Genomic Screening: A Healthy Future or a Heavily Policed One?

Eggplants, peaches, humans, and leeches have something in common—a slightly acidic molecule with a double helical structure, DNA (Deoxyribonucleic Acid). Genes are composed of DNA, and they function through the 'central dogma,' as outlined in the image below.

However, for this article, I will look at population-level genomic analysis including health and policy implications. Genes may not determine your life precisely, but they set the bounds of possibility. They play a chance game, disposing you towards other-worldly genius and fragile egos, perfectly sculpted bodies, and neurodegenerative disorders.

Quite naturally, understanding the protein-coding and regulatory functions of DNA, RNA, and protein synthesis can help us take preventive measures before diseased symptoms appear. For example, suppose a mutation is detected in the BRCA 1 gene, increasing the risk of breast cancer. In that case, one can, if necessary, undergo a mastectomy (like Angelina Jolie did). Another upcoming field is pharmacogenomics (which combines the science of drugs and the study of genes) and studies the effect of genes on drug response. The findings are used to develop safe and more effective medicines by altering the active ingredients and dosage.

As for policy, it is an entirely different ballgame. While science is based on observable and verified facts, the approach can be as well-rounded, as misguided, or plain destructive. For example, with the advent of big data and genomic analysis, governments can collect vast amounts of information about citizen preferences. This data is then used to invest in projects that will benefit the most people possible. Such as supporting disability-friendly infrastructure (ramps, braille signs, etc.) in counties that have a higher proportion of elderly and disabled people along with those who are disposed towards rapid aging.

Sadly, there are also some serious ethical questions we must face. Genotypes are an excellent determiner of height, weight, tendency of addiction, and bone density, making them a perfect benchmark to judge athletes across sports. Will rapid screening and analysis lead to genotypic discrimination in national and professional teams? Furthermore, oversimplification of genetics can lead to conclusions about less tangible properties such as intelligence and open-mindedness—yardsticks on which employees are currently evaluated and could be biologically judged in a misguided manner soon. Lastly, history has taught us that we must be mindful of misunderstanding and oversimplification, but also manipulation and oppression. The inherent 'inferiority of Africans' justified slavery and the holocaust was based on the 'impurity' of Jews, gypsies, and commies. Governments with strong views and enough control (usually autocratic or totalitarian) can give genetics as a reason to justify their wrongdoing relating to preferential treatment and systemic discrimination.

Genetics was the most powerful idea of 20th-century biology and is the most critical tool of 21st-century humankind. It yields immense knowledge and implications for any life form. As processes are developed to read, analyze, and alter the very code that wrote us, we must acknowledge genetics' lifesaving ability and be cautious of society, culture, government, and the very people it is supposed to heal.

Image adapted from Khan Academy: https://www.khanacademy.org/science/high-school-biology/hs-molecular-genetics/hs-rna-and-protein-synthesis/a/intro-to-gene-expression-central-dogma

Citations:

Gostin, L. "Genetic discrimination: the use of genetically based diagnostic and prognostic tests by employers and insurers." American journal of law & medicine vol. 17,1-2 (1991): 109-44.

Phillips, Kathryn A et al. "Genomic sequencing: assessing the health care system, policy, and big-data implications." Health affairs (Project Hope) vol. 33,7 (2014): 1246-53. doi:10.1377/hlthaff.2014.0020

Conlon, Thomas J, and Fulvio Mavilio. "The Pharmacology of Gene and Cell Therapy." Molecular therapy. Methods & clinical development vol. 8 181-182. 15 Mar. 2018, doi:10.1016/j.omtm.2017.12.007

Written By: Vatsal Kabra

Edited By: Aarushi Bansal