A blog from the Centre for Research Ethics & Bioethics (CRB)

Tag: genetics (Page 4 of 4)

Commercial gene tests and incidental findings

I read Arthur Caplan’s criticism of the personalized gene tests that some companies insist we must buy to gain control over our future health. I could not help wondering if his criticism is applicable also to the idea that biobanks should inform research participants about incidental findings about their genes.

Caplan rejects the crystal ball view of genetic information that is utilized in the marketing for commercial gene tests: the image that genetic information is uniquely predictive about YOUR future health.

The crystal ball image is a prejudice. It is a gene myth that makes people believe they MUST get genetic information to control their future health. It is a myth that makes people think they have a RIGHT to look into the crystal ball, now that this uniquely powerful instrument is available.

But disease risk is the result of complex interactions between genes and environment, and “no one knows how a single person’s lifestyle, upbringing and environment interacts with their particular genes to create risks,” Caplan writes.

If this is true and genetic information in abstraction is far from predictive, then I cannot avoid worrying about how the crystal ball image shapes also the ethical discussion about incidental findings in genomic biobank research.

In this discussion, accidentally discovered individual genetic variation is sometimes described as a good that participants have a right to be informed about, in return for the biological material they donate to the biobank.

If Caplan is right and such information typically is not worth the money, how can it be a good that participants have a right to receive such information from the biobank in return for their sample?

Do well-meant ethical arguments sometimes resemble unethical marketing campaigns?

Pär Segerdahl

Approaching future issues - the Ethics Blog

Genetic exceptionalism and unforgivingness

What fuels the tendency to view genetic information as exceptionally private and sensitive? Is information about an individual’s genetic disposition for eye color more sensitive than the fact that he has blue eyes?

In Rethinking Informed Consent in Bioethics, Neil C. Manson and Onora O’Neill make heroic efforts against an avalanche of arguments for genetic exceptionalism. For each argument meant to reveal how uniquely private, how exceptionally sensitive, and how extraordinarily risky genetic information is, Manson and O’Neill find elucidating examples, analogies and comparisons that cool down tendencies to exaggerate genetic information as incomparably dangerous.

What fuels the exceptionalism that Manson and O’Neill fight? They suggest that it has to do with metaphors that tempt us to reify information; temptations that, for various reasons, are intensified when we think about DNA. Once again, their analysis is clarifying.

Another form of genetic exceptionalism strikes me, however; one that has less to do with information. I’m thinking of GMO exceptionalism. For thousands of years, humans improved plants and animals through breeding them. This traditional way of modifying organisms is not without environmental risks. When analogous risks appear with GMO, however, they tend to change meaning and become seen as extraordinary risks, revealing the ineradicable riskiness of genetic manipulation.

Why are we prepared to embrace traditionally modified organisms, TMO, when basically the same risks with GMO make us want to exterminate every genetically manipulated bastard?

Unforgivingness. I believe that this all-too familiar emotional response drives genetic exceptionalism, and many other forms of exceptionalism.

Consider the response of becoming unforgiving. Yesterday we laughed with our friend. Today we learn that he spread rumors about us. His familar smile immediately acquires a different meaning. Yesterday it was shared joy. Today it is an ugly mask hiding an intrinsically untrustworthy individual who must be put in quarantine forever. Every trait of character turns into a defect of character. The whole person becomes an objection; an exception among humans.

Manson and O´Neill are right when they analyze a tendency to reify information in genetic exceptionalism. But I want to suggest that what fuels this tendency, what makes us more than willing to yield to the temptation, is an emotional state of mind that also produces many other forms of exceptionalism.

We need to acknowledge the emotional dimension of philosophical and ethical thinking. We don’t think well when we are unforgiving towards our subject matter. We think dogmatically and unjustly.

In their efforts to think well about genetic information, Manson and O’Neill can be understood as doing forgiveness work.

They calm us down and patiently show us that our friend, although he sometimes does wrong, is not that intrinsically bad character we want to see him as, when we are in our unfortunate unforgiving state of mind.

We are helped towards a state of mind where we can think more freely and justly about the risks and benefits of genetics.

