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Questions like this are actually something I think about a lot, being in the midst of dealing with many classes on ethics and moral philosophy.
On the one hand, my first reaction is to note that-- at least for Jews-- incest is prohibited by the Torah, and thus should not be done.
On the other hand, I also have long thought it very healthy that religion does not control what is and is not permissible in a secular society. As an American, my feeling is, as long as it's two consenting adults, and no one is physically harmed, people ought to be free to engage in whatever kind of sexual behavior they please. It's a free country.
Personally, it seems to me that incestuous relationships would inevitably be prone to causing psychoemotional confusion and self/other boundary problems, among other ill effects; but then again, people seem to cheerfully engage in all kinds of sexual behavior that seems unhealthy to me, and appear no worse for it, so what do I know? Probably best not to judge, I expect.
BTW, a friend of mine who's an OB/GYN with a specialty in reproductive assistance therapies let me know that, in her opinion, the genetic issue is a non-starter, since a single close genetic match is unlikely to result in severe abnormalities. Generally, severe abnormalities as a result of incest occur only after prolonged inbreeding, such as among the royal houses of Europe, or even more so, among the royal houses of the Ancient Near East. So she says, at any rate. Not, I add, that it makes me any more comfortable with the idea. But nonetheless, it does make me feel all the more strongly that this probably should be a "live and let live" issue.
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Dull sublunary lovers love,
Whose soul is sense, cannot admit
Absence, because it doth remove
That thing which elemented it.
(From "A Valediction: Forbidding Mourning" by John Donne)
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