Questioning the Human Genome Project

In 2003, after 13 years of research, the Human Genome Project (HGP) was completed. On the one hand, it was heralded as a major scientific breakthrough, and a landmark in our biological understanding; on the other, it was criticised on ethical and other grounds, and accused of being radically less valuable than had been claimed, most consistently by evolutionary geneticist and philosopher of science Richard Lewontin. Bill Clinton lyrically described the goal of the project as “learning the language in which God created life”, but five years after completion, what exactly have we learned? 

Like Lewontin, I was highly sceptical of the value of the Human Genome Project, which seemed to be woefully naïve in its assessment of what was being attempted, although ultimately it seems some good has come from the $2.7 billion project – but not so much of the kind that its advocates advanced at the time. The HGP has hammered fresh nails into the coffin of naïve belief in genetic determinism and dogmatic adaptionist philosophies, and undermined the assumptions that motivated the research in the first place. I consider this to be a great success in terms of philosophy of science!

I originally intended to title this piece, rather cryptically: “One Down, Four Billion to Go”, since a first and obvious criticism of the HGP is that it doesn’t map the human genome, it maps a human genome. Much of the DNA for the public project came from an anonymous male donor from Buffalo, New York, codenamed RP11. One wag noted in respect of the project that once all the chromosomes were fully mapped and sequenced “they'll tell us everything there is to know about one French farmer and a lady from Philadelphia.” We can’t claim to have complete human genetic knowledge until we’ve mapped a reasonable sample size, and that isn’t what’s been done. In fact, because of the genetic variation between individuals, there simply can’t be one definitive human sequence – and suggesting there can be creates serious questions about an appropriate definition for what should be considered ‘normal’.

But that’s just the tip of the iceberg when it comes to issues. The HGP claims to map a complete genome, but in fact what it has focused upon is identifying the 20-25 thousand genes present in DNA – and this isn’t necessarily the same as the complete genome. In fact, it’s about 5% of the genetic data. Some scientists, secure in their beliefs concerning genes, think this is sufficient, but this rests on very simplistic ideas about DNA. The non-coding regions, conventionally dismissed as “junk DNA” actually serve very important roles. Putting aside the putative role in the creation of new genes I have touted previously, the non-coding DNA contains many regulatory signals that are vital to understanding the relevant biology.  

To cast light upon some of the major misconceptions, I’d like to make an analogy between the data contained within DNA and a telephone directory. Mapping the genetic data is much like collating a list of telephone numbers – that volume of data is certainly useful, when you know what it’s for. But having a human gene sequence without the biological knowledge to go with it is like publishing a telephone directory without inventing the telephone. Actually, if you examine some of the bizarrely optimistic claims concerning the possibilities of genetic engineering that might be unlocked by the Human Genome Project, the metaphor becomes something like the belief that one can work out how to build a telephone by studying the telephone directory. 

There's a similar problem here to the one I discussed previously concerning genes and behaviour: scientists had ideas about inheritance prior to Watson and Crick discovering the DNA double helix, then assumed that genes would explain everything that was known about inheritance. This has lead to what Lewontin has called “the doctrine of DNA” – a belief that genes are the ultimate explanatory device, and that genes can be linked to everything in biology, psychology and beyond, that deciphering the genetic code gives us the knowledge to program our own organisms. He parodies this by saying: “Any computer that did as poor a job of computation as an organism does from its genetic ‘program’ would immediately be thrown into the trash and its manufacturer would be sued by the purchaser.”

The genetic engineering we are currently conducting is not really akin to what a programmer does in writing a functioning utility; it is much more like what a hacker does when they subvert an existing utility they didn’t write, and don’t necessarily understand. There are serious ethical issues surrounding modern genetics that stretch far beyond just the Human Genome Project. David Heyd noted that: “tampering with the natural biological process of species evolution and individual evolution… [is] a form of metaphysical trespass.” The Senior Editor of Science, Barbara Jasny, admitted that “the Human Genome Project [stretches] the limits of the technology and the limits of our ability to ethically and rationally apply genetic information to our lives.” 

Abby Littman of Montreal’s McGill University is another outspoken critic of the project. She contends that “Everything that's been done so far is about managing the genome project instead of questioning the whole issue of whether there should be a human genome project.” She accuses the molecular geneticists involves of focussing on the wrong part of the problem if the goal is better health, and of not having adequate public consultation on the project. She asks:

Why are we so busy mapping the genome? Why don't we map the environment instead of mapping the genome and worry about things that really make us sick that we don't know anything about? Why do we think it's so much easier to change genes than environmental conditions that put us at risk? Because it's more expensive to clean up the environment than to deal with people who are at medical risk because of the environment. 

