Hereditary Conditions and Reproductive Coercion: Letter from Russia

Abstract

Sergei V. Jargin

An individual feels ashamed when some undesirable truth about one’s fundamental character is revealed to the self or others. Sick and unattractive people often appear as sufferers of shame [1]. Besides, whistle-blowing and denunciation are often regarded as shameful acts. On the contrary, many violators of laws and mores do not experience any shame and emerge as winners. This pertains to diverse phenomena, discussed in preceding publications: child and elder abuse, sexual coercion, professional misconduct in medicine. For doctors, this applies to suboptimal prescriptions due to conflicts of interest, let alone invasive procedures without sufficient indications [2,3]. What can be done to route the emotion of shame in the right direction, so that not the victims and whistleblowers but the perpetrators would be ashamed? Publications with names and references seem to be the best way.

In a milieu tolerating sexual and reproductive coercion, where sexually transmitted infections (STI) or hereditary diseases are concealed from partners, such conditions cease to be a private matter. In case of the latter, this pertains also to the kinship. Contraceptive sabotage should be regarded as offence with infliction of bodily harm if an abortion or unwanted pregnancy, STI or genetic disease has been inflicted. In particular, concealment from a partner or spouse of a known hereditary disorder may have grave consequences. Of note, STI are usually curable but genetic diseases are generally not. This gives to a medical professional a moral right in some cases to disregard the obligation to secrecy, when it can be assumed that of the offender, his or her relatives would continue spreading abnormal genotype. Fortunately, genetic testing and counseling are improving; so that the above considerations may be revised one day.

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