5 ms·

Let me ask an even crueler question. Let me preface by saying I am a parent of a child that needed some minor postpartum care in order to survive, so how horrib

by daxorid 10y ago

Let me ask an even crueler question. Let me preface by saying I am a parent of a child that needed some minor postpartum care in order to survive, so how horrible this sounds is not lost on me: At what point do we stop holding up infant mortality as the gold standard of medical care? Spending untold resources on keeping alive infants who would otherwise die is inherently dysgenic, and allowing whatever conflagration of genetic anomalies that contribute to the necessity of postpartum care will inevitably lead to higher incidences of these cases in the future, as these genes are allowed to propagate into future generations. Infant mortality is emotionally devastating, but preventing it will almost certainly increase our society's long-term medical costs.

JoeAltmaier 10y ago
But it also selects for empathy and parenting. Both will help build a better society. In fact we've been sacrificing physical skills for emotional ones, as long as human societies have existed. This is nothing new for sure.
sliverstorm 10y ago
On the other hand, something that is trivially treatable can be borne without issue, which, who knows, could enable later advancement. Just look at the established tradeoff our species makes- our children are born helpless. Isn't caring for them dysgenic? But, being able to care for & protect them enables significant brain development to happen outside the womb. Swaddling, clearing a wrapped umbilical cord, suctioning the nose & mouth... there are lots of things we do that improve mortality that are trivial.
pmarsh 10y ago
Along this topic, if we are spending so much on these infants why is our rate higher than other first world countries? Finland which is number one, "used the least resources and attained average results, making Finland the most efficient public sector health service producer according to the study's authors" https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-infant-mortality-rate-is-a-national-embarrassment/ https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-i... Granted it's way better than many other countries, but still we shouldn't be so off. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html https://www.cia.gov/library/publications/the-world-factbook/...
- tedunangst 10y ago
  Spending is unevenly distributed. Poverty and drugs have a negative effect. Basically, spending 100 million on one baby born without a heart doesn't save twenty other crack babies.
xkcd-sucks 10y ago
"fail early, fail often"
- npiazza83 10y ago
  If you want to be a visionary, go out and have some accidents!
cfmcdonald 10y ago
Wasn't this line of thinking discredited with the Nazis? Is eugenics back now? Do you also have a modest proposal for solving the problem of all those excess poor children?
- rch 10y ago
  Wright or wrong, this doesn't fit the definition of eugenics.
  - ceejayoz 10y ago
    How does this not fit the definition of eugenics? > Spending untold resources on keeping alive infants who would otherwise die is inherently dysgenic, and allowing whatever conflagration of genetic anomalies that contribute to the necessity of postpartum care will inevitably lead to higher incidences of these cases in the future, as these genes are allowed to propagate into future generations.
    - tedunangst 10y ago
      Well, cystic fibrosis patients are encouraged not to have children. Is that eugenics? In the extreme, with enough time and money we could even harvest eggs and sperm from CF patients to ensure they can procreate even if they don't live long enough to do so. Is it eugenics to not spend those resources?
      - ceejayoz 10y ago
        It's a pretty big gap between "don't treat preemies who might be perfectly normal once stabilized" (case in point: my kids) and "you should think about not giving a kid a death sentence" that CF entails.
- daxorid 10y ago
  Eugenic/dysgenic thinking has never been discredited. Rather, it has fallen out of favor for ethical, not scientific reasons.
dredmorbius 10y ago
Childhood mortality has to have imposed a tremendous selective pressure, on both the immune system and general congenital defects. I've been reflecting on what lifting this selective pressure means. Also on the fact that this lifting is nonuniform across cultures -- infants in less-developed nations are still subject to most of these effects. That said: most of the improvement is through public health measures (clean drinking water, sewerage systems, municipal waste collection) and nutrition. Heroic measures are very much the outlier. That may be an even stronger argument against them -- other than as a learning experience, the resources they consume relative to providing much more basic, and effective, outcomes interventions is difficult to defend. From the CDC: Infant mortality in the US <1 year was "up to" 30% in 1900. Maternal mortality was around 0.8% in 1900. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm

by daxorid 10y ago

JoeAltmaier 10y ago

But it also selects for empathy and parenting. Both will help build a better society. In fact we've been sacrificing physical skills for emotional ones, as long as human societies have existed. This is nothing new for sure.

sliverstorm 10y ago

On the other hand, something that is trivially treatable can be borne without issue, which, who knows, could enable later advancement. Just look at the established tradeoff our species makes- our children are born helpless. Isn't caring for them dysgenic? But, being able to care for & protect them enables significant brain development to happen outside the womb. Swaddling, clearing a wrapped umbilical cord, suctioning the nose & mouth... there are lots of things we do that improve mortality that are trivial.

pmarsh 10y ago

Along this topic, if we are spending so much on these infants why is our rate higher than other first world countries? Finland which is number one, "used the least resources and attained average results, making Finland the most efficient public sector health service producer according to the study's authors" https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-infant-mortality-rate-is-a-national-embarrassment/ https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-i... Granted it's way better than many other countries, but still we shouldn't be so off. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html https://www.cia.gov/library/publications/the-world-factbook/...

tedunangst 10y ago
Spending is unevenly distributed. Poverty and drugs have a negative effect. Basically, spending 100 million on one baby born without a heart doesn't save twenty other crack babies.

xkcd-sucks 10y ago

"fail early, fail often"

npiazza83 10y ago
If you want to be a visionary, go out and have some accidents!

cfmcdonald 10y ago

Wasn't this line of thinking discredited with the Nazis? Is eugenics back now? Do you also have a modest proposal for solving the problem of all those excess poor children?

rch 10y ago
Wright or wrong, this doesn't fit the definition of eugenics.
- ceejayoz 10y ago
  How does this not fit the definition of eugenics? > Spending untold resources on keeping alive infants who would otherwise die is inherently dysgenic, and allowing whatever conflagration of genetic anomalies that contribute to the necessity of postpartum care will inevitably lead to higher incidences of these cases in the future, as these genes are allowed to propagate into future generations.
  - tedunangst 10y ago
    Well, cystic fibrosis patients are encouraged not to have children. Is that eugenics? In the extreme, with enough time and money we could even harvest eggs and sperm from CF patients to ensure they can procreate even if they don't live long enough to do so. Is it eugenics to not spend those resources?
    - ceejayoz 10y ago
      It's a pretty big gap between "don't treat preemies who might be perfectly normal once stabilized" (case in point: my kids) and "you should think about not giving a kid a death sentence" that CF entails.
daxorid 10y ago
Eugenic/dysgenic thinking has never been discredited. Rather, it has fallen out of favor for ethical, not scientific reasons.

dredmorbius 10y ago

Childhood mortality has to have imposed a tremendous selective pressure, on both the immune system and general congenital defects. I've been reflecting on what lifting this selective pressure means. Also on the fact that this lifting is nonuniform across cultures -- infants in less-developed nations are still subject to most of these effects. That said: most of the improvement is through public health measures (clean drinking water, sewerage systems, municipal waste collection) and nutrition. Heroic measures are very much the outlier. That may be an even stronger argument against them -- other than as a learning experience, the resources they consume relative to providing much more basic, and effective, outcomes interventions is difficult to defend. From the CDC: Infant mortality in the US <1 year was "up to" 30% in 1900. Maternal mortality was around 0.8% in 1900. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm