DPN) , whose prenatal diagnosis unit offers screening outside the scope of approval permitted by French law. According to French law, prenatal diagnosis "aims to detect in utero a serious condition in the embryo or fetus" (Article L. 162-16, first paragraph, in the ). This 1994 law excludes personal convenience diagnoses aimed at knowing the characteristics of the unborn child. However, this approach is not without its limitations, as it can result in false positives, leading to diagnoses of diseases or disabilities that are non-existent, and false negatives, failing to detect diseases or disabilities. The amniocentesis technique was introduced in France in the 1970s, with its primary application being the detection of Down syndrome. This development marked a significant revolution in the field of genetic counseling, as it enabled the identification of fetuses suspected of being disabled or diseased before their birth. Since at least 2018, the unit has also offered screening for certain mutations associated with autism, followed by a proposed medical abortion for the future mother. Medical abortion (IMG) In France, the regulatory framework surrounding medical abortion (IMG) differs from that of voluntary abortion (IVG). This distinction arises because medical abortion, most commonly initiated following a prenatal diagnosis, is authorized at any point during the pregnancy, as outlined under Article L. 162-12 of the Public Health Code. The eugenic implications emerge as a result of the criteria that influence parents' decisions to opt for IMG, with this choice being shaped by their personal preferences (along with their economic and social circumstances), rather than those of the unborn child. This shift in criteria is evidenced by the increasing number of abortions performed on fetuses deemed to have conditions that do not meet the criteria for severe and incurable diseases, such as cleft lip Additionally, there has been a discernible shift in the use of IMG in cases of curable diseases, such as phenylketonuria. for couples at risk of transmitting a genetic disease to their future child. It involves taking one or two cells from an embryo resulting from in vitro fertilization, on the third day. According to the Biomedicine Agency, three-quarters of the 918 PGD requests it examined in 2016 were approved, with 774 embryo transfers, 251 pregnancies, and 199 live births. Deputy Philippe Berta proposed preimplantation screening for aneuploidies (and thus trisomies) during the 2019 bioethics law revision, which sparked debate over its eugenic nature but was not adopted. Selection of gametes Doctors Pierre Jalbert and Georges David have posited that techniques based on sperm and egg donation give rise to a eugenic question, given the selection process that occurs among donors under medical supervision, encompassing factors such as fertility and "genetic quality," with matching criteria. This eugenic question assumes particular relevance in the context of "genetic defects," which result in the exclusion of certain donors. Jacques Testart has characterized this selection as a "practice [that] subtly resumes the improvement project of Galtonian eugenics." Gene therapy and germline therapy Germline therapy, a procedure that was initially studied and promoted by geneticist in 1993 involves the correction of genetic defects directly in the father's sperm. This approach holds the potential for orthogenic effects prior to the sorting of embryos. Genome editing techniques are particularly associated with "positive" eugenics, enabling the selection of individuals based on the expression of genes associated, for instance, with intelligence. == See also ==