With genetic testing for disease risk and athletic ability available to consumers online, genetic testing can only tell so much about their inherited genes. Clearly not everyone develops characteristics they are at genetic risk for. So should be concerning ourselves with such tests? Do we concern ourselves with treating diseases and conditions we don't have now? We see that Dr. Kathiresan does not often recommend genetic testing to patients and can give clinical recommendations without these tests. When do we draw the line of benefiting from this technology and using it for unneeded purposes?
Sunday, March 6, 2011
Recreational Genomics
With genetic testing for disease risk and athletic ability available to consumers online, genetic testing can only tell so much about their inherited genes. Clearly not everyone develops characteristics they are at genetic risk for. So should be concerning ourselves with such tests? Do we concern ourselves with treating diseases and conditions we don't have now? We see that Dr. Kathiresan does not often recommend genetic testing to patients and can give clinical recommendations without these tests. When do we draw the line of benefiting from this technology and using it for unneeded purposes?
Subscribe to:
Post Comments (Atom)
I believe that right now genetic tests are not developed enough for people to be making decision on what they should do for the rest of their lives. This is clearly seen in the reading, “Direct-To-Consumer Genetic Tests: Misleading Test Results Are Further Complicated by Deceptive Marketing and Other Questionable Practices.” The reading focused on different companies genetic tests and the results of these tests. It clearly showed how much more research is needed to even be able to trust the results that are obtained. Thus, as of right now I do not think that we should concern ourselves with conditions that we may or may not acquire in the future. Instead of worrying about the actual test results of mutations one may or may not have, we as a society should be trying to change our lifestyles to more healthy ways in general. We should not need genetic test results to give us an incentive to eat healthy, exercise, and so on.
ReplyDeleteI feel that policies and recommendations on a national scale need to be implemented first. Thus, we will know exactly who should make use of or be recommended to receive a genetic test. Then the technology of genetic tests will less likely be used for unnecessary purposes. People in general need to be focusing on their family history because that is definitely a big component or determinant on someone getting a condition or not.
A lot of the diseases being screened for are consequence of the interation between genetic predisposition and lifestyle behaviors. While genetic screening is on the verge of becoming abused for other recreational purposes besides health measures, I do not believe that screening for hereditary health problems at an early timeframe is miss using this technology because it takes extreme measures for a lot of people to get serious about their health and become motivated to make the proper lifestyle changes to ensure the most optimal health possible given their predisposition to certain health conditions. Thus if individuals are provided the option to find out the trajectory that their health may take ahead of time, the probability of individuals implementing proper precautionary lifestyle habits would be greater and easier to maintain because their parents could even integrate them into their child’s life so that the child would be more inclined to carrying out these health behaviors than a child whose parents did not create such an environment conducive to leading a balanced lifestyle.
ReplyDeleteAnything in regards to diseases and disorders, I fully support the use of screening and diagnostic testing, but when it comes down to recreational purposes and screening for specific skills, that is where I personally draw the line. I feel that screening for athletic ability and other skills that a child may be genetically predisposed to being good at takes away from the adventure and excitement of living and leading a full life. This is because if a child’s destiny is established for them prior to having the chance to explore their talents and what they are good at, then they will miss out on developing and coming into their own selves and will also miss out on learning many life lessons that can only be learned through real life experiences.
I think its clear that we concern ourselves with treating diseases and conditions that we don't have now, especially after reading the mentioned article in which Dr. Quake sought medical advice for a disease that he showed no characteristics of. While I am not against the use of genetic testing for those who would like it, I do not feel that we should be concerning ourselves so much over the tests or the results. I agree with K.Ruggiero that we should not need to know that we have genetic mutations in order to make healthy lifestyle choices. If a person uses tanning beds and smokes cigarettes then finds out that they have mutations for skin and lung cancer, it would be reasonable to expect that they stop those risky behaviors. But if a person never starts using tanning beds or smoking cigarettes, I doubt that they would feel inclined to start just because of a negative result. If healthy behavior is encouraged regardless of genetics, the tests may not be helpful to the general population.
ReplyDeleteI think it is hard to draw the line between benefiting from the technology and using it for unneeded purposes; people define their individual needs completely differently. Maybe some people do feel that it is beneficial to genetically screen their children to determine their talents, even though this clearly crosses a line for other people. For the general population, genetic testing is unneeded. As Dr. Kathiresan said, he does not need genetic testing results to make clinical recommendations. But if a person has access to a test that they can afford that they find necessary, I don't see a reason to discourage the use. -Becca Adlman
This comment has been removed by the author.