Her view is that most human disabilities happen after we are born, and are caused by accidents, injuries or environmental factors. She also questions the eugenic implications of this kind of project: “Do we want to live in a society where nobody is born with Down's syndrome? If so, why? That's an ultimate aim of these tests. Does this make us a better society? I'd like to make geneticists think about these questions as they do their work.”

If the critics are correct that the health benefits of the HGP to the public are far lower than has been suggested, who are the benefactors of this research? One obvious candidate is biotechnology and pharmaceutical companies. Lewontin notes: “No prominent molecular biologist of my acquaintance is without a financial stake in the biotechnology business.” The data produced by this research could have been extremely valuable to pharmaceutical companies as a potential source of new drugs, and to other biotech companies, but even this value appears to be less than was anticipated. Craig Venter, the president of Celera, the company which conducted the private portion of the genome mapping, stated that “the drug industry has been saying 'one gene, one patent, one drug', but the uses for this approach can be counted on the fingers… The notion that one gene equals one disease, or that one gene produces one key protein, is flying out of the window.”

A more likely benefactor from the research are health insurance companies, who can potentially use information obtained from a sample of DNA to reject people who show genetic predisposition to certain medical conditions. Thomas Murray suggests that “the most important movement in the ethics of workplace genetic testing has been away from the original vision of a public health measure, to screening as a way of reducing illness-related costs with no effect on the overall incidence of disease.” So now we are looking at the Human Genome Project not as a great advance in health care, but as a means of insurance companies denying medical cover – the health benefits for the general public are thus worse than they were before the project began.

All this makes it sound that nothing good has come from the Human Genome Project, but as I said earlier there is a significant silver lining: by exposing the naivety of overly simplistic interpretations of genetics, the HGP has helped improve our understanding of biology by undermining old fashioned deterministic models. Venter notes, in assessing the impact of the project his company has assisted in completing:

There are two fallacies to be avoided: determinism, the idea that all characteristics of a person are hard-wired by the genome; and reductionism, that now the human genome is completely known it is just a matter of time before our understanding of gene functions and interactions will provide a complete causal description of human variability. In everyday language the talk is about a gene for this and a gene for that. We are now finding that that is rarely so. The number of genes that work in that way can almost be counted on your fingers, because we are just not hard-wired in that way.

We have learned that organic biochemistry is not as simple as dialing a telephone number. There are complex multi-dimensional relationships between the tens of thousands of genes involved in building and regulating our bodies, and these can only be fully understood when taken also in the context of the conditions we live in. To understand an organism requires more than a knowledge of its genes, we must know how those genes interact (something we barely understand) and how those interactions relate to the organism’s environment. The assumption of the linear influence of individual genes has suffered a fatal, yet long overdue, blow. Critics of the Human Genome Project have been saying this for decades now, but the biotechnology community has simply ignored the practical – and ethical – implications of their work, in the blind lust for either knowledge, money, or both.

A statement issued by Celera in 2001 admitted “because of the relatively low number of genes… it will be necessary to look elsewhere for the mechanisms that generate the complexities inherent in human development.” Responding to this, Ari Patrinos of the US Department of Energy (who funded much of the public research) said: “It’s kind of humbling, isn’t it?” Any project that can inspire a meek outlook among scientists is certainly exceptional, but at a cost of $2.7 billion I can’t help but wish that there were cheaper ways of teaching humility to the scientific community.

Comments

[Peter Crowther]

Can I present a slightly different point of view here? I'm coming at this with two biases: 1) I do some work on genetic epidemiology, and 2) I have a very disabled nephew.

The HGP has also forced development of a lot of related technology, both for acquiring genetic data and for analysing it. There's some fascinating research involving Microsoft Research, for example, where there's been a realisation that cross-over during sexual reproduction does not occur at random points - there are some places on the genome where it is likely, and the vast majority of places where it is very unlikely. This is "hot off the press" - the data is no more than a couple of years old. We're at a very, very early stage of dealing with the human genome, or indeed any other genome. The HGP has allowed us to gather large amounts of raw data, and it will take a long time for that data to be analysed. The same is true with other large projects, such as the large astronomy projects - the costs are front-loaded with data acquisition costs, then the benefits of the data are realised through years or decades of analysis. Why is the HGP somehow different?

