Cowan, Ruth Schwartz. "Genetic Technology and Reproductive Choice," in Daniel J. Kevles and Leroy Hood, eds. The Code of Codes: Scientific and Social Issues in the Human Genome Project. Cambridge, MA: Harvard University Press, 1992. pp. 244-263.

The primary practical usefulness of the Human Genome Project (HGP)--at least for the foreseeable future--is pre-natal diagnostics; that is foetal testing, not therapy as no such in utero therapy exists other than abortion (which as Cowan suggests, is hardly therapeutic). Ruth Schwartz Cowan offers a history of pre-natal diagnosis that is informed by analyses of technical systems and feminist ethics.

Pre-natal testing is considered in terms of the three characteristics that all technological systems share. First, their motives are highly significant, but are not wholly deterministic. Second, they have embedded objectives which are different from their overt objectives; as wise consumers and citizens we must be ever vigilant in determining what these embedded objectives are. Third, they have unintended consequences, which we should nonetheless try to anticipate and guard against.

The first characteristic to be determined pre-natally was sex, beginning in 1949. The first practical application of this discovery was to screen for sex where there was a family history of haemophilia, a practice that soon became routine. The first documented case of a foetus being aborted following pre-natal screening (the foetus was known to have Down's syndrome) came less than twenty years later. By 1975 amniocentesis had moved into regular clinical practice; this in combination with the American Roe v. Wade "abortion on demand" legislation led to "non-medical" sex selection, opening up an ethical dilemma which put the theses of "doing no harm," "respecting patient autonomy" and "non-directive counselling" into conflict with one another. To this day no consensus has been reached.

Feminist ethics are employed to tread a path through this conflict. Cowan uses Carol Gilligan's work on ethics to conclude that "nurturance matters" (358) and that it matters first. She argues that this principle guides decisions in two ways: since the goal of all nurturance is to ensure independence one considers (1) whether independence for the foetus is a future probability and (2) how nurturing this foetus/child will affect one's ability to nurture others or oneself. Policy built along this principle places the decision to abort or not to abort in the hands of women.

Tensions exist between fears about eugenic uses of pre-natal testing and fears about infringement on individual rights, in this case access to abortion. Cowan argues that history shows that there is nothing to fear so long as abortion is kept firmly in the control of women: "why fear a future in which ever more children will be ever more wanted by their mothers?" Ultimately the argument is a civil libertarian one that gives precedence to the rights of individuals (in this case individual women) over all other considerations and that warns against government "interference" and regulation.

See also Hershey, "Choosing Disability".