BIRTH DEFECTS: MODERN APPROACHES TO DIAGNOSIS AND PREVENTION (Proceedings of the Fourth International Conference, Vienna, September 2-8, 1973). Edited by Arno G. Motulsky and W. Lenz. Amsterdam, Excerpta Medica, 1974, $40.40

[摘要] The final plenary grouping, entitled Modern Approaches to Diagnosis and Prevention, could stand by itself as a monograph. There are four articles covering prenatal diagnosis and three updating data on current screening programs, including a progress report upon what has been to me one of the most dramatic epidemiologic approaches to voluntary control of genetic disease-the Baltimore-Washington detection program for Tay-Sachs heterozygotes. Essays on genetic counseling by two outstanding scholars, C. O. Carter and J. H. Edwards, conclude this section. The final paragraph of Dr. Edwards' essay might well be engrossed in red, illuminated, and hung upon the office wall of those undertaking any form of counseling: "genetic counseling and foetal selection are unlikely to have much effect on the frequency of the underlying determinants of disease, and must be justified on grounds of private, rather than public, benefit. An extension of either activity into the field of normal variation may have serious consequences at the population level and can confer little benefit at the private level."During my reading of this book I was tempted on several occasions to make trite reference to Orwell and Huxley, or at least to the contemporary dictum of informed consent. In the end this proved completely unnecessary, since the final contribution before Professor Lenz' summary is an excellent essay by Arno Motulsky on the ethical issues of birth defects. This should be required reading for all students of genetics or medicine, and-above all-for those workers in the information media who compose or reconstruct learned pontifications.

[学科分类] 儿科学