Downs Syndrome... depends what we have to do (in terms of the collateral damage to the genome) to get rid of it. Let me offer an example. My nephew has Edwards Syndrome (somewhat worse than Downs, generally fatal before birth - he's now 12, and the doctors are amazed). The stress on the family - including the extended family - is immense. If he had been born healthy, or never conceived, a significant amount of human suffering would have been avoided; the family members definitely want to avoid having to care for another Edwards Syndrome child. Genetic techniques mean we now know a) which side of the family it's on, b) who needs to get tested to see whether they're at risk of having Edwards Syndrome children (do we have that risk, for example), and c) that my niece is not a carrier - so she's safe to have kids, if she wishes, once she grows up. On a very small scale, the techniques can help people to gain information that will help them to make life-changing decisions. But like all science and technology, they're a two-edged sword. *Used appropriately* - and that's difficult to determine in advance, legislate for or enforce - they can be helpful. Used inappropriately they can make life a lot worse.

[Chris]

Peter: as ever, I appreciate the counterpoint!

Your argument that the human genome project can be seen as data gathering for future benefit, a la astronomical surveys is compelling. But I suppose what my argument in this piece amounts to is:

(1) people made all kinds of insane suggestions as to what the human genome project would mean, and it's clear now that they were completely batty to think many of these things. Confidence in science has outstripped understanding of current scientific models.

(2) if the goal of the human genome project were health benefits, which is often claimed, the money spent could have been invested in other research (into environmental causes, for instance) for considerably greater health benefits. It could even have been invested in *health care* instead of research for dramatically greater health benefits.

Regarding Edwards Syndrome, Downs Syndrome and other genetically inherited diseases: I am extremely sympathetic to the argument you advance here. I think this is the narrow edge of the wedge of the eugenics problem (the equivalent of the "abortion after rape" issue in the abortion debate). But there's a slippery slope here, and one which is already in play if you consider the situation in China with regards to abortion as a tool for ensuring a male heir.

I'm certainly not going to make a case that eugenic actions are not permitted - but I will make the case that actions with such monumental social implications warrant serious public discussion, and this debate has thus far been largely absent.

Best wishes!

[zeech]

I havent followed the HGP in detail, but are you sure Chris that you arent mistaking the claims of the media with the claims of the scientists themselves? Or even the claims of the scientists trying to get grant money?

Similar to the media surrounding that big european particle accelerator, are you really sure that the scientists themselves are spinning sci-fi stories?

Even with a layman's knowledge of genetics, I'm fully aware genes often have a myriad of effects. Curing downs syndrome may cause some cancer to pop up, or whatever. I find it hard to imagine that scientists would fail to know something like that. Maybe you're listening to Biotech company PR?

I guess the point is, people will lie and propagandise in all sorts of ways to achieve goals that may be unrelated. It's sad that it has to be so, but I doubt much funding would occur for valuable research if not.

If you're arguing against the HGP, I find it hard to imagine how someone can argue that we shouldnt find out some knowledge. If you're saying the money should have been spent elsewhere.... well, imagine how many genomes we could have mapped for the $700 billion in the financial bailout package? Or the trillions spent on the Iraq war?
$2.7 billion is just pocket change compared to the money used on possibly more pointless endeavours.

Knowledge is eternal and transformative. Plugging up dams with your (very expensive) fingers probably doesnt matter as much in the long run.

[Chris]

zeech: Yes, scientists (many in the employ of biotech companies admittedly) were making the grand claims. It was not media distortion, which I accept has happened in the case of the Large Hadron Collider, where scientists have made more modest claims. I don't oppose the Large Hardon Collider - I almost worked at CERN had my life taken another path - since this project is in line with its claimed goals. I don't believe the HGP can entirely make this claim.

I accept that there are other giant wastes of money around, and of course I oppose these too, but my point here is that if the goal of the project was better *health care* this was the wrong subject to research. What people actually need is too often getting lost in the shuffle in modern science.

"Knowledge is eternal and transformative."

The philosophy of science shows us that knowledge is far from eternal. It is both malleable and changeable. It is eternally subject to revision.

But the prioritising of knowledge over quality of life or other ethical concerns contributes at times to a mutilation of life and society, and indeed in some cases poses a threat to almost all life on the planet (the Manhattan Project, to name just one prominent example).

