GENEWATCH
 
UNREQUITED LOVE: REFLECTIONS ON GENOMICS, AS WRITTEN IN 2032
By Arthur L. Caplan
 



Humans love ourselves. We really do. We think that the universe revolves around us, or at least we did for many centuries. In biology, the elevation of our species continues to endure. This extravagant, albeit unwarranted, narcissism is reflected in the fact that when it comes to genomics, no species' genes could, in humanity's view, possibly be more important, more worthy of analysis, more deserving of testing, more appropriate for engineering and alteration then ours.

Ironically, it was the mapping of the human genome in 2000 that should have triggered the end of our biological self-aggrandizement. It took only thirty years, roughly up to the year 2030, from the time that the announcement was made that teams led by Francis Collins and J Craig Venter had jointly produced a very crude map of the human genome to demonstrate that nature had left our love of our own species unrequited.

The drive to map genomics and indeed the drive to fund genomics in the USA and other nations was sold to the public, the media and other scientists in the 1990s with the promise that if we could unlock the instructions for building the members of our species, for understanding the very essence of our nature, then all sorts of good things would follow. We would head to the doctor armed with a printout of our DNA to receive personalized care based upon our risk profile for acquiring diseases. Better still, we would lower the cost of health care by using genetic analysis to catch disease early before it took root, or to prevent it altogether.

Efforts by private companies to move personalized risk testing to the Internet quickly followed the publication of the first genome map. A variety of companies in the decade after the Collins/Venter mapping announcement jumped on the 'spitomics' bandwagon, encouraging individuals to spit in a cup and send off their DNA to a lab in order to find out whether they were at risk for cancer, diabetes, Alzheimer's and other conditions; to gain insight into the identity of their forebears; or to find out if their kids were likely to have food allergies or become star athletes.

As it turned out, these activities met with little public enthusiasm. The lack of standards about the accuracy and sensitivity of genetic tests, the relative difficulty in using risk information, and the absence of serious efforts to ensure competent counseling undermined interest in genetic testing. Simply having information about risk without the prospect of an efficacious intervention that could alter that risk dimmed interest in personal genetic risk assessment. And as doctor and patient slowly came to understand, despite the fascination of knowing your genes, you could diminish your risk of most diseases by losing weight, exercising more, reducing alcohol intake, getting enough rest, eating a balanced diet, not smoking and not engaging in risky sexual activity-no genetic test required. Genomic risk factor testing played only a minor role in health care by the third decade of the 21st century.

By 2030, it was clear that our genome was complex, hard to understand with any real precision, and tricky to manipulate. It was much easier to analyze the genomes of animals, plants and microbes. These proved simpler, less ethically controversial to try to modify, and had as much bearing on our health and welfare as trying to understand and modify our own genomes.

By the third decade of the 21st century, genomics had revolutionized agriculture. As the earth warmed and the human population grew, the only way to create sufficient food was to genetically engineer plants and microbes. The creation of drought resistant crops, microbes capable of creating edible proteins with little impact on the environment, and disease resistant strains of fish, vegetables and other plants and animals led to a green revolution in farming and fishing that both fed the world, enriched corporations and helped reduce the damage done to water, soil and the atmosphere by older methods of creating food.

Genomics in the form of synthetic biology had also begun to revolutionize medicine. Microbes could be disabled through genetic engineering and plagues such as malaria, HIV, TB, measles and lethal bacterial infections were diminishing through a variety of vector-targeted genetically-based interventions. Drug manufacturing was closely linked to genomics and synthetic biology with many more efficacious and safer drugs and vaccines being manufactured using modified bacteria and microbes.

While it is true that doctors paid attention by 2030 to individual responses to drugs based upon pharmacogenomics studies, the real impact of genetics was being felt outside the realm of human genomes. The self-conceit of earlier decades that human genes because they are in humans ought to occupy the attention of efforts to apply new genetic knowledge had collapsed. Understanding and changing the genomes of other species proved far more productive in improving health and well-being. nnn

 

Arthur L. Caplan, PhD, is the Emmanuel and Robert Hart Director of the Center for Bioethics and the Sydney D Caplan Professor of Bioethics at the University of Pennsylvania in Philadelphia. He writes a regular column on bioethics for MSNBC.com.


 
 
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