This chapter uses the case of inherited blood disorders (IBD) as a lens through which to examine the impacts of a global biomedical discourse of genetic risk in cousin marriage in the particular context of implementing genetics services in the Sultanate of Oman, and against the backdrop of a regional public health agenda regarding IBD in the Gulf states. IBD currently represent the very core of the emerging medical genetics services in Oman, as well as in several of the other oil-rich Gulf countries (Bahrain, Qatar, United Arab Emirates, Saudi Arabia). Oman has experienced profound and rather extraordinary social upheavals...

In recent years there have been public debates in some European countries on the genetic risks of so-called ‘customary marriages’, especially marriages between cousins. The European media maintain that in Western Europe cousin marriages have noticeably increased, as a result of the influx of migrants from the Middle East who – as many of the commentators declare with utter conviction – remain devoted to the ‘ traditional’ marriage practices of their countries of origin (cf. Elderen et al. 2010; Giordano et al. 1998: 244; Port and Bittles 2001: 97–98; 415–416). In the UK and in Germany, debate has centred on...

Fifty years after substantial Pakistani migration to Britain began, there is no firm evidence of any significant decline in the rate of consanguineous and especially first cousin marriage among the children and grandchildren of pioneer-generation migrants. This contradicts the general expectation that cousin marriage will decline with urbanization, modernization and the transition to smaller families (see Introduction and chapter one of this volume). Since the 1980s, evidence has also accumulated showing that consanguineous marriage among British Pakistanis confers a significant health risk for children: the prevalence of many mostly very rare recessive genetic conditions is higher among British Pakistanis than...

In some Western European countries immigrants’ transnational consanguineous marriages have been debated from the perspective of genetic risk (see chapter five, this volume). In Denmark, consanguineous immigrant marriages have also been the topic of public and political debate. However, the discussions have primarily centred not on health issues but on the risk that transnational consanguineous marriages are forced marriages. To counter this concern, the Danish Parliament in 2003 introduced the ‘rule of supposition of forced marriage’ – often referred to simply as either the ‘rule of supposition’ or as ‘the cousin rule’ – which made it very difficult for a married couple...

In the Netherlands, the majority population regards marriage between cousins as incestuous and inviting the risk of having disabled offspring; the practice is, therefore, taboo. In present-day politics in the Netherlands, cousin marriage is also directly associated with forced marriage (see chapter six on the similar political stance adopted in Denmark). The current government therefore proposes to enact a law prohibiting cousin marriage in cases of forced marriage.¹ Furthermore, consanguineous unions among immigrant groups – specifically Dutch Moroccans and Turks – are also subject to political debate in the context of immigration policy. However, the (recent) political debate on the prohibition of...

Since the establishment of the State of Israel in 1948, the Israeli population has witnessed many changes and a very significant health improvement was achieved. For instance, the infant mortality rates declined more than tenfold from 37.3 in 1955 to 3.6 per 1,000 live births in 2011. However, across this time period, a significant gap has remained between infant mortality rates in the Israel’s Jewish population (2.7 per 1,000 live births in 2011) and among Israel’s non-Jews (6.6 per 1,000 live births in 2011) (Statistical abstracts of Israel 2013). These differences have been explained by the higher rates of congenital...

This chapter focuses on the use of carrier screening for premarital matching, as it has developed in Jewish communities characterized by endogamy (and sometimes consanguinity), high prevalence of severe recessive diseases, arranged marriages, and a religious ban on abortion. When administered by the state, such programmes for ‘healthy endogamy’ (see chapter eight, this volume) may result in criticism for their medicalization of spouse selection, marriage and family planning. Although the Jewish programme, which was developed by the community and for the community, has often received justified praise, this chapter will also consider some of its downsides, including the stigmatization of...

Current counselling and screening recommendations for consanguineous couples before a pregnancy (also referred to as the preconception phase) focus on taking a thorough medical history and informing couples about their increased risk, but no additional screening is advised based on consanguinity alone (Bennett et al. 2002; Modell and Darr 2002). If the couple has a ‘positive’ family history for a genetic disorder (if there is a known family history of a genetic condition), genetic counsellors can predict the percentage of additional risk for a child with this specific disorder and can offer, if available, carrier and prenatal testing to the...