ReplyDeleteI agree wholeheartedly with K. Ruggiero's comment that direct-to-consumer genetic tests are not developed enough for people to make drastic, life-altering decisions based on their results. We saw this with the at-home genetic tests sold at Walgreens. The company even warned on their website that the results should not be used to make health decisions. However, while I believe that genetic testing should not be used as the first step for detecting possible diseases, if there is a significant family history, genetic testing can be an important tool for assessing susceptibility to a disease or illness. Genetic testing will mostly likely never be available to everyone. Even if whole-genome sequencing were to become as "cheap" as $1,000, there will always be those who cannot afford it, just like there are those that cannot afford simple medications now. Therefore, I am on the fence about whether or not genetic testing should be used to predict conditions that may develop years or even decades in the future or if it should be limited to testing for a condition that an individual is currently thought to be susceptible to.
ReplyDeleteAfter having learned about genetic testing and having read the article for this week I have mixed feelings about this topic. As far as what K. Ruggiero says, I do agree that some, if not most genetic tests are not reliable enough yet or developed enough to make such a decision as to completely change our lifestyles based on those results. However, I do think that there are some benefits of getting these tests done, drawing of course, a boundary when they are not completely necessary.
ReplyDeleteI think that if a Doctor has a patient who is not completely sure about their family history, perhaps having many relatives who died of unknown reason or suddenly, getting a genetic test is necessary because they may be at great risk for something that they don't know about. It is true that sometimes family history is not something we an completely take in as true, as it says in the article, people may not really know their true family history in its entirety.
Also, I think that getting these tests done should depend on the type of disease. If the test is for a disease that has no cure or there is no way of changing the lifestyle in order to prevent the disease then there is no reason to spend the time or money on a genetic test. This would only cause unnecessary stress. For a disease like cardiovascular disease however, changing one's lifestyle may greatly affect the outcome so in this case, a genetic test should be done. On the other hand, diseases such as many cancers have no cure so there is no reason to have a genetic test for them. The only thing people can do is maintain their yearly routine of scanning for these diseases.
Because genetic tests are so new I think their popularity is rapidly increasing but people should not be fooled and believe everything companies say about these test and should not put all of their trust into these tests.
As scientific innovations and technologies evolve, our knowledge and expectations increase. These technological advances have helped us move from an infectious diseases to a chronic disease era. Nowadays, prevention rather than treatment is the most efficient and cost-effective way to go when it comes to our health. We concern ourselves with treating diseases and conditions we don’t have in part because we want to take control over our lives and of course we don’t want to suffer in the future. It is a human natural reaction.
ReplyDeleteI am a skeptic about this whole genetic testing issue and I have too many questions. Part of me argues the fact that as we continue to find maladaptive genes and save individuals from genetic predisposed diseases, as they reproduce and continue to inherit such genes, then what is going to happen in the future? Are we going to have more people with genetic inherited diseases? What is the next step? Find ways to alter each individual gene to make them perfect? On the other hand, I think about what is the right thing to do. We have the technology for a reason and we should save everyone as long as we can, but is it ok to inform people at a young age about a “bad” gene and let them live a somewhat worrisome life? Doesn’t that alter your mental and physical wellbeing, which then can trigger these mutations to manifest? It goes back to the question of nature versus nurture. Same people with the same genetic makeup but different environment—one can manifest the disease and the other doesn’t. As we have read throughout class, genetic testing is not the sole factor taken into account when looking at inherited disease risk.
Now, I do not think we should be concerning ourselves but it is kind of the social norm and it will continue to evolve. The drawing line is a complicated question, but if left up to me it should be just for disease risk and only if the disease has a treatment.
I think it is important that genetic testing be available for individuals who have a genetic predisposition to a specific illness/health problem. By receiving genetic testing, an individual can reduce the risks associated with developing the actual disease because they could change/monitor their lifestyle and behaviors. In doing so, the individual may avoid environmental and behavioral factors that may either trigger the disease or contribute to its development.
