Abstract
By enhancing the survival of certain patients with inheritable disorders, advances in medical therapy have pro duced an apparent conflict between medical ethics and the natural laws governing the viability of humans. There has arisen considerable concern that the quality of the human gene pool will deteriorate if medicine succeeds in significantly alter ing the survival and reproductive fitness of individuals with deleterious genetic disorders which were heretofore selected against by nature. A review of the successful treatment cur rently used for phenylketonuria (PKU) is given as an example of therapy for a genetic disorder which will not significantly increase the gene frequency in the population. However, the disastrous and unexpected results of reproduction by phenyl ketonuric women dramatically illustrate the unforeseen prob lems that may arise from new therapeutic approaches. Ther apy that confers normal reproductive fitness on a previously incapacitating disorder inherited in a dominant manner will increase the future frequency of the disorder. Medicine is now in the early stages of implementing methods of efficient genetic counseling and prenatal diagnosis which will not only benefit the affected family but will hopefully lessen the impact of deleterious genetic diseases on future generations.
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