Genetic Testing

For all of human history people have gotten sick and died. Many of these once-fatal illnesses are now treatable through modern technology, with surgery, antibiotics, radiation, and other means used to help protect an individual's health. Health through these means is an accepted component of western medicine with little thought given to the ethical dilemmas of these treatments. However, genetic testing, another potentially useful method of diagnosis and treatment is heavily scrutinized and debated. Why should this be so, and what are the arguments on each side of the issue?

The reason genetic testing is not currently enjoying widespread acceptance is threefold. One, mankind has learned and become cautious due to past mistakes. The over prescription of many antibiotics has lead to the population of resistant strains. The introduction of insecticides has lead to mass killings of many species of higher animals such as some birds and fish. In these instances not enough forethought was given as to what the potential consequences of these actions were, and many people are afraid something similar might happen with genetics. This argument hopefully can be circumvented through proper prior investigation into the results of genetic testing and manipulation, but it is very difficult to convince people that this is the case.

Secondly, it is not as easy to persuade an individual that genetics is ethical. In past medicinal developments, there was generally an alternative explanation available that made the technique appear "natural." For instance, cows and bulls mate naturally, so there is no reason not to choose which one. Also, because some bacteria synthesize antibiotics naturally, it appeared that there was no fundamental difference in selecting which bacteria made what. These and many other examples are demonstrations of different euphemistic ideas of the average populace to remove all ethical debate. However, the general populace seems to believe that all bacteria are simply bacteria and all humans are intrinsically different, special creatures. This provides no room for a euphemism of genetic testing. This argument does not speak overly strongly as it appears to be a simple fear of the unknown that provokes it; it does not seem to be based on rational thought and has no supportive evidence as yet.

Finally, the third argument against genetic testing is that it is not practical, cost efficient, or necessary to modern medicine. This argument may be the best one. At present genetic testing is highly cost prohibitive and the merits of many of the tests are not well determined. In addition, the question is raised regarding who is to pay for these tests, and what should be done in the event of a positive result? This opens the door to a large number of new ethical questions, some of which apparently are not so knew after all.

The technological aspects of genetic testing reveal increasing potential. Early detection, necessary for treatment of diseases such as PKU and retinoblastoma, can be easily accomplished through a fairly accurate genetic test. The potential for developing several different tumors can be partially assayed through genetic testing. Once testing positive genetically the individual can then monitor his or her diet and doctor appointments in an effort to catch the disease in an early stage or perhaps circumvent it entirely. ON the downside, however, genetic tests are not one hundred percent accurate. There are false positives and false negatives, and many traits cannot be accurately assessed through genetic testing due to multilocal nature and environmental effects. Generally however, genetic testing appears to affect an individual's and a population's health more positively than negatively.

However, this does not mean that everyone should be checked for every disease. There is a monetary cost involved in genetic testing, ranging from two to two thousand dollars per test. Clearly it is not cost-effective to inventory millions of people for genes present in less than one tenth of one percent of the population. Because of this, it makes sense that only high-risk individuals (due to family history etc) be examined through genetic testing. This way minimum cost is imposed as well providing addition protection for a majority of those who may eventually develop the particular disease being tested for. In addition, early detection can lead to earlier care which generally results in a large monetary savings as well as protecting quality of life. However, it again raises some ethical questions, many of which deal with insurance.

So far it has been noted that current genetic tests can be inaccurate, that results are ambiguous, that in many cases the consequences of positive results are unknown, that it is impractical to test all people for all genes, and that there is a high cost involved in simply testing for genetic traits. Because of this, only a small fragment of the population can be tested. These people, if testing positive, could potentially be a large financial burden to others, including insurance companies. Because of the selective population being tested, there is unfortunately an opportunity for insurance companies to discriminate against these people (vs those not tested who may still become afflicted or vs those who have a similar illness that is not testable for). Also, it allows for the possibility of the unavailability of insurance or at the least higher premiums. One of the major current arguments regarding genetic testing questions whether insurance companies can be trusted.

Insurance companies are "providers of payment for calamity." They receive the money for this payment through charges levied against those protected by them. The charges are based on risk factors including hobbies, occupations, lifestyle, and family history. Unfortunately space does not permit the large discussion possible on this topic, but more information is available at http://members.tripod.com/~AFoggyone/insure.html

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