ReplyDeleteHowever, I also feel that genetic testing should not be overused by individuals who do not have a genetic predisposition or family history of a disease. I believe these individuals should be restricted from receiving genetic testing because there is a potential that the outcome of the test will do more harm then good. For example, if a person finds out that they have an increased risk for a disease they may begin to worry more and could ultimately increase their own risks of developing the disease due to stress. Additionally, I think that if genetic testing is available to all individuals who are willing to pay for the services (no matter their health status), there would be misuse and there may be potential harms from making this information accessible for everyone.
Thus, I find the major issue with genetic testing to be regulation. As G.Sepulveda said, it is important to decide where to draw the line when discussing genetic testing. However, in my opinion, genetic testing should only be offered and utilized by individuals who have a true health concern - in which case finding the results of the test would most likely do more good than harm.
I think that in the future genetic testing will be helpful in preventing diseases but as of right now it is we do not have enough information to properly use genetic testing. The article focused on the use of statins which i have learned in several other classes have only be proven to be beneficial in those who have already suffered from a heart attack so by prescribing such medication we may be over medicating our society and not benefiting them from the medication. I believe the line should be drawn that genetic testing should only be used for genes/traits that we fully understand and have proven beneficial methods of preventing such a disease from occurring in individuals.
ReplyDeleteI agree with Becca's comment that every individual's view on the necessity of genetic testing is different because of personal preferences, opinions, and health concerns. Furthermore, I do not think that genetic testing should be denied for anybody - if they are able to afford it and would like to know their status regarding a certain disease, no one should be able to keep that information from them. That is not to say that physicians and genetic counselors should blindly recommend testing, but they certainly should not withhold it. The individual requesting the genetic test should be thoroughly informed about the risks and benefits associated with the test, the reliability and validity, and the next steps they should take depending on the results. As long as the person does not hurt himself/herself or anyone else with the information (such as their children), I do not see any harm in permitting freedom for genetic testing.
ReplyDeleteI believe that currently the tests for genetic diseases are not reliable enough to give an absolute result. However, I do think that genetic tests are a good way to keep track of a genetic diseases that you may develop. The disease you may develop and family history should be the deciding factors if you were to get a genetic test. If family history and the disease are not relevant then it would most likely be a waste of time to get a test.
ReplyDeleteIf you test positive for one of these tests you can take the right steps to protect yourself in the future. If you are pro-active enough it is very possible to avoid a disease all together. I personally would not get a genetic test, I feel that the news could be too much and I wouldn't want a "positive" test to rule my life.
I agree with mfidler and G. Sepulveda. Taking it further to an economical standpoint, if all tests become readily available for anyone to purchase, there could be serious consequences. We saw in the film "In the Family" that Myriad genetic testing company claimed several years ago that advertising the BRCA test would drive the price down. However, as the narrator argued, the price has remained extremely high. So you have to ask - Who can afford these tests? Only the wealthy. The fact that only the upper class can afford this kind of genetic testing (and likely purchase it for a sense of comfort rather than based on family history) could place these individuals at even higher social advantage compared to those who can't pay (and may actually have high risk).
ReplyDeleteOn a completely different note, regarding the genetic testing to determine athletic ability: It's been proven, in some cases, that the body can adapt to how the body is performing. For example, there are genes coding for the different phenotypes of muscle cells that result in an individual being more skilled in certain athletic activities. However, it has been shown that genes alone are not the definitive determinant of a person's athletic ability; muscle cells can adapt, convert into other cell types according to activity/training. By attributing athletic ability to genes alone, we're undermining our own body's abilities. Not everything is in the genes.
I think that it is great that years of research is now allowing us to use genetic tests to detect for disease risks or threatening mutations. However, we can't completely trust the results that genetic testing gives us. Someone who is at genetic risk for disease might not develop it, and the same is true for someone who develops a disease that they are not at genetic risk for. I am on the borderline between the pros and cons of genetic testing. I like how genetic testing can lead to healthier lifestyles and behavioral changes. But I also believe that genetic testing is extremely costly, and can lead to unwanted anxiety.
ReplyDeleteMy whole entire father's side of my family has some form of cardiovascular disease. This part of my family history tells me that I could possibly be at risk for eventually developing CVD. Having this in mind I always try to exercise and eat well. I do not need to take a genetic test to waste my time and money to tell me that. Let's say I did take a genetic test and the results showed I wasn't at risk for CVD. This would be insignificant to me because I would not want to change my healthily lifestyle and I would know that there is always a chance that I can get CVD, regardless of the testing results. If the genetic testing results told me that I was at risk for CVD, then I would probably get lots of anxiety. I am presently healthy and should not be too concerned with what diseases I would get in the future, especially since I am exercising and eating well now.
