Lazarus, A. (2026, January 23).
Medpagetoday.com;
A growing body of contemporary research and reporting exposes how old ideas can find new life when repurposed within modern systems of medicine, technology, and public policy. Over the last decade, several trends have converged:
- The rise of polygenic scoring for embryos and adults;
- Rapid growth in commercial direct-to-consumer genetic testing;
- Artificial intelligence (AI)-driven "risk stratification" tools in healthcare and insurance;
- The proliferation of biobanks disproportionately populated by individuals from privileged backgrounds; and
- The reemergence of academic interest in "optimal reproduction," "biological improvement," and "population efficiency."
While these movements hold extraordinary possibilities for treating illness and ameliorating suffering, they also have the potential to be used to enhance certain traits and delete others -- ones that are simply disliked by those in power. Individually, each development has scientific merit and, in many cases, real potential to prevent disease and improve care.
Collectively, however, they raise questions that are both familiar and deeply unsettling.
Echoes of the Past
The U.S. and many other countries have long histories of medicalized discrimination under the banner of "improving the population." During the early and mid-20th century, physicians, judges, social workers, and university researchers pursued policies and practices -- sterilization, segregation, restrictive marriage laws, immigration exclusions -- rooted in the belief that some lives were more valuable than others. The rhetoric of the era portrayed these policies as scientific, progressive, and necessary for social order and the betterment of humanity. They provided Hitler with a distorted justification for his anti-Semitic beliefs, leading to efforts to exterminate the Jews and other marginalized ethnic minorities in Germany from 1933 to 1945.
Here are some thoughts:
Dr. Lazarus makes a compelling case that the greatest danger of "new eugenics" lies in its invisibility, embedded in algorithms, risk scores, and efficiency narratives rather than overt coercion, making it far harder to recognize or resist. His warning that systems rewarding predictive power can quietly marginalize the vulnerable is well-founded, though one might gently push back that conflating individual reproductive choice with state-coerced eugenics risks muddying an important moral distinction. Nonetheless, his closing challenge that a society's worth is measured by how fiercely it protects the vulnerable, not how efficiently it rewards the "fit," is a powerful and necessary reminder.
