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Although the increase represents a near doubling of the risk, the result is still not considered large enough to discourage cousins from having children, said Dr. Arno Motulsky, a professor emeritus of medicine and genome sciences at the University of Washington, and the senior author of the report. Motulsky said. Even at its worst, 7 percent, he said, ''93 percent of the time, nothing is going to happen. The report is in today's issue of The Journal of Genetic Counseling. Motulsky said, ''we give people all the various possibilities and risks and leave it up to them to make a decision.
Some might decide a doubling of the risk is not something they want to face. He and his colleagues said no one questioned the right of people with genetic disorders to have children, even though some have far higher levels of risk than first cousins. For example, people with Huntington's disease, a severe neurological disorder that comes on in adulthood, have a 50 percent chance of passing the disease to their children.
The researchers, a panel convened by the National Society of Genetic Counselors, based their conclusions on a review of six major studies conducted from to August , involving many thousands of births. Motulsky said medical geneticists had known for a long time that there was little or no harm in cousins marrying and having children. Twenty-four states have laws forbidding first cousins from marrying, and seven states have limits like requiring genetic counseling. But no countries in Europe have such prohibitions, and in parts of the Middle East, Africa and Asia, marriages between cousins are considered preferable.
Motulsky said many immigrants from cultures where cousin marriages are common expect to continue the tradition in the United States, and doctors and genetic counselors should respect their wishes. Laws against cousin marriage should be abolished, he said. Even though longstanding ones reflect a view that such marriages are ''really bad,'' he said, ''the data show it isn't that bad. Motulsky said researchers did not know why marriage between cousins was viewed with such distaste in the United States. He said some of the revulsion might have stemmed from the eugenics movement, which intended to improve the human race by deciding who should be allowed to breed.
The movement flourished in this country early in the 20th century. It is not known how many cousins marry or live together. Estimates of marriages between related people, which include first cousins and more distant ones, range from less than 0. In the past, small studies have found much higher rates in some areas. A survey in found The report made a point of saying that the term ''incest'' should not be applied to cousins but only to sexual relations between siblings or between parents and children. Babies who result from those unions are thought to be at significantly higher risk of genetic problems, the report said, but there is not enough data to be sure. The new report says that genetic counselors should advise cousins who want to have children together in much the same way they advise everybody else and that no extra genetic tests are required before conception.
The guidelines urge counselors to take a thorough family history and, as they do for all clients, look for any diseases that might run in the family or in the clients' ethnic groups and order tests accordingly. During pregnancy, the woman should have the standard blood tests used to screen for certain neurological problems and other disorders and an ultrasound examination.
There is growing argument and debate over the issues, caused by the genetics problems which are originating mainly through cousin marriages. The perceptions of genetic problems are over- emphasized in the developed nations due to the technology, medical treatment available and awareness of the genetic issues and with less serious concern in the developing countries which could not afford the technology and cost of medicine. Therefore, there is a need to know, how and where the problem lies and what impact it has on child health care.
Cosmopolitanism is the notion that all human beings share a similar moral and scientific normative system 14, The cosmopolitan knowledge is the common body of knowledge across the discipline and geographical boundaries. In this paper 'cosmopolitan knowledge' I used as scientific debate on the cousin marriages. The term 'indigenous knowledge' refers to ethnic and cultural perceptions of the people in a particular region which share origins and a common belief system. Cosmopolitan knowledge is a lesser debated issue among the common man in developing countries, like Pakistan, where cousin marriages prevail on a large scale. Does the cosmopolitan knowledge of congenital disorders undermine the indigenous perspectives of the belief system in the community of Kabirwala Pakistan?
This is an effort to know how cosmopolitan knowledge differs with the indigenous perceptions of congenital diseases among the families who are living under a woman exchange system among cousins and how the system is affecting child health care and why health services are unable to handle the issue within the cultural context. I was working on my research project "exchange marriage system" in Kabirwala, a town in Pakistan.
During the fieldwork, I found the blind and disabled persons whose parents were married on the basis of the exchange marriage. Fig 2 Respondents level of the education [ 2 ]. I conducted interviews in a village of Kabirwala with the spouses' who were married with cousins, their children to know the issue of genetic and their perceptions about the issue. The data was analyzed in line with Grounded Theory Method. This method develops the categories from the data 19, 20, I developed the concepts and categories from the interviews.
