The Best Predictive Health Ethics Blogs - June 2008

California and Direct-to-Consumer Genetic Testing:

California's decision to send cease-and-desist letters to thirteen direct-to-consumer genetic testing companies (including 23andME, deCODEme, Knome, and Navigenics) ignited a blogging wild-fire of mostly outraged responses. Some of the more widely read expressions of protest were blogged at Wired Science and include Thomas Goetz's much-echoed Attention, California Health Dept.: My DNA Is My Data (17 June 2008). For an alternative reaction see Steve Murphy's posts on the topic at Gene Sherpa, which include: Do you hear that sound Mr Anderson? (15 June 2008), A$$ Kicking (17 June 2008), and R'Uh-R'Oh Shaggy!!! (17 June 2008). Although many of the replies to Murphy's posts offer only more expressions of outrage, Daniel MacArthur at Genetic Future engages Murphy in a thoughtful exchange beginning with California cracks down on genetic testing companies (15 June 2008) and Cat-fight over California (18 June 2008). Finally, for a good overview of the news and blogging on the subject, see Blaine Bettinger's recent post The Genetic Mess in California - A Round-Up, and My Thoughts (30 June 2008) at The Genetic Genealogist.

Employee Wellness

Matt Mealiffe of DNA and You writes in response to the news that Japan will require companies and local governments to "measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups" with the standard of "33.5 inches for men and 35.4 inches for women" (see Norimitsu Onishi, Japan, Seeking Trim Waists, Measures Millions. The New York Times. 13 June 2008). In Mealiffe's assessment (14 June 2008), mandatory waistline measurement is "bold social policy" which may be, however, genetic discrimination.

In an unrelated post on a similar topic, Jane Sarasohn-Kahn of Health Populi reports employee attitudes regarding the privacy risks of employers' wellness programs. Writing in Is worker wellness a privacy issue? (5 June 2008), Sarasohn-Kahn summarizes the findings of a recent report: "Employees are concerned that this information could be used to reduce benefits or for even more egregious purposes". An overview of the findings, "Health and Wellness: the shift from managing illness to promoting health" is available from the Center for Studying Health System Change [PDF].

Law & Policy

Andrew W. Torrance of BioLaw: Law and the Life Sciences reflects on the sometimes presumed amoral status of patent law in U.S. – a status that is not presumed in Europe. In Patently Immoral Genes (2 June 2008), Torrance shares the recent, related work of the European Society of Human Genetics ("ESHG") which "has issued recommendations that would severely limit patents on genes in the European Patent Office (EPO) and member states of the EPC." According to Torrance, "the ESHG recommends that the EPO establish an 'ethics committee' to police the patentability of controversial technological innovations". He believes that this news may be of interest to policy makers in the States, including: California Democrat, Xavier Becerra, a sponsor of the "Genomic Research and Accessibility Act" (H.R.-977 – Thomas | GovTrack.us).

Nick Agar writes at What Sorts of People on a report by The Bioethics Council of New Zealand on the completion of its program Who gets born? Pre-birth testing. The report responds to the New Zealand government's decision to fund pre-implantation genetic diagnosis for couples with a high risk of conceiving a child with a genetic disorder. In NZ bioethics council (27 June 2008), Agar notes that "the emphasis is very much on facilitating parental choice, with health professionals given the role of supplying parents with the information they need to make choices consistent with their values". He observes that the Council made a deliberate effort to solicit participation from a wide range of "interested parties", but cautions that there may be "a bit of fallacy of bureaucratic representativeness here – if a committee’s composition approximately matches the representation of various communities in the general population then its pronouncements must be representative of the viewpoints of those different communities".

Personalized Medicine

Reflecting, in part, on the prevalence of "Personalize Medicine" in the recent 2008 BIO Convention, Jennifer Miller at Bioethics International defines the topic and introduces some of the ethical and legal issues. She identifies six ethical issues in Personalized medicine: an introduction, its promises and the ethics (26 June 2008):

(1) just access to, allocation and application of the new technologies, (2) privacy concerns, (3) respecting parties’ autonomy, (4) obtaining quality informed consents, (5) intellectual property rights, particularly in connection with bio-banking, (6) overall resource allocation and prioritization questions ….

Reviews

Bonnie Green, writing for BioethicsBytes (17 June 2008), reviews "An Adventure into Ourselves", the third episode of a four-part television series entitled DNA: The Human Race (Channel 4, 2003). [BioethicsBytes hosts and reviews resources for ethics education. The project aims "to assist in the teaching of bioethics, with particular emphasis on multimedia materials (film, TV, streamed media) as case studies".] Green's thorough review of "An Adventure into Ourselves" marks interesting quotations and highlights the social and political context of the Human Genome Project (HGP). She observes that the series and the episode form "an excellent basis for teaching both the science and bioethics of the HGP and large scale sociotechnical projects". The post also includes YouTube footage from related programming about the X-Prize.

Writing for Gene Expression, "Herrick" reviews Heredity and Hope: The Case for Genetic Screening, by Ruth Schwartz Cowan (Harvard University Press: 2008. 270 pp. $27.95, £18.95). This blogger points to three aspects of Cowan's book on genetic screening. In Heredity and Hope by Ruth Schwartz Cowan (11 June 2008), "Herrick" observes that Cowan distinguishes contemporary genetic medicine from mid-20th century eugenics by 1) showing that "genetic screening is a bottom-up social phenomenon, not a top-down mandate", 2) highlighting the "pro-natalist" aspects of contemporary genetic screening, and 3) sharing happy-ending stories about the proper use of this technology. In conclusion, "Herrick" observes:

Functionally, Cowan does the same thing for genetic screening that The New Republic did for tough-on-crime policies in the 80's and 90's: Cowan does some liberal hand-wringing while telling the reader that no, you're not becoming a Brownshirt if you agree to an amnio.