I think that using genetic testing is very situational; it should be used after evaluating the patient's specific case and if there is an existing treatment or management plan available. Using a genetic test detect the risk for a disease such as Alzheimer's disease would be completely unneeded. There is no known treatment or prevention for this disease, and so testing for it would only cause unwanted stress.
I think the most important distinction between times when genetic testing is necessary and when its not is that it is necessary in times when a clear change in behavior will occur based on the results. For example in the article it seemed like the only course of action if someone found out they had the gene in question was a course of medicine that is already commonly prescribed (aspirin and statins), in this case I don’t think that it’s a good allocation of resources to recommend genetic testing. In the case of the breast cancer gene the diagnosis leads to a surgery option that will significantly reduce the risk of developing breast cancer and that would not be done otherwise. The only place where this can get a little fishy is in situations like we watched in the video in class about genetic testing in Chinese children. This is an example of a grey area where some people would argue that there would be a behavior change to avoid unfavorable outcomes based on the results. The unfavorable results of course being adolescence ‘wasted’ trying to be good at something your genes suggest you may never be the best at. I personally don’t see an ethical issue with parents genotyping their children mostly because I feel like pressuring your kids to do something you believe they will be the best at is nothing new. I think the bigger problem is that people honestly believe that these tests are completely accurate judges of potential when the reality is that genes can only tell so much. As I said before if there is a clear way to avoid a disease/condition that we know someone can get based on a genetic test then sure we should bother ourselves with the test. On the other side, if the test cannot accurately predict something (like the athletic testing done for children) or if there is not a different change of action to be done based on the results (like the cardio testing) then I don’t see a reason for the test and would say they are unneeded.
ReplyDeleteAlthough genetic tests are undeniably limited in their ability to provide accurate predictions for the future, I still personally believe in their potential for development. People with genetic risks do not always get the diseases or conditions that they are predisposed to but genes still play a huge role in our health and overall functioning. Therefore, it is extremely essential for research in genetics to take things further and try to develop more accurate testing measures. As stated in the article, assessments of genetic risk can potentially provide new information that may not be present in a patient's family history or initial physical examination. Though doctors have varying opinions on the necessity of genetic tests to make clinical evaluations and recommendations, I don't see the harm in seeking out that extra information if the genetic test is easily accessible and affordable, just to be safe. Clearly, doctors should not rely solely on these tests to determine their patients' medical assessments but they can be helpful for early prevention of future problems. Even if the problems are never meant to arise, despite the genetic test result, there is no harm in taking precaution for one's own health. Though I agree that genetic tests should not the the primary basis for the way doctors treat their patients, I do think they should be taken into consideration and offered as an option for the patient with full disclosure of its accuracy and future imnplications.
ReplyDeleteI agree with mfidler in that there is a risk that individuals will use the tests unnecessarily, possibly resulting in unwarranted anxiety if a gene is detected that puts one at a slightly higher risk of developing a certain disease. It is very likely that the disease could in fact be quite rare within the general population and could never develop, but without the education of risk assessment provided during genetic counseling sessions, many individuals will be unaware of the reality of the situation. In this respect I feel that direct-to-consumer genetic testing would not be beneficial to the population at this point in its development. Not only does it seem like DTC tests are unreliable and inaccurate judging by the articles we have been reading for class, but I also feel as though our society isn't ready to be given so much independence and freedom to assess their own genes and the implications they could potentially pose in the future. For most, as soon as the word "mutation" presented itself, stomachs would sink, thoughts of early onset of disease and premature death would cloud minds, and the reality of the situation would be lost in the face of faulty risk assessment.
ReplyDeleteBefore DTC can bring more good than harm to the population, people need to be educated on the implications of various test results and be given resources that should be taken advantage of post-test.
Personally I don't like the idea of these "direct-to-consumer" genetic testing kits, I just don't trust the whole idea of "just spit in a cup and in days you'll see what may or may not be wrong with you". It just seems way too "gimmicky" to me, and definitely not something that I would want to participate in. It may be convenient for some people but I think it makes a lot more sense for people to go to a professional to get something of this nature done, to actually explain what the results of the test are because it would seem that any "joe schmo" could easily misinterpret the results of these types of tests..
