Politics must remain separate from medical discourse. Those who practise or influence health care, including individuals active in political life, should possess a deep grounding in ethics and the history of ethical practice. This should not be reserved for later professional training but embedded in early education and made central to core curricula. The history that led to the Nuremberg trials, and the principles that emerged from them, must be studied alongside pivotal demonstrations such as the Milgram experiment, which revealed how readily ordinary people can abandon moral responsibility and conform to authority or group think/pressure. Such lessons underscore that safeguarding ethics in medicine is essential to protect individuals from the consequences of collective compliance and political interference.
The Born in Bradford study provides one of the clearest demonstrations that consanguinity is not a neutral cultural practice. Consanguinity is a major direct determinant of childhood health, survival, and lifelong wellbeing. First cousin marriages were shown to double the rate of congenital anomalies compared to the national average, with nearly one third of all congenital abnormalities in the cohort directly attributable to blood-related unions. This translated into strikingly elevated infant mortality, with local reviews in Bradford, Birmingham, and Redbridge attributing between 20 and 40 per cent of child deaths to genetic disorders associated with consanguinity. The biological mechanism is well established: inheritance of a greater proportion of recessive mutations within closed kinship structures, often compounded by repeated endogamy across generations. This mechanism results not only in structural, sensory, and neurological disorders but also in measurable reductions in IQ, a factor that carries lifelong implications for educational attainment, independence, and employment prospects. These outcomes collectively constitute a heavy burden on children who inherit risks they did not choose, while families and health systems shoulder the consequences in resource demand and care provision.
The ethical implications are profound. It is not a rejection of the equal worth of individuals with disability, chronic illness, or lower IQ to assert that knowingly amplifying the probability of these outcomes is wrong. Every child has a moral right to be born with the best possible chance of health, and to deliberately increase the risk of preventable disease, cognitive disadvantage, and early death violates that principle. IQ and health capacity are not abstract markers but practical determinants of survival, opportunity, and quality of life. At a societal level, repeated consanguinity reduces average IQ, lowers productivity, and sustains cycles of poverty. At an individual level, it consigns children to avoidable hardship and dependency. Respect for cultural tradition cannot outweigh the rights of the most vulnerable. The persistence of high rates of consanguineous marriage, even after evidence has shown its consequences, reflects not cultural preservation but an ethical failure to protect children from foreseeable and preventable suffering.
Dr Isabella D. Cooper
References:
Small, N., Kelly, B., Malawsky, D. S., Lodh, R., Oddie, S., & Wright, J. (2024). Mortality, morbidity and educational outcomes in children of consanguineous parents in the Born in Bradford cohort. Wellcome Open Research, 9.
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Zlotogora, J., & Shalev, S. A. (2010). The consequences of consanguinity on the rates of malformations and major medical conditions at birth and in early childhood in inbred populations. American Journal of Medical Genetics, Part A, 152(8), 2023–2028.
doi.org/10.1002/AJMG.A.33537
Masefield, S. C., Prady, S. L., Sheldon, T. A., Small, N., Jarvis, S., & Pickett, K. E. (2022). The Effects of Caring for Young Children with Developmental Disabilities on Mothers’ Health and Healthcare Use: Analysis of Primary Care Data in the Born in Bradford Cohort. Journal of Developmental and Physical Disabilities, 34(1), 67–87.
doi.org/10.1007/S10882-021-0…