Smith-Lemli-Opitz Syndrome and a Florida “Wrongful Birth” Case

On July 23, 2007 a jury in Tampa awarded Daniel and Amara Estrada $21 million for a prenatal mis-diagnosis. The couple claimed that if the University of South Florida, Dr. Boris Kousseff had successfully diagnosed the genetic disorder, they would have terminated the pregnancy. The jury’s award is currently limited by state limits on negligence claims against public universities and other government agencies.

Greg Dahlmann, in yesterday’s posting on The American Journal of Bioethics’ editors’ blog (blog.bioethics.net) provides a comment on the use of the term "wrongful birth" and a brief summary of the case. blog.bioethics.net links to the following news sources:

Couple awarded $21 million in Florida 'wrongful birth' case. Tampa, Florida (AP). CNN.com/us, July 24, 2007.

For 'wrongful birth,' $23.5M: A jury sides with a family over a USF geneticist's "rotten advice." By Colleen Jenkins, St. Petersburg Times, July 24, 2007.

USF, Physician Liable For Botched Diagnosis. By Thomas W. Krause. The Tampa Tribune, July 24, 2007

A Wrongful Birth? By Elizabeth Weil. The New York Times Magazine, March 12, 2006.

A recent article by Carolyn Chachkin, What potent blood: non-invasive prenatal genetic diagnosis and the transformation of modern prenatal care, published in the American Journal of Law & Medicine (2007. Vol. 33, No. 1, 9-53) provides a review of the many ethical, legal and social implications of prenatal genetic diagnosis; these include “wrongful birth” lawsuits.

Genetics and Predictive Health in the News, July 2-9, 2007

Colorectal and Prostate Cancer

Study identifies a common genetic risk factor for colorectal and prostate cancer. July 8, 2007. University of Southern California. Eurekalert: http://www.eurekalert.org/pub_releases/2007-07/uosc-sia070607.php
"[O]ne of seven genetic risk factors previously identified as increasing the probability of developing prostate cancer also increases the probability of developing colorectal cancer".

U-M, Israeli scientists report major advance in search for genes associated with colon cancer. July 8, 2007. University of Michigan Health System. Eurekalert: http://www.eurekalert.org/pub_releases/2007-07/uomh-uis070307.php
"In a paper to be published in the July issue of Cancer Biology and Therapy, the international research team reports finding a significant link between genetic variation in a single region of human chromosome 8 and the risk of colorectal cancer. . . . The researchers compared the genetic makeup and family history of more than 1,800 colorectal cancer patients with that of 1,900 healthy people with the same breakdown of age, gender and ethnicity - either Ashkenazi Jew, Sephardic Jew or Arab/non-Jew".

Genetic Testing

Publication Announcement: Comparison of State Laws for Direct-to-Consumer Testing. July 06, 2007. The Genetics and Public Policy Center. DNApolicy.org: http://www.dnapolicy.org/news.release.php?action=detail&pressrelease_id=81
"Despite increased attention to the potential of direct-to-consumer (DTC) genetic tests to mislead consumers or waste their money – including a Federal Trade Commission warning in July 2006 – 26 states and the District of Columbia permit DTC laboratory testing without restriction, according to a new survey by the Genetics and Public Policy Center. .... [O]nly 13 states prohibit DTC testing, while 11 permit it only for specified categories of tests, which tend to exclude genetic tests".

Translational Research

$2 million Komen Award will fund research to reduce risk of breast cancer. July 5, 2007. Georgetown University Medical Center. Eurekalert: http://www.eurekalert.org/pub_releases/2007-07/gumc-mk070507.php
"Now that screening for genes that predispose a woman to breast cancer is routinely available, women at an increased risk are looking for ways to keep themselves healthy. Insoo Bae, PhD, a junior faculty member of the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center received a $2 million research award from Susan G. Komen for the Cure . . . .

Bae . . . has developed a new methodology for studying the interaction between environmental carcinogens and genetic risk for breast cancer".

Asthma

Gene linked to childhood asthma: Scientists have identified a gene that is strongly associated with an increased risk of childhood asthma. July 4, 2007. BBC News: http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/6261876.stm
"Studying more than 2,000 children, they pinpointed a gene called ORMDL3, which was found at higher levels in the blood cells of children with asthma. . . . Carrying a specific variant of this gene may increase the risk of developing asthma by up to 70%".

Reproductive Technologies

Pre-implantation genetic screening reduces both ongoing pregnancy and live birth rates in over 35s. European Society for Human Reproduction and Embryology, July 4, 2007. Eurekalert: http://www.eurekalert.org/pub_releases/2007-07/esfh-pgs070407.php
"Lyon, France: Preimplantation genetic screening (PGS), often considered to hold out the best chance for older women undergoing IVF to have a pregnancy and birth, does not increase on-going pregnancy or live birth rates ...."

Genomics

NIH Roadmap leads to genomics. Stewart, A. July 3, 2007. Newsletter, PHG Foundation:
http://www.phgfoundation.org/news/month/07/2007/#story_3497
"As part of its Roadmap strategy to tackle major opportunities and gaps in biomedical research, the US National Institutes of Health has published its latest list of priority research areas that cut across all 27 of its constituent institutes and centres. There is a clear focus on genomics . . . ."