I interpreted and elaborated the data relevant to genetic problems for understanding the issue and categorized the data according to the themes. Relevant reports, articles were used to strengthen the findings of the primary data 16, 17, Mehboob [ 3 ] 57 year old male is married with his cousin Rubia, 42 years. Rubia has nominal education. The couple have 11 children 3 sons and 8 daughters , and one child Rakha in Fig 3 died one month after birth.
Among the 11 children, two Tahir and Najma are blind and one child Mehwi has a hearing problem. The couple called it a matter of taqdeer destiny and argued that two children are blind due to their sin and one had died because "us kay din poray ho gaye thay" he has finished his life: means he has only this life given by God. When I asked, "was this not a genetic problem?
It is a matter of luck, destiny and genetics has minor role to play, explained the respondents. Aslam, a year old man has different views about the genetic issues and he argues that genetic issues are not real ones, and that the Prophet's daughter was married with Ali the cousin of Prophet Muhammad. He explains: "it is not possible that cousin marriage has problems and that the Prophet did not forbid it". People believe that the religious interpretation is the real one, and it is Allah who gives and solves genetic problems.
It encourages the elders to be conformist with the local traditions and follow the traditional norms to regulate cousin network. However, a year, Kalsoom a female, argued that parents control the decision-making authority because they want to rule their offspring. She tells that religion has given authority to parents but they should use this authority in a careful manner. She explains that genetics has no link with cousin marriage. The respondent claimed it is God who does whatever HE wants.
Nevertheless, Kabir, a year male believes that cousin marriages are as a source of security, stability, strength and unity. Cousin marriages determined the level of the kinship involvement in the Kabirwala community. Marriage with nearest relative is preferred. The relationship between in-laws extends beyond the couple. If a marriage is successful, it will be followed by others between the two families. Fig 4 indicates the few ratios of alternatives. Cousin links, formed through marriages persist and are reinforced through the generations. It is found in this study see Fig 5. The cousin marriages form a kind of social capital because the relatives are responsible to provide for a person in need.
These cousins help, support and maintain the social security of a person in Pakistan. Akram, a year male respondent elaborated his account and said, his children are more beautiful than his brothers because he was married with his cousin and his brother was married with someone other than cousins. He mentioned that it was due to his own genes that his spouse gave birth to beautiful children. However, Kalim a year, male disagreed with the above argument and he said it was marriage of his cousins that has given a blind child.
Akram is a single case so whose generalization is not possible. Some young and educated respondents have awareness about the cousin marriages and genetics problems. Rabia, 25 years, a single, female respondent mentioned that cousin marriages creates zahanat ki kami less intellect , kamzori physical-weakness , zahni bemari abnormality , and apas main gharello jahgrey domestic conflicts. Although there is evidence of blind and disabled children from cousin marriages. This appears to be with medical research on the subjects.
There is nominal awareness among the people of the genetic issues. The community is not aware about role of the genetic disorders. If anybody in the community has knowledge they negate it due to the belief system. There is a dearth of the research in the community of Kabirwala with reference to the cousin marriages and the probability of genetic diseases. The scientists working in the field of inbreeding have an opportunity to study the community which has a chain of cross-cousin marriages from generations.
The inbreeding scientists may be able to find some significant results about the chain of genetic diseases; the following policy steps are suggested. The people in the community of Kabirwala believe that disease is a matter of destiny and luck. They do not know that there is a possibility of positive relationship between the genetic disorders and the marriages. It is possible to provide education to the people. It would be helpful to add the issue to the school syllabus.
The imam is a person who may effectively convince the people, because the majority of the people could not read and write. The people believe the religious teachings. These illiterate people could be influenced through the cultural specific ways and means. This is an easy way for the health professional to convince the local imam about the possible inherited diseases so that he is a catalyst of social change. Short run measures are also possible to sensitize the people through media and stage-drama. However, these measure are likely not sustainable because the media is either restricted or without due credibility to spread such kind of information.
However, there is no counselling service available in the community of Kabirwala yet. But the ban on cousin marriage will be counter productive in this cultural context where breaking the law is considered as 'fashion' and 'symbol of superiority'. Non-conformity indicates a high social status in this community.
Carriers of sickle cell disease may be mildly symptomatic themselves. A first cousin couple who marries, and are no closer than first cousins, have the same risk cousin marriage problems having a child with a genetic illness as cousin marriage problems woman cousin marriage problems birth after the age of These illiterate people The Privilege Of Education In Canada be influenced through the cousin marriage problems specific ways and cousin marriage problems.