ReplyDeleteActually I found an article from WebMD that talks about this matter in that that FDA is urging federal regulators to "go slowly in allowing companies to sell genetic testing kits directly to consumers, amid worries that test results could be easily misinterpret... Medical students don’t understand it and practicing docs don’t understand it and we certainly can’t expect consumers to do that.”
http://www.webmd.com/heart-disease/news/20110309/fda-panel-urges-caution-on-genetic-test-kits
So I don't think there is any appropriate reason to use a genetic testing kit, let's leave that to the professionals..
Though genetic testing is faulty in a number of ways - some individuals do not acquire the physical characteristics their genes may suggest, or the limited knowledge we have about the thousands of genes is involved in diseases, including heart disease - I believe it's important for those individuals with a strong family history of disease to get a genetic test. For those that are unsure of their family history, maybe it's necessary for them to get a genetic test as well. Preventative measures save money and lives. Plus, the utilization of these genetic tests can only help scientists improve said tests for future patients.
ReplyDeleteThere is definitely a fine line between using genetic tests for detection of diseases and what we saw in class where China did genetic testing on young children. What China is doing may be looked down upon in the Western world due to cultural differences. In my opinion, that kind of genetic testing is unnecessary; genetics of shyness and intellect does not equate to becoming a great business administrator.
It is necessary to supplement family history and risk of a disease with consideration of an individual’s lifestyle in regards to genetic testing. However, I do not think that we should be concerning ourselves, as a whole population, about whether or not people are taking a genetic test. I feel this is a very personal and reflective decision, to get a screening done, and it is not fair to impede on someone else’s private right to their own information. The tests are available, and morally, I do not feel in the right to state whether or not someone should, or should not, get tested. Those that have a history of disease should be equally at right to take a test or not take it, as those who do not have a history of disease. I personally would not want to take a genetic test and I would expect to keep this choice available. Likewise, a friend of mine would consider it and I would also expect that they will be able to keep their choice.
ReplyDeleteAs T. Burks commented on “drawing the line”, I agree with the fact that there is a boundary needed for what someone can be genetically tested for. I believe there are moral and ethical conflicts in concern, specifically in regards to stripping away some aspects of autonomy from an individual. I think that genetic testing for recreational use, in regards to athleticism, can be detrimental. The tests would have to be applied to adolescents who may not understand the extent of the results or screening. They won't have enough basic information or understanding to make an educational choice about getting tested. Once the results have been read, how are adolescents supposed to handle what was found? Doesn't this take away from growing up: finding out what you enjoy and don't enjoy as well as what you are good at and what you aren't good at? How much influence do parents have on this choice? This type of recreational genetic testing goes too far in my opinion and I hope that in the future these types of choices will not be offered – and on that note, how reliable will the results of these tests even be? What about all other factors that influence a person’s athletic ability: passion, drive, determination, practicing?
As many have already pointed out, most genetic testing available is very expensive and does not always give the most accurate prediction of future disease states or risks. While there are some situations in which genetic testing in the presence of a family history of a disease like Huntington's Disease, which is autosomal dominant and a positive test result means that the individual is sure to develop the disease, is certainly recommended, genetic testing is often misused. Since so many diseases are the result of the expression of multiple genes as well as certain environmental exposures and lifestyle factors, genetic testing may at this point be in large part unnecessary. I found the example given in the article to be a particularly good example of genetic testing for the sake of genetic testing. There are many other much more cost effective tests available that can help determine an individual's heart disease risk, especially if just focusing on cholesterol and whether or not to be placed on statins. Every individual has mutations, we all most likely have some mutation that places us at some higher risk of developing disease x or y, but knowing what those mutations are does not necessarily translate into being able to mitigate those risks. While the allure of knowing what is encoded in our DNA is great, it's simply not practical at this time. In a health care system where utilization of services far outpaces the funds to pay for those services, the last thing we should be doing is expanding the use of very expensive and in many cases largely inconclusive tests when much more accurate and cost effective alternatives exist.
ReplyDeleteI must say that I agree with WaylonC on the idea that some individuals don not acquire the physical characteristics their genes may suggest. We may also never develop the diseases that they say we may develop. It is, however, very important for individuals in a certain community, with a given familial background, or direct introduction to certain diseases, to get genetically tested but to say that it is always good for them to get tested so that one can learn the physical gifts that it was blessed with. What if an acident were to occur and the individual were no longer able to display those abilities but their genetic tests claimed that they were destined to do so? It is not always necessary for one to know these things but when it comes to the health and well-being of the individual, if genetic testing can inform the person on life threatening news, then by all means, there is no line crossed. But for mere personal gain, that is where the line has definitly been crossed. Such powerful development should be used for the betterment of the health, not the physical ability such as sports.
