This Conclusion sums up the main arguments in the book, addresses some final questions, and suggests some future directions of travel. In particular, it returns to the eugenics question, and examines whether current practices in modern liberal states might be in line with a type of eugenics that does not involve state coercion, but that rather involves manipulation, and chiefly the manipulation of women. It also emphasises how an analysis of individual choice should be a secondary concern in our approach to the ethics of selecting against disability, and that the position of the state should be our starting point. The last part of the chapter offers additional reflections on the topic of starting points, and on the importance of thinking further about the nature of pregnancy.