BY GREGORY STOCK
While much of the public’s attention
is focused on the possibilities of human cloning and designer
children, a facet of the genomics revolution that hasn’t
generated much debate is unfolding in the background. And the
implications of this will be far-reaching. Scientists are predicting
that within a decade, you will be able to walk into your doctor’s
office and get a relatively comprehensive genetic analysis.
Rather than take a specific genetic test for, say, cystic fibrosis,
you will be able to read your entire genetic constitution as
easily as getting a blood workup. Craig Venter, famous for his
sequencing race against the public Human Genome Project, predicts
that a complete sequencing of your genome will cost under $1,000
in five years.
What will the implications be for us as individuals
and for society at large? On Jan. 26, a symposium — “The
Storefront Genome” — will bring to UCLA some of
the most influential scientists and thinkers in this realm to
discuss the broad impacts that cheap, comprehensive genetic
analysis will have on medicine, the law, reproduction, society
and even our sense of ourselves.
The insurance industry, for one, will undergo
profound change. Insurance is a mechanism for sharing unknown
risks, so if people can easily determine their individual risk
factors, insurance, as it is structured today, won’t work.
If you find out from an anonymous genetic test that you are
at real risk for early heart disease, you might load up on all
the low-cost life insurance you can find. The ability to cheaply
sequence genomes will also affect law enforcement. In Britain,
police are already trying to use genetic analysis from tissue
debris at crime scenes — not to identify offenders directly,
but to discover their likely skin, eye and hair color, their
ethnicity, height and build.
Using comprehensive individual genetic analysis
also will make it possible to make choices about the genetics
of your children — not just to avoid disease, but to influence
non-disease factors such as temperament, personality and potential.
The practice of medicine itself will shift
as patients look for help in figuring out what all this genetic
information means for them personally. The coming deluge of
genetic information about us will transform the patient/physician
relationship, because most physicians will not be able to interpret
this new data for us. Thus, medicine will become increasingly
centered around information technology. And medicine will become
increasingly preventive in nature as well. Pharmacogenetics
— tailoring drugs to our individual genetic constitutions
— will play a growing role in keeping us healthy, but
overall health-care costs will almost certainly continue to
climb because we will be able to do more, and we will want to.
But who’s going to pay for all this? That is the big question.
Few current health-care plans in the United States cover long-term
preventive measures.
Finally, how will this new information about
our biological potentials, vulnerabilities and identities change
our sense of who we are? This is perhaps the most intriguing
question. The genomics revolution holds the promise of enormous
benefits, but it also poses huge challenges that we must face
— not shy away from — because they will be here
sooner than we imagine.
Stock directs UCLA’s Program on
Medicine, Technology and Society. His book, “Redesigning
Humans: Our Inevitable Genetic Future,” won the Kistler
Book Award for best science book from the Foundation for the
Future. For more details on the symposium hosted by the Center
for Society, the Individual and Genetics, go to
www.arc2.ucla.edu/csig/symp1.htm.