ReplyDeleteThe acts of China are looked down on many individuals, such as myself, mainly becasuse it is causing harm to those that it is being done to. The individual is being sculpted into something that it has no say over but what their genetic test said that they would be good at. What ever happened to letting the child live a life that it sees fit and developing characteristics that is loves? Why must they be forced to do somehting? If my genetic test stated that i am to be a great olympic runner, i would have wanted the choice to become one, rather than to force. I believe that i still would have grown up with the passion for Midwifery that i have now, but with a ability to run really fast. would i want that to be my life? Absolutly not.
I think it is imperative to decide where to draw the line when discussing genetic testing, because there are many ways I which it can be abused. For example, in the video we saw with the Chinese children who were tested at the earliest at two, to discover what their personality weaknesses and strengths were. I was really perturbed by this; it take away the child’s free will and expression, it’s somewhat like manufacturing individuals for certain professions.
ReplyDeleteI believe that genetic testing should be exclusively and utilized by individuals who have a true health concerns or have a family history for a particular disease, in this case; the tests would do more help than harm the individual. If family history and the disease are not relevant then it would most likely be a waste of time to get a test.
In this way, if the test results come back positive the individual has the opportunity to take the intuitive to be proactive and take steps for preventing the future diagnosis of the disease. However, once we start testing for intellectual and physical abilities, like in the Chinese children, I believe more harm than good will be done.
I also agree with WaylonC in that individuals with a strong family history of a certain disease should be tested for a genetic mutation, especially if the severity of the disease is high. Although genetic testing can have the potential to have positive affects on an individuals health, I agree that while they may be useful in some cases, it seems as if a doctors recommendation for a patient ultimately is the same, whether or not a genetic test has been conducted. For instance, if a patient comes into a doctors office with a high prevalence of heart disease in his or her family, a physician will most likely recommend nutritious eating and a physically active lifestyle to a patient of this type, regardless of the results of a genetic test. However, in certain cases the tests are more useful. If a patient can only alter their risk for a certain disease through medical intervention, such as surgery or the continued use of a medication, rather than personal change, it is beneficial to know the results of the genetic test so that proper action can be taken. I think that the severity of a disease should be taken into account before a genetic test is ordered. If there are no additional measures that can be taken if the result is positive, I think that the test is not necessary. It is imperative that the patient, as well as the physician recommending the genetic test, take into account all benefits and potential effects of having a genetic test.
ReplyDeleteEspecially after reading the GAO report on DTC genetic tests, I think there is a lot more negative coming from excess genetic testing than good. The results are not only often questionable and misleading, but they suggest that they can empower people and give important results for decision making. Genes are only part of a person's overall health profile, and interact with environmental and lifestyle factors to contribute to health conditions. I agree with other statements made by K. Ruggiero and Becca that everyone would benefit from exercise, eating healthy, not smoking etc. regardless of genetic profile, and that most health conditions can be diagnosed and treated without using genes at all. Involving them when not necessary introduces psychological concerns such as anxiety or guilt, and can lead to social concerns when it is used for determining a person's future such as using it to determine athletic ability, etc. I think these tests should be reserved for those of high risk who would significantly benefit clinically from genetic knowledge, and it should be done with genetic counseling and analysis available. I think a lot of why these tests have increasing popularity is because people in our culture in particular want quick, easy answers to health problems, although genetic determinism is not an accurate way to think about genetics.
ReplyDeleteI agree with many of my classmates who have discussed the importance of genetic testing only for those individuals with family history for particular conditions. I don’t think that genetic testing should be used by those without a specific concern, because like the article says, often times we don’t develop characteristics that our genes dictate we should. It’s unfortunate that for some individuals it takes a genetic test to provide enough motivation to alter lifestyle behaviors in hopes of preventing the development of a particular disease. I’d like to think that people without a strong family history of a certain condition can engage in preventative measures to even further lessen their risk for their development. Like MariaPia Rivero discussed, it’s a double-edged testing genes for the potential to develop cancer, where there is no absolute cure. Knowing about this increased risk may only provide the individual with extra stress and anxiety. For someone to alter major aspects of their lifestyle just according to the possibility that certain conditions may develop doesn’t seem right, rather it should be other motivations that inspire individuals to be aware of disease prevention.