The argument that knowledge for knowledge's sake is sufficient justification for any kind of research motivated some pretty horrific experiments in Nazi Germany. (Not that I'm comparing the Human Genome Project to this!) There has to be some ethical and social considerations to the scientific process, and my contention is that the scientific community is falling quite short of this standard right now in its lust for profitable knowledge.

Best wishes!

[zeech]

Heheh, well, I'm a bit of a fan of unethical science, so you're talking to the wrong fellow. (For example, I find it rather sad that China now needs to suck up to the rest of the world for trade, so they wont be going crazy with all sorts of interesting human experimentation.)

But still, biotech to me equals startups and stock prices, which equals fantastic claims. I'm not informed on the issue, but my gut feeling still says that the scientists promoting the HGP were not entirely free of PR. (then again, considering the grant funding process, maybe noone is.)

Knowledge is eternal if you have decent version control :P Even if something is revised, the original knowledge is retained :)

[Peter Crowther]

Chris: I agree with you that if the goal was better healthcare then in the short to medium term the investment would have been better placed in other research - though I'm not sure it would have been better placed in better care*. I suspect nobody can yet make the call on the long term results of the HGP. I don't know what your time horizon is, but I'll cheerfully take the couple-of-generations view with the HGP.

zeech: Knowledge is eternal if you have decent version control

The knowledge of phlogiston chemistry, to take one relevant example that's being discussed elsewhere?

* In terms of years of life gained per unit currency spent, it would probably have been best placed in improvements to the environment in some of world's poorest nations - better drinking water and sanitation, for example.

[Chris]

zeech: "Knowledge is eternal if you have decent version control :P"

Ha. :) I want to counter by saying: Humanity is not eternal, thus neither is knowledge. :P

Peter: I appreciate the attempt at the long view... but my recurring complaint against the scientific community here is that it does not see itself as a servant to society but rather an independent knowledge-focussed hegemony which (following the lines painted by zeech) pursues knowledge for knowledge's sake. I see this position as deeply flawed.

My counter proposal is that we are all part of society, and we should all consider how our work connects to that society. There was other research that could have been conducted that could have produced genuine health benefits for everyone, instead of benefiting biotechnology companies with a temporary stock boom. I'm not saying the HGP was wrong, or that it won't be useful, just that it embodies the confused priorities of the scientific community at large.

Best wishes!

[zeech]

Heheh, since we're countering, I'll counter counter by saying that our knowledge might survive longer than us if we had a good backup medium for our version control ;)

(although, it's a commonly recognised issue that knowledge/information is far more ephemeral now in the era of magnetic disks than it was in the era of stone tablets ;)

Where's the atom-etched diamond lattice sheets dammit!? :P

[Peter Crowther]

... whereas my view is "every man for himself". If a scientist can screw several $bn of cash out of some people for research, shame on those people if they've not worked out how it will benefit them... and if a group of scientists can collectively pull the wool over the funders' eyes, then it is *still* up to the funders to pull the funding, give partial funding pending better evidence, or whatever they choose to protect their interests.

I agree with we are all part of society, and we should all consider how our work connects to that society, but possibly not in the way you expect. I am somewhere between libertarian and anarchist, and I certainly consider how my work *connects to* the people around me - but that is definitely not the same as my work *benefiting* those around me. I consider that it should benefit me, and those I choose it to benefit. Anything else is accident.

I disagree with the confused priorities of the scientific community at large because I do not believe that there is such a thing as a "scientific community at large" that is a single entity and whose priorities could ever be considered as homogeneous. It's a scienist-eat-scientist world out there!

[Chris]

zeech: ha, can I suggest it would be better to work on having our species survive than having our knowledge survive? Just a thought! :)

Peter: I take your point concerning the role of funding here; it's an interesting alternative point of pressure that could be applied.

"I consider that it should benefit me, and those I choose it to benefit."

I accept this kind of position, although it is obviously not my own. But even in your formulation, anything that radically destroys the environment (say) is not something that could ever be seen to benefit you and the people you choose to benefit.

"I do not believe that there is such a thing as a 'scientific community at large'"

I actually hear this a lot! :) The fact that the scientific community at large is at war with itself doesn't make it any less of a collective entity, though. Anyone who calls themselves a scientist is part of the scientific community at large - a community need not be a united community. Remember that community can mean many things, and one of those is a shared cultural or historical heritage - it is in this sense that I invoke the term "scientific community".

