I’m not moving nearly as fast as I wanted to this morning, so instead of actually doing a few things I should be, I’m going to make random comments on bioethics-y things I’ve read this morning. Oh, lucky you.
First up is new AJOB corresponding editor Ricki Lewis’s post on nutrigenetics, science and semantics. It’s a good article and an interesting read, talking about companies that purport to offer customized lifestyle and dietary suggestions based on population based gene/health biomarkers. The Government Accountability Office (GAO) had some concerns about this practice, so they set up a sting involving mislabeled DNA, simply to see what results were returned to them. This alone is terrifically interesting, and you should read Ricki’s article rather than my summary for the full take on it (there is little point in my reproducing an already well-written essay!).
What I find interesting, though, is that the concept of nutrigenetics hasn’t been talked about more often, or raised more ire. It could simply be that I’m not hanging around the right people, but when BiDil first came on the market, there was a big kerfuffle over the very concept of treating people based on what basically amounts to racial profiling. The folks I knew who were strongly for BiDil used a “genetics makes us different and we should acknowledge that” argument, while those against railed against phony conceptions of race, stereotyping, and so forth. I fell in the middle, noting that there are certain diseases that affect certain groups at a much higher incidence than others, and thus it would be foolish of us to pretend that there wouldn’t be medications affecting certain groups differently, as well. But I also agreed that one of the most problematic things about BiDil was determining just who would receive the treatment.
In that, this bit with nutrigenetics reminds me of BiDil, because both rely on self-identification as a primary mode of their functionality. Ricki’s essay and the GAO results suggest that nutrigenetic companies are relying much more on the self-reported lifestyle and even age and gender description provided by clients than any genetic testing (for example, shouldn’t they have been easily able to spot the gender discrepency?), and to quote the always-quotable House, “patients lie.”
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Continuing the trend of “I really was on the cutting edge,” virtual psychiatry and telemedicine continue to grow. Dr. Crounse had a good idea with Dr. Goodwell, it was just a little too ahead of itself in the grand scheme of things.
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Finally, and stumbled across on my own, I came across the baby home gender early detection kit, which claims to tell you the gender of your lima bean at 5 weeks gestation. I have no idea how accurate these tests are, because I’m too lazy to look right now (or maybe more accurately, I should be out of the house inside 20 minutes, and am still lounging in my flannel PJs with the cats), but I have to wonder at some of the implications for family planning that these tests offer. It is not uncommon for families to want to gender balance their children, and right now that’s done via expense and IVF. Could these early gender tests become the poor-man’s way to gender balancing children, allowing women to opt to abort pregnancies that are wrongly gendered for the parents desire?