The 1997 film “Gattaca” portrays a world in which your genes can be used to determine the date of your death. Your DNA is used to determine your profession and therefore your wealth. In this world parents carefully select the children’s attributions before conception. This technology is not so different from what is available today.
In “Your genes, on sale now!” I summarised the main arguments for genetic testing. I am now here to give you the other side of the argument. Some have argued the genetic testing such as the type done by 23andMe
is heading down the road of a Gattaca-like scenario. Some of the arguments against genetic testing bare stark similarity to the Sci-Fi classic.
1. Designer babies.
This is perhaps one of the more extreme objections to genetic testing. Pre-implantation genetic diagnosis has been available for quite some time now. Couples with a family history of genetic disease may elect to have IVF. Once the embryos have begun to divide in the petri dish, a few cells are taken and tested for the genetic disorder.
Currently it is too difficult to get enough DNA from so few cells to test for more than one or two genetic tests. However as the technology improves it is becoming clear that this is not too far off. It may soon be possibly to select embryos for their risk of cancer or heart disease. It is theoretically possibly to select embryos based on eye and hair colour. Although in this scenario you can still only work with the genes that existed in the parents.
2. The person won’t understand the genetic information.
This is an objection to the way in which genetic information is given to the patient rather than to the testing itself. It is an argument against genetic testing being available to the public, without it being administered by a doctor or genetic specialist.
The argument is that most people do not have enough knowledge about genetics and medicine to understand the information that they will get from genetic testing. For example the test will tell you your relative risk of getting a disease. It does not tell you how likely you are to get the disease, just how much more or less likely than the average person.
23andMe has made quite an effort to make sure that the information they give out can be understood by people without a medical background. Take a look at their FAQ and see if you agree.
3. The person will have anxiety about their health after getting the results.
Knowing that you are likely to suffer a major health issue like cancer or Huntington’s disease could have major psychological ramifications. You might decide to spend your life savings or even end your life. How do you deal with this kind of decision, when you only have probability, not a diagnosis?
4. Results may not be relevant.
The results of a genetic test are based on scientific studies. These studies are often done with middle aged Anglo-Saxon study participants. If you are young and of Asian descent then the results may not be all that relevant to you. This means that you could waste a lot of money getting tested and then find that the results are inconclusive. This blog describes just such an experience.
The solution here is fairly obvious. The studies need to be done in more populations so that they can be generalised.
5. People may be discriminated against by insurance companies or employers.
This is where Gattaca was probably dead on. Almost as soon as genetic testing became common place, health insurance agents started to factor it into their calculations. If they could ask people for their risk of heart disease, then they could adjust insurance premiums and charge people at high genetic risk more. Or even refuse to insure them.
The US federal legislation is starting to catch up with these issues. The Genetic Information Nondiscrimination Act, or GINA prohibits the use of genetic information in health insurance and employment decisions. There is currently no such protection for Australians.
So you’ve heard the arguments for and against. What is your decision? Will you get genetic testing or not? I haven’t had mine done yet, but I would seriously consider it if I were about to have children.
All I know is that Gattaca seems to be becoming more relevant in my life sooner than I expected…
Gattaca By ncomment: http://www.flickr.com/photos/marm0ta/313434580/
DNA By olga.palma: http://www.flickr.com/photos/25036088@N06/2433551344/