Last year, China adopted a new law on maternal and infant health care. The law mandates that all persons have a premarital medical examination to detect serious genetic diseases, some infectious diseases, and "relevant" mental disorders. If a detected disorder is deemed serious, the couple is not permitted to marry without committing to contraception or tubal ligation. Prenatal testing is enforced, and pregnancy is terminated if the fetus has a serious genetic or somatic abnormality [1, 2].

A law "for prevention of progeny with hereditary defects" is not a Chinese invention. It was proclaimed in Germany in 1933 and enforced the sterilization of persons with "congenital mental defects, schizophrenia, manic-depressive psychosis, hereditary epilepsy ... and severe alcoholism" [3]. This law, endorsed by physicians, was a harbinger of one of the darkest episodes of modern history—the Holocaust [3].

In China, the ratio between male and female infants has increased to 1.1 because of prenatal sex selection (abortion of females) and (for lack of ultrasonography) the postnatal killing of females. Only one child per family is permitted, and male children are preferred for agricultural labor [4]. China's burgeoning population is unquestionably detrimental to its well-being, and a legitimate goal is fewer but healthier babies. Nonetheless, the compulsory exclusion of some parents and fetuses is unethical. No less disturbing is the impassive response by the world medical community. Although some have expressed contempt for China's eugenics law [1, 5], others justify a nonpartisan stance, claiming that "it is perilous to impose western morality on China" [2]. It is troubling that leading representatives of the medical community have not been at the forefront of protests against China's gross violation of medical ethics and human rights. The danger lies not in the imposition of Western morality on China but in silence, the equivalent of consent.