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Once upon a time, we had hypothetical conversations about a time when everyday people would have access to their genetic information, to use as they pleased. We knew it would happen eventually. We just never thought it would be so soon.
Today, for $400 a company called 23AndMe will provide a detailed genetic analysis of a small sample of your saliva. Test results currently include around 90 conditions and traits, and more are added every month. Even more striking is the sharp decrease in the cost of this service: just a year ago, it cost $1000. With constantly expanding capabilities and a steadily decreasing price, it seems almost inevitable that 23AndMe’s popularity will skyrocket.
As fascinating as this is, one must consider the possible ramifications should this new trend go mainstream. I can imagine that there will be quite a bit of confusion between genes that predispose a person towards a certain condition and genes that actually cause a condition. Having interned in an oncology center for two summers, I have met a number of patients who, upon finding out that they had tested positive for BRCA1 or BRCA2 mutations (two types of mutations that are strongly associated with an increased risk of cancers of the breast and female reproductive system), immediately burst into tears because they mistook this as a diagnosis of cancer. In a clinical setting, these test results are carefully explained to the patient by a physician or a genetic counselor, so these misconceptions can be immediately corrected. However, depending on how much information this company provides, there is a possibility that people will misinterpret the 23AndMe analysis. This brings to mind a chaotic scenario, in which doctor’s offices are flooded with panicked patients seeking treatments for diseases that they don’t even have.
If used appropriately, I think that widely accessible genetic testing will be a huge help to those who choose to take advantage of it. If we know what diseases we are at risk of developing, we can make important lifestyle choices to try to avoid them. Increased vigilance will facilitate early detection, and therefore improve the chances of a more favorable prognosis. This could very well be the first step towards a healthier and better informed population.
P.S. Even if you don’t respond to my post, you should check out this article. (Or talk to Professor Rosenberg.)
http://www.wired.com/medtech/genetics/magazine/15-12/ff_genomics
Also, here is the website for 23AndMe: https://www.23andme.com/
1 comment:
23andMe and similar companies are breaking ground in the field of commercialized genetic testing, and the legal issues presented by these companies are just as fascinating as the ethical kinks you raised. In order to eliminate the issue that you mentioned, which is that misinformed buyers of this genetic testing service will confuse genetic predisposition for a disease with the disease itself, many states require such testing to involve a doctor or other medical professional. New York, in particular, has threatened 23andMe and other companies with fines and jail time.
The argument that 23andMe spokesman Paul Kranhold gives to defend his company's practices is that "23andMe's services are not medical...they are educational." In other words, since 23andMe does not claim to be a diagnostic service that offers medical advice, it can offer genetic testing without a doctor's involvement. Is this a legitimate claim?
I think that it is a weak copout that attempts to exploit a loophole in the law without much justification. Even if 23andMe views itself as a purely recreational website offering an educational product, consumers may view the information they gain from its genetic analysis as important medical information. 23andMe is being threatened by the state of New York for good reason: its irresponsibility is creating enormous potential for problems.
http://www.forbes.com/2008/04/17/genes-regulation-testing-biz-cx_mh_bl_0418genes.html
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