Pär Segerdahl

We want to be just - the Ethics Blog

Interesting conferences

The Ethics Blog recommends three important conferences this autumn:

1.      Genomics for Healthcare and Socio-Economic Progress

This conference is organized by the Wales Gene Park. It discusses the economic potential of genomics in, for example, healthcare, agriculture and bio-energy.

  • When? 13-14 September 2012
  • Where? Radisson Blu Hotel, Cardiff
  • Website? Here

2.      HandsOn: Biobanks

This interactive conference is organized by BBMRI.se. It dicusses biobanking and the value of biobank research.

  • When? 20-21 September 2012
  • Where? Uppsala, Sweden
  • Website? Here

3.      Children’s Participation and Decision-Making in Medical Matters

This conference is organized by the Nordic Committee on Bioethics. It discusses the ethics of children’s participation in medical research.

  • When? 11-12 October 2012
  • Where? Lund, Sweden
  • Website? Here

Visit the websites to find out more about these interesting events!

Pär Segerdahl

We recommend conferences - the ethics blog

What do donors need to know about future research?

I’m reading a Scientific American Guest Blog, on the ethics of future-use DNA sampling. Donating DNA to research is described as a more lasting donation than donating organs or embryos: DNA is information and information can last longer.

That donating DNA is such a lasting donation seems to imply that the future use to which the DNA can be put to use is more open. Who knows what information future researchers might be able to obtain from DNA donated today?

The author of the guest blog, Ricki Lewis, asks how consent can be obtained for DNA sampling intended for future genetic research.

She rejects the view that researchers must know in advance where the research might lead and inform donors about it; and if research takes unforeseen directions years or decades after the donation, researchers must contact donors again for renewed consent.

This view is rejected because knowing where research might lead “is not how science works.” And renewed consent would be “confusing, disturbing, and likely expensive.” – I agree.

Ricki Lewis’s own solution is the following:

  • “…informed consent documents should state that the sample might be used in the future to get information unknown today. Participants or patients can agree, or not sign.”

Both solutions seem to operate on a level that strikes me as less relevant to DNA donors.

People who donate DNA to science probably want to contribute to research that can improve prevention, diagnosis and treatment of various diseases. That is the level at which they are concerned about the future use of their DNA: the level of the practical significance of the research.

The exact scientific path that future research takes is less relevant to donors, I believe, as long as the research has the kind of practical significance that motivates their donation. And to ask for consent to do science as science is done – without knowing in advance where it might lead – could be confusing.

I also wonder: could a consent form that emphasizes the open and unpredictable nature of scientific research be misused on the practical level that probably concern donors more?

Pär Segerdahl

Approaching future issues - the Ethics Blog

Collection of papers brings out neglected aspect of ethics

If you wrestle with ethical and legal difficulties associated with genetic science, a recent virtual issue of the Hastings Center Report could be good to think with.

The issue collects earlier material on ethics and genetics. There are pieces about the perils of genetic-specific legislation; about the difficulties of understanding behavioral genetics; about the prospects of personalized medicine; about the meaning of transhumanism; and much else.

Reading the virtual collection, it strikes me that our ethical difficulties surprisingly seldom are of a purely evaluative kind, or about what is morally right or wrong, or about what we ethically should or should not do.

Our ethical challenges are more typically about thinking well; about understanding complex facts properly; about avoiding tempting oversimplifications in our descriptions of reality.

In short, our ethical challenges are very much about facing reality well.

The philosopher Bernard Williams spoke of thick ethical concepts: notions like “courage” that seem to have both evaluative and descriptive content.

I am inclined to say that ethics is “thick” in this sense. Ethics is more often than not about describing reality justly. Ethical challenges are surprisingly often about coming to terms with oversimplified descriptions that prompt premature normative conclusions.

Just consider these two tempting oversimplifications of genetics, which produce an abundance of normative and political conclusions:

  1. The mistaken assumption that if the main source of variation is not genetic, it will be fairly easy to make environmental interventions.
  2. The mistaken assumption that if the primary source of variation is genetic, environmental interventions will be useless.

These assumptions are discussed in Erik Parens’ paper about why talking about behavioral genetics is important and difficult (on page 13).

Even though it is not its purpose, the virtual collection of papers on genetics makes it conspicuous how often our ethical challenges are of a descriptive kind.

Pär Segerdahl

We recommend readings - the Ethics Blog

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