ReplyDeleteI think that people should only get a genetic test if they are at risk to develop a certain disease, given that knowing if that person has the gene will lead to greatly decreasing their chances of getting the disease in the future. For example, if there's a treatment they should be doing or something out there for them, otherwise the genetic test wouldn't be beneficial to the individual. Its evident that not everyone inherits genetic characteristics, and many people develop diseases that have never been seen in the family before. That being said, the line for genetic testing should be drawn according to the strength a person's family history. I think that if physicians recommend genetic tests for unneeded purposes, thousands of dollars would have been wasted if the person couldn't have benefited from the test anyways. I agree with Caroline that people without a strong family history of a certain condition should engage in preventative measures to lessen their risk, and not rely on a genetic test in order to alter their lifestyle behaviors.
ReplyDeleteI agree with G. Sepulveda in the fact that prevention rather than treatment is most efficient and cost-effective when it comes to our health. Although not all tests are completely reliable, I believe screening and diagnostic testing is appropriate when a family history is present or a predisposition is apparent because it can detect a serious health problem and, as a result, motivate individuals to implement proper lifestyle changes and engage in information about their health condition to improve the situation. The genetic testing can help an individual in properly acknowledging behavioral and environmental factors and monitoring lifestyle choices to reduce the risk or onset of said disease.
ReplyDeleteUnfortunately, there are some individuals or doctors who may abuse or over-use genetic testing which may cause additional anxiety as M.Fidler stated. As long as proper regulations or policies are in place concerning genetic testing for individuals with a predisposition/family history, I believe it is a positive addition to the health care field. Currently the Centers for Disease Control and Prevention require laboratories performing genetic testing to adhere to the general provisions of the CLIA. To ensure quality of genetic testing, the CDC and Center for Medicare and Medicaid Services (CMS) are creating new requirements for improved testing. These are appropriate measures to ensure effectiveness and regulation for the general population.
I agree with the people who have posted above me. Although genetic testing can be helpful when figuring out the risk of a person being susceptible to a certain disease, the technology still needs to be advanced. Even for the BRCA 1 gene, although the risk of getting breast cancer can be found, there is no way of knowing when the person may get the cancer. Clinicians should continue to look at family history and environmental factors. That being said, I also believe that a person should not be tested unless they are at higher risk that usual for a disease as this can cause psychological stress and unnecessary worrying. Furthermore, testing for other qualities such as height or speed does not guarantee that your child will be an athlete. It takes time and effort to develop the skills to play a sport, however, your child may have an edge. Additionally, this may push children in a direction they may not want to pursue.
ReplyDeleteI also agree that genetic tests should mainly be done only if someone is interesting in knowing about their predisposition to a certain disease. With regards to testing for certain athletic abilities, this reminds me of the video we watched in class about china sending their children to camps to get tested for professions they would be good at. Such tests are not related to health, are mostly done on young children. If parents take the results of these tests very seriously, a child may be forced to do activities he/she does not enjoy and may be robbed of their childhood by not being able to explore the world and decide on their own what they would be interesting in doing. For me, I feel as though if an individual has a higher risk of getting a disease (due to family history, lifestyle choices, etc), they should be able to do the genetic tests once they have been given all the pros and cons of doing such a test. However, I think that testing for athletic ability is taking these tests a bit too far.
ReplyDeleteI think that it is very important for genetic testing to remain an option for both doctors and patients. As knowledge continues to increase in regards to what particular genes are associated with diseases or disorders, there are many things that can be detected from screening for a particular genetic variant. Doctors should have as many options available to them when it comes to properly diagnosing and being aware of a patients past and present health. With that being said, it has been the goal of our healthcare industry to push towards a more cost-effective, efficient way of doing medicine. The answer to this problem is of course: preventitive medicine. Preventitive medicine is a cheap, less invasive method of increasing overall health, whether it be for a community or for a country. The recent advancements in genetic testing are a form of preventitive medicine. They help doctors recognize potential risks that a patient may have.
