New Forms To Old Ideas: Social
Darwinism and Human Research
- Luzitano B. Ferreira1
& Henry P. Novion2
1Pos-Graduate Program,
University of S‹o Paulo, Brazil.
Email: lbferr@rge.fmrp.usp.br
2Department of Genetics
and Morphology, University of Bras’lia, Brazil
Eubios Journal of Asian and International Bioethics 13 (2003), 206-7.
Abstract
Social Darwinism can be defined as an
attempt to apply the principles of biologic evolution to the social theories
and the moral codes of society. The fundamental principle is that all human
beings must follow the patterns of behavior that occur in nature, where the
"fight for survival" prevails. The equivocal application of the evolutionary
theory to society has given "scientific sustentation" to certain practices like
racism and imperialism. It gave strength to the idea of human races
biologically superior and inferior, trying to justify the segregation,
exploration and application of different ethical principles to human beings. In
reality, the application in the medical sciences of a theory like the social
Darwinism does not belong to the past. A subtle way emerged in the last years
as an ethical argument in favour of some researches with extremely vulnerable
patients in developing countries. Nevertheless, as history has shown us, the
application of inferior ethical patterns to the human beings from less favored
social classes is not founded on science, possesses severe ethical problems and
is not new.
Social Darwinism and Human Research
Social Darwinism can be defined as an
attempt to apply the principles of biological evolution to social theories and
to the moral codes of society. The fundamental principle of this thought is
that human beings must follow the behavior patterns that occur in nature where
the "fight for survival" prevails.
The equivocal utilization of the
evolutionary theory to society gave "scientific and ethic sustentation" to
certain practices like racism and authoritarianism. It gave strength to the
idea of biologically superior and inferior human races, trying to justify the
segregation, exploration and discriminatory application of ethical principles
to human beings.
The application of inferior ethical
principles to the less favored social classes is extremely antique, as well as
the attempt to justify it. Under the influence of social Darwinism, this
practice was broadly utilized and justified in several areas, including the
medical sciences.
This theory had great support in the
United States and Europe in the beginning of the twentieth century, more
because of its political application than for its scientific side. It was a
failing attempt to scientifically justify the social competition, class
stratification and imperialism (1).
To the social Darwinists, there would be not
only the "fight for survival" individually, but also among ethnic groups and
even among nations, which was not only natural but healthy, for the competition
and war were ways by which the biologically capable groups would eliminate the
less qualified, thus improving humanity.
There was the belief in the evolution of
populations and that the transformations would be the passage to a superior
stage. The "white race" was superior to the others because of the "success" of
the occidental civilization (2). Ethnic mixture, considered extremely
hazardous, was strongly discouraged (3). The same way of mixed races, the
African, Amerindian and Asiatic societies were considered to be delayed,
primitive and biologically inferior when compared to the European.
The idea of the "survival of the fitness"
was also used to explain the difference between rich and poor, fortifying the
theories of racial and class superiority. To the social Darwinists, efforts to
improve the conditions of poor people were considered frivolous, nonsense and a
dangerous interference with natural processes and laws (4). In accordance with
these theories, the rich people had this condition because they were stronger
and managed to "fight for survival".
The idea of biologically determined and
naturally selected superior and inferior human beings, as well as the belief
that intelligence, criminality and other characteristics were genetically
determined and could not be changed with the environment favored the
flourishing of the eugenic movement (5).
It can be considered that the modern
Eugenia arose in the end of the nineteenth century and in the beginning of the
twentieth century. This movement that intended to "improve" the quality of the
populations had great acceptance in the United States, England and Germany.
In the United States, the Restriction Act
to Immigration, instituted at 1924 made the immigrants from Eastern Europe,
considered genetically inferior, to be forbidden to get into the country, with
the justification of protection to the politics, culture and biological
characteristics of Americans (6). In 1931, there were laws of voluntary and
involuntary sterilization in 27 American states for people considered insane,
idiot, epileptics, criminal and "morally perverted" (7). Some of these laws
were struck off the books for being unconstitutionals. Programs based on
concepts of Eugenia influenced nations like Canada, Norway, Finland, France and
Japan. In Sweden, between the decades of 1930 and 1970, with the purpose of
diminishing the number of births of children with genetic disorders, thousands
of people were sterilized, mostly women (8).
Eugenic ideas flourished also in
developing countries. Brazilians geneticists inclined to Eugenia defended the
classification of some races as hereditarily superior, whereas others were
considered inferior and had no value to the society (9).
