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What you are searching for (and it is a completely valid exercise) are instances where the government, in a free state, might be justified in constraining mature individual choice regarding unions/marriage.
There seems to me to be three aspects to this question: legal ramifications regarding property and rights; health ramifications regarding progeny; and 'moral' ramifications regarding who ought to marry or unite with whom.
The property and rights issue (as in right to collect spousal benefits, etc) is one which I am not much concerned regarding. I assume that the issues or complexities that arise here will not be terribly difficult to work out, regardless if we are talking about a same gender married couple or even a group of six geriatric lovers up at Singing Oaks Retirement Home. Hell, we can just put a couple of Enron or Haliburton lawyers on it.
As to the second question, the health ramifications, I think there is just the one which you allude to that might apply here uniquely.
Quote:The thing is, isn't it the issue of genetic problems stemming from the coupling of siblings that led to the bar against siblings marrying?
Actually, I doubt this assumption. Most cultures, but certainly not all, have had some rules prohibiting incest. As these cultural groups have commonly been quite geographically isolated from each other, we might properly hypothesize a naturally occuring (gene based) propensity to get out of the house and mingle with the Hatfields. An example from primatology...baboon females universally leave their home troup (giving up all status and all existing support connections) to join with, and mate with, members of the non-related troop. The gain, genetically, is variation.
That, of course, is different from prevention of 'deformity'. I recall reading a (I think it was) Scientifc American article years ago which had studied the rates of deformity/abnormality in the progeny of incest, and the rates were not particularly high. I've tried to find this article, but haven't been able to. But once again, we have to consider other such causal links to birth defects...eg, fetal alcohol syndrome, military exposed to agent orange, etc., and then consider how the 'state' ought to proceded in a free nation.
And there is the historical question here of when did any particular human culture figure out that the young inherit characteristics from the parents. Perhaps in the neolithic, when animals and plants became domesticated. Perhaps earlier. But it would have been an empirical observation made by some individual who would then have had to convince his cultural group that such a mechanism existed, and that the cause of blue eyes wasn't really from humping under a clear blue sky, or whatever. (I suppose that we ought to note here too that, in the Old Testament, there is really quite a lot of incest going on, and it apparently wasn't problematical at the time).
The third aspect here, the 'moral' notions, is the really interesting one, at least to me. Such moral codes may well arise out of a common 'yuck!' response (the genetic propensity thing...not unlike staying away from a pile of Uncle Fred's poop), or out of empirical observation leading to law formulation (as when it was discovered that high disease rates were coincident with drinking Thames water where effluent was concentrated), or the codes could arise out of completely false notions (leaking blood is bad, therefore menstruation is bad) which just get carried up through time and are enforced for reasons of group solidarity.
The reason I find this third aspect the most interesting one is because it is precisely this group solidarity through maintenance of traditions (give me that old time religion) which pretty transparently applies to the 'homosexuality is bad' notion.
There always seems to have been a conflict between a 'conservative' or traditionalist urge and a 'liberal' or 'screw you and your arbitrary rules' urge in human groups.
But...and this is the biggy...the Constitution is not a conservative document. As one of the SC justices said (I'm paraphrasing from memory) "the constitution allows for, is designed for, an expanding sphere of liberty".