Best wishes!

[zeech]

Heheh, actually I'd prefer we were the engineers of new better species, rather than preserving our own :)

[Steven]

Chris: Is it possible that you are conflating choice of personal ethics with economic results in meeting a particular ethics system? I think that the view of the scientific community pursuing knowledge for knowledge sake can be characterized as an ethical choice. There involves no economic calculus since the goal are the means itself. Another system of ethics would be that their role as scientists is to benefit society. In that sense, the pursuit of knowledge at least has some ground (although difficult to assess) for a calculus as to whether particular pursuits of knowledge are more or less beneficial to society. However, it seems like you might be imposing your own ethics of the role of science being to benefit society and then arguing that HGP might not be the best way of achieving this. However, the arguments are conflated into seemingly one argument where I think it would be easier to follow and break down if the two arguments were made distinct. My understanding of ethics is still in the early stages so I just wanted to throw this out there.

Also, I have to disagree with the overly-simplified characterization of genetics and the role of genetic discrimination by insurance companies. Sure, there are potentials for abuse but I believe there is much more complexity to this. If insurers were able to genetically screen, then they would more efficiently categorize risks and create smaller pools. This would benefit the genetically-advantaged(since they would no longer have to pool risks with the less genetically-endowed) and hurt the genetically-disadvanged. It creates a distribution problem but it improves the efficiency of insurance companies (more accuracy and less risk exposure) and that sector of the economy. Distribution problems are generally considered an ethics issue, and I agree with most people's ethics that it would be unfair distributively. However, answering this distributive problem is better served through government redistribution through for example taxing the genetically-advantaged and giving relief to the genetically disadvantaged (looking also at income, etc of course). I think more efficient markets should not be sacrificed for ethics reasons when those ethics can still be served through government redistribution, while still allowing for the efficiency increase.

>Peter: I appreciate the attempt at the >long view... but my recurring complaint >against the scientific community here is >that it does not see itself as a servant >to society but rather an independent >knowledge-focussed hegemony which >(following the lines painted by zeech) >pursues knowledge for knowledge's sake. I >see this position as deeply flawed.
>
>My counter proposal is that we are all >part of society, and we should all >consider how our work connects to that >society. There was other research that >could have been conducted that could have >produced genuine health benefits for >everyone, instead of benefiting >biotechnology companies with a temporary >stock boom. I'm not saying the HGP was >wrong, or that it won't be useful, just >that it embodies the confused priorities >of the scientific community at large.

[Chris]

Steven: Thank you for sharing your perspective here!

Your talk of efficiency makes it sound as if you float along through life with solely a focus upon the systems, and not the people. This is usual for someone who expresses Rational (someone whose brain activity is focussed in the orbito-frontal cortex). My argument is that advice from people with access to this perspective is valuable for society, but that allowing this perspective to trump the human perspective results in abhorrent situations (relative to the populace at large). This in turn tarnishes science's reputation, and thus creates a problem that needs to be addressed.

"I think that the view of the scientific community pursuing knowledge for knowledge sake can be characterized as an ethical choice."

Certainly, it has an ethical criteria. But then we have society providing the money for this to be done so, mostly via the marketplace. And here, we have a major issue since this complex is the chief degrader of the environment and a significant producer of human misery.

An extreme comparison may be clarifying here. The Marxist state behind the horrors in Soviet Russia also had an ethical criteria, as did Hitler. It is thus rather dangerous to stop at simply observing that a system of ethics is in place - we also must consider the implications of those ethics in a broader framework.

You, as so many Rationally-biased individuals seem to want to do, wish to hold the scientists blameless in this - because they are pursuing their own ethical agenda in isolation. But these scientists do not live in isolation, and they are responsible for the outcome of their actions irrespective of how this relates to their personal ethics. (At the moment, I'm just poking at this with a stick to point out that there is a hornet's nest here.) :)

In this piece, for instance, you (inadvertently?) advocate for a caste system based upon genetic discrimination. I'm sure many players here would not be horrified by this suggestion, but I certainly am! If you have not already watched Gattaca, I heartily recommend you do so.

I offer severe criticisms of science from time to time because our intellectual elite are too quick to hold scientists blameless "they're just pursuing knowledge for knowledge's sake". Well this is a modification of the "only following orders" defence deployed by those incriminated in the wake of the atrocities of World War II - and this defence doesn't cut it in the eyes of the world.