This movement had its peak and showed the greatest
atrocities in Germany. Efforts were made to apply the principles of
natural selection to human populations on the basis of the idea that racial
integrity was threatened because medical care had begun to destroy the
natural struggle for existence and the numbers of poor persons and
misfits were threatening to overwhelm the talented and able (10). During the
Second Great World War, Nazi physicians and scientists participated actively of
experiments without any ethical commitment. Prisoners from the concentration
camps were exposed to several experiments that tested the limits of human
beings to mustard gas, extreme coldness, great heights and elevated pressures
(11). The Nazi physicians that had as their basis Eugenia and social Darwinism,
for the most part were not coerced, but carried out an action with which they
sympathized politically (12).
The application in the medical sciences of
a theory with such negative aspects like social Darwinism does not belong only
to the past. It still survives in some contexts, like in the belief that the
survival of people with chronic diseases could diminish the level of health of
human beings preserving less capable people, when economists defend a
competitive market for health system reforms (13) or the belief that the
increase of poor people with less education could diminish the intelligence
level of the species. Another subtle way of this theory that emerged during the
last years is that one found in some scientific researches with the acquired
human immunodeficiency syndrome in developing countries.
The publication of an
article in The New England Journal of Medicine, was the initial point for the discussion
of the distinct medical treatment for human beings in accordance to their
social-economic condition. Lurie and Wolfe (14) denounced the performance of 15
researches without ethic, in developing countries like Uganda, Ethiopia, Zimbabwe
and South Africa, where patients received inadequate treatment or no treatment
at all.
Cases like these and others reported in
developing countries were compared with one of the most known episodes of
researches without ethics with human beings, the Tuskegee case. This occurred
during 40 years, between 1932 and 1972, when even after the knowledge that the
penicillin was effective against syphilis, 412 Afro-Americans were not treated
to determine the natural history of the disease.
The defenders of the researches with HIV
in developing countries argue that exist several ethical principles applied in
all the cases of researches with human beings, but the interpretation and
application of these principles should be inherent to cultural, social and
economical situations (15). Nevertheless, medicine should have responsibilities
about the vulnerable ones and the objectives of a research should always be
secondary to the welfare of the subjects, particularly when the researches are
conducted in developing countries (16), where the subjects are in conditions of
extreme vulnerability. The attempt to apply inferior ethical patterns to
subjects of developing countries is exactly the other side of what should be
expected, where the more vulnerable people should be the ones to receive more
caring.
The pandemic caused by AIDS and its
repercussions, especially in developing countries are well known. Only in the
year of 2000, there was an increase of 5.3 million people infected with the HIV
and more than 20 million HIV-positives do not have access to the medications
(17). In some developing countries, the number of people infected and the
deaths because of this disease are alarming.
It is evident that there are great
differences in relation to the access, utilization of services and technology
between developed and developing nations. It also seems clear that these absurd
differences are far away of being solved. Nevertheless, according to Lie (18),
recognizing that there could be limitations to what could be done in the sense
of improving the social conditions is entirely different from giving an
inferior treatment when we could do it in a different way.
At times where economic rationalism and
the capitalism are dominant, the researches are more inclined to economy than
to ethical principles (19). Possibly because of these aspects, years before the
publication of the article that gave origin to this discussion about distinct
ethical treatment to human beings in accordance to their social-economical
conditions, Angell (20), talking about the possibility of an ethical
imperialism, called attention for the fact that the researched subjects should
have some fundamental rights and that if we accepted that the ethic in research
is relative, there could be created situations where the populations of the
third world were utilized in researches considered unethical in developed
countries. The prediction seems to have come true. Ethical imperialism in the
attempt to deny the equality of research subjects, created distinct categories
of subjects, or "under subjects" (21), that remember ideas to the social
Darwinism.
The "scientific" utilization to do a
hierarchy and justify the application of distinct ethical patterns to human
beings always existed. To justify slavery, the African descendants were
considered biologically inferior, based upon "scientific" evidences that
proposed that moral characteristics, intellectual capacity and social
differences between "white" and "black" were inherited. During the colonization
of the United States, the native Americans were considered lazy, not civilized,
savages and with no possibility of changing, to justify the explorations of
their lands (22).
Evidently, there were great differences
between the researches developed with minorities in the Nazi concentration
camps and African descendants in Tuskegee or the ones performed nowadays in
developing countries. Nevertheless, they have at least one thing in common: the
utilization of vulnerable people in scientific researches with little ethical
worries, no matter if the justification to this attitude was a consequence of
an inexpressive and arbitrary genetic difference, a morphologic characteristic
like the color of the skin, or even the social condition of the subjects.
The attempt to apply inferior ethical
patterns to research subjects from less favored social classes does not
represent only a retrace in the conquests delineated by the Helsinki
Declaration, but the return one century backwards to a doubtful theory like
social Darwinism. Unfortunately, these old ideas come by new ways, still
influence some medical research.
References
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