ReplyDeleteIndividual's who have a genetic disposition to a specific illness benefit the most from advancements in genetics. The results of these tests may be life saving, because individual's at risk can change/monitor their lifestyle and change their behaviors accordingly. In doing this, the individual may avoid environmental factors that may either act as a trigger for the disease or contribute to its subsequent development.
The problem with the area of genetic testing remains in its manipulation to those who are unfamiliar with it. Different companies market genetic tests as a miracle test. Most of these companies operate on emotional appeals directly to consumers and make claims that are superfluous and illegitimate. Reading this article reminded me of the video we watched in class. Geneticists in China claimed to be able to screen young children for future traits they would develop that would lend themselves the best to pursuing a particular career or future. The kids were then placed within the fields to which the results of the genetic tests claimed they be the best suited for. To me this area of genetics seems more closely associated with dark arts than actual science.
It seems very simple—if we are able to provide clinical recommendations without genetic testing, then why do so? Genetic testing has its benefits and weaknesses; the overuse of performing them unfortunately makes them a controversial issue. People should not attempt to treat disease and conditions before there is a complete and accurate diagnosis.
ReplyDeleteDoing so brings anxiety and fear of something there isn’t a full understanding of. Accuracy is key; many tests will result false positive results. If so, the wrong treatment could be provided therefore making the true disease worse. Genetic tests aren’t invasive, just swab the inside of your mouth, but being tested is an entire process. You may not be prepared to hear and understand the results—genetic counseling is necessary.
Also, if there are physicians ordering plentiful amount of genetic testing, the issue of money arises. Genetic tests cost hundreds of dollars, for those who don’t need them because they’ve been properly assessed without testing are squandering their money and the health insurance’s, at that.
Tests are beneficial when they are necessary and safe in all area, especially to not bring any harm to the patient. The most important component is the patient.
I believe that genetic testing is a good idea for medical purposes involving detection and prevention of diseases. It allows patients to willingly get involved in their health, by encouraging them to partake in healthier lifestyles. I think that patients with family histories of chronic diseases will use the information found in a genetic test to work on living healthier lifestyles that can drastically decrease their susceptibility to chronic diseases such as heart disease, diabetes, etc. Patients who know what diseases they are susceptible to can begin taking the necessary steps in order to reduce the likelihood of onset.
ReplyDeleteI also acknowledge the downsides of genetic testing but I think the benefits the success of the tests will provide to the public and medical community will far outweigh any problems people see with the testing. I do not think there is a problem will people learning more about their genome and about the diseases they are most susceptible to.
Additionally, I wholeheartedly agree with WaylonC's comment that "it is important for those individuals with a strong family history of disease to get a genetic test [...] preventative measures save money and lives." The potential that genetic tests have in revamping medicine is extremely advantageous to patients. The rates of morbidity and mortality could potentially be drastically reduced and patients will not only be more informed about their health histories, but more inclined to do something about it.
Although i do not necessarily agree with this point of view, and i agree with the common theme of everyone else's comments against genetic testing for athletic ability and things that we have no yet gained full understanding on, i thought it would be interesting to try and argue the opposite side. Someone advocating this testing could argue that testing people for things such as athletic ability could push people to reach their full potential (because they know they can excel). Also, one could argue that knowing what people are genetically predisposed to be best at could be good because people would concentrate on these areas and be more likely to succeed, and arguably be less exposed to the traumatic effects of failure. In addition, someone could argue, that if we can give clinical recommendations why not base our recommendations on both genetic testing and clinical observations? Genetic testing may be new, but at one time so what basic medicine, and look what that has done for humanity. I do not agree necessarily with these ideas, i just thought it would be fun to try to put myself in the opposing standpoint and argue against my own views. I feel that genetic testing could have endless possibilities, but i think we need to master it first, before it's exposed so readily to the population, and if it is used, it should be used in cases deemed necessary.
ReplyDeleteI think it is interesting that we have the ability to buy genetic testing materials that can assess what our inherited characteristics are. Clearly, we do not inherit all the characteristics we receive from our parents, but I am curious to see how well these tests could give a person an idea about how much they could improve as an athlete, or what they are capable of.
ReplyDeleteIn terms of looking at predispositions for disease, I believe this too is very relevant and important for people to consider, especially if by modifying certain lifestyle behaviors they can avoid the disease. For example, if a genetic test shows that a person may be at risk for developing some chronic illness, they might want to consider living a more active lifestyle and eating healthier to reduce the likelihood of experiencing that disease.