Genetic tests stir debate
Published 9:00 pm Wednesday, August 9, 2006
LONDON – The decision in Britain to allow couples to screen embryos for genes that raise the risk of developing cancer highlights the vastly different practice in the U.S. and has revived calls for a global standard on the issue.
In a commentary published Wednesday in the New England Journal of Medicine, Dr. Peter Braude, head of the Department of Women’s Health at King’s College in London, said fresh approaches to the ethics of screening may be necessary in Britain.
Braude referred to the decision in May by a British government regulatory agency to add susceptibility to certain cancers to the list of conditions for which genetic screening is permitted.
“These different policies definitely show us what the problems are,” said Dr. George Annas, chairman of the department of law, bioethics and human rights at Boston University. “But they don’t help us to solve them.”
The issue, ethicists say, is that technology has outpaced society’s ability to regulate it.
“Right now, we can only screen for a handful of conditions,” said Annas. “But in the future, we’re going to be able to screen for literally everything that has a genetic component. And at that point, there may be no embryos that are deemed fit for life.”
The decision by Britain’s Human Fertility and Embryology Authority to allow testing for the likelihood of developing cancer is a departure from what had been permitted, namely testing for conditions that are certain to develop, such as cystic fibrosis or Huntington’s disease.
Unlike other conditions for which embryos are screened, cancer genes don’t automatically destine a child to develop that disease. Cancer also is preventable, even in people with bad genes, and treatable if they do develop it.
To some experts, testing for potential cancers uncomfortably shifts the goal posts of genetic screening.
“What the British are looking at are susceptibilities, which to me is a big leap,” said Dr. Tanmoy Mukherjee, co-director of Reproductive Medicine Associates of New York. “Having a gene for susceptibility does increase your chances if something else happens down the road, but it doesn’t necessarily mean you will develop these cancers.”
