Genetics Advances Could Be Mixed Blessing

RTos 22.12.98 06:22


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By Marie McInerney
ADELAIDE, Australia (Reuters) - It promises to deliver a new golden age of health, but gene technology could prove a bitter pill to swallow for some individuals and groups around the world.
Life insurance companies in this brave new world could refuse cover to someone diagnosed as likely to contract a debilitating disease, no matter when it may strike. A crippling disease like Huntington's -- a disorder of the central nervous system -- may not strike for many years, or at all.
Employers could demand job applicants undergo gene testing to try to cut down sick leave and early retirement costs.
Ethnic and religious groups with a propensity to particular gene disorders could feel stigmatized or just become research fodder for medical gains to be enjoyed elsewhere, skeptics suggest.
And that is even before the obvious questions about abortion and human embryo research are raised, and before any decisive results from research into genes or mutations responsible for certain behavioral traits, or even intelligence.
"We do not allow discrimination on the basis of color, religion, gender....Why on earth would you want a society in which you actively discriminated on the basis of their genes?" Australian molecular geneticist David Turner told Reuters.
"TIDE OF FEAR AND DOUBT"
Speakers at an international conference into the ethical implications of genetic research in Australia recently raised concerns that new waves of financial and social discrimination could target people identified as facing serious diseases.
Representative Nita Lowey, a New York Democrat, said many of the benefits offered by genetic testing could be "washed away on a tide of fear and doubt" if people believed tests could cost them their jobs or insurance cover.
Citing a 1997 survey in which most respondents said they would not take genetic tests for diseases if insurance companies or employers were granted access to the results, Lowey warned of the risks of failure to address genetic discrimination.
"Instead of the Human Genome Project opening a new era of understanding and treatment, it will create a world in which ignorance is preferable to knowledge and in which medicine is sacrificed to the job market," she told GeneCom 98 delegates.
MAPPING THE HUMAN GENOME
The Human Genome Project, a A$3 billion (US$1.9 billion) global program to map and sequence all human genes, has been hailed as spurring a new golden age in medicine which could wipe out major diseases.
Scientists say there are now up to about 4,000 generally rare diseases, such as Huntington's disease, cystic fibrosis, and Duchenne muscular dystrophy, with so-called genetic markers that can identify people who are at risk of contracting them.
They are working on tests that will show predisposition to more common ailments, such as some cancers and heart diseases, diabetes, asthma, Alzheimer's disease and schizophrenia.
Turner said advance knowledge of predisposition to a disease may enable people to adopt lifestyles that could reduce the risk of, or delay the onset of, a disorder.
But he said finding a gene associated with a disorder was a long way from fully understanding the underlying pathology and even further from knowing how to control the disorder.
"So, for a long time, knowledge of a future disorder will be a sentence without remission," he said.
In the meantime, the conference was told societies needed to begin to grapple with some of the implications of gene testing, amid warnings that a little bit of knowledge can be a very dangerous thing.
COMMERCIAL AND SOCIAL RISKS
Life insurance poses early problems -- the question is whether the industry should gain access to gene tests to ensure people predisposed to fatal illnesses do not abuse the system.
"If somebody knows he has a gene that is going to do some damage later in life, I think the temptation would be very strong to rush out and get an insurance policy, a large one," British scientist Sir John Maddox told the conference.
But there could be a major advantage for insurers: gene tests may not necessarily cut disease levels, but could identify which people will suffer what.
"It comes down...to the issue ultimately between the profitability of the insurance companies on the one hand and the public good of not discriminating against people on issues over which they have no control themselves," Turner said.
Also at risk on other levels, the conference was told, are certain ethnic and religious groups, among them the gypsies of Europe, the Amish of Pennsylvania, and the Ashkenazi Jews.
Many researchers are concentrating their efforts on such groups which, because of isolation or other reasons, have a high propensity for some genetic disorders.
Australian geneticist Luba Kalaydjieva said there was no shortage of research grants into gypsies, who count among the most restricted genetic isolates in the world, chiefly due to discrimination and their own enduring social mores.
"But getting funding for actually helping these communities is another matter," she said.
U.S academic Nanette Elster said there was concern among Ashkenazi Jews who had been diagnosed as particularly prone to a gene-based breast cancer and Tay-Sachs, a painful neurodegenerative disease which was fatal for young children.
"There is a real fear with genetics about eugenics and Ashkenazi Jews are particularly sensitive to that given the experience of the Holocaust," she told Reuters.
"If we get into the whole area of behavioral genetics, what is going to happen if a particular racial or ethnic group is identified as having a particular gene predisposing to what we would consider a negative social trait or negative behavior?" she asked.


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