For more on this, see my earlier piece on the Ethics of Science. Your perspective here would also be welcomed.

It probably seems to you that I am pushing too far - this is because I am taking the counterpoint role on this out of necessity (who else is?) It is through discussions with other individuals, such as yourself, that I hope to refine this counterpoint.

Many thanks!

[Steven]

On the ethics, I think I agree with you. Just because the fact that a scientist's decision can be characterized as an 'ethics' decision does not make it right or free of culpability. My only point is that I think things become clearer if you break down your argument into two parts. First is the ethical role of science. The second is, given an ethical role of science as being to benefit society, how does HGP do? People can agree/disagree with either/both of the two parts which is why I think it helps to separate the two.

Regarding the first part, I agree with you on the ethical role of science. On the second part, I have a feeling that you are pushing things to make a point and I am glad you are doing it. Taking an unpopular opposing view is great fuel for discussion and critical thought.

I think the genetic 'caste' system is unfortunately, already here and has always been here, in some respects. We already inherit genes that put us in categories of physical health, intelligence, predispositions to disease, etc, whether we know about the details or not. It is just that a deliberate caste system has not been structured and imposed by society because of limited information about the actual genes- we only see the physical manifestations of those genes.

Now the question is, what happens when we acquire more information about peoples' genetic makeup? 1) We can discriminate and structure a social caste system around people's genes. 2) we can take a Rawlsian approach and try and equalize everyone despite their genes, because given the choice ex ante, before knowing what genes we had, we think that people would prefer equality over playing the 'genetic lottery'. 3) The third option is to avoid this situation altogether by maintaining a veil of ignorance of one's genes and limit research into information about people's genetic structure.

Your argument, as I see it, is for the third option because you believe it would otherwise lead to the first - a social caste system based on genetics. My argument is that in a free market for insurance, yes it would in effect create a sort of genetic caste system in terms of insurance costs, but then it is the government's role (assuming we all agree this is the ethical thing to do) to step in and implement the second option - to equalize everyone through a system of tax and transfer, subsidies or even universal health care (!).

The argument for maintaining the veil of ignorance on genetic disposition because of a fear of genetic discrimination is instinctual and natural to many people because of the atrocities committed in the past. And because of the past, we should be careful and that is why we are even having this discussion. However, at the same time, we must work to separate out irrational fears so that we are able to take a more balanced and objective approach in order to best benefit society.

[Chris]

Steven: thanks for this wonderful supplement to your earlier comment! You are right, I am pushing myself into a counterweight position here in order to advance the discussion. I have no specific agenda, other than to push past assumptions about science and its relationship with society into a space where we can discuss these topics both reasonably and openly.

I don't think a Rawlsian approach will fly here. Rawls tries really hard, but you can't offset inequalities without creating new inequalities and/or money-draining bureaucracies... it's essentially an infinite regression. I accept that we will never achieve perfect equality, but I am wary of proposals that increase existing inequalities - this is my concern.

I personally feel the argument for a "veil of ignorance" is stronger than you seem to - your choice of wording betrays a certain bias. :) I would say "right to genetic privacy" - thus spinning the issue the other way. ;)

Thanks for sharing your thoughts!

[Steven]

A right to genetic privacy is an interesting spin. If and when the time comes where meaningful information about a person's genetic characteristics becomes readily available, we will have to face this issue of possible inequality.

Are the benefits of knowledge of one's genetic predispositions to certain diseases and maladies worth the accompanying potential for inequality that comes with such increased knowledge? No one can know for certain now, but if there are significant health and planning benefits to such knowledge, then I think a Rawlsian view on how to best approach and handle such accompanying inequalities could be useful (although not necessarily as the only lens through which to view such issues).

[Chris]

Steven: I can see where you are coming from on this, but I still balk at turning to Rawls for a solution. Rawls' idea is to address inequalities through the erection of new institutions that compensate - but our cultural experience of institutions hasn't been so positive on the whole! :) Plus, few people with conservative political views are interested in such steps. I think this would be an uphill struggle.

My overriding concern here is that these genetic predispositions represent skews in probabilities, but insurance companies are likely to want to use them as exclusions. I wonder if we can prevent the insurance companies from wielding this information against the people they are supposed to help, when the majority of people may seem to benefit from this discrimination.

One thing is for certain, there will be interesting social and political decisions to be taken on this road!

Thanks for the discussion!