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Presidential Genes?

Posted by Pete Shanks on January 20th, 2009


[ This was originally posted as  "Will Candidates' DNA Play a Role in Future Elections?" at AlterNet. ]

Moments after Barack Obama was elected, pundits began to speculate about future elections. And for once there is a new idea to add to the horse-race discussions: some commentators have proposed that we look at candidates' genomes to discover if they have the qualities we need in a president.

Personalized genome scans will almost certainly be better, cheaper and much more widely available during the next presidential election cycle. It therefore makes sense to discuss this possibility now, outside of the partisan frenzy stoked by campaigns. The Wall Street Journal, the New England Journal of Medicine, and the New York Times have all given space to the idea, and the authors have taken very different positions.

Would an inspection of candidates' DNA be helpful? Could we learn enough about their health, character and ability to justify this intrusion into their genomic privacy? Should anything be off-limits? These are valid and interesting questions with important policy implications. Considering them in the context of a hypothetical election can also teach us something useful about how and when to apply the results of genetic tests to our own everyday lives.

Some enthusiastic researchers, notably the Personal Genome Project's George Church, think we should scan the DNA of all candidates, and publish the results. Public health scholars Robert Green and George Annas, on the other hand, warn against the possibility of "genetic McCarthyism." They're concerned that DNA results would be abused as a new form of opposition research, with dire and misleading warnings being broadcast in attack ads: "Can we risk as President someone who may [perhaps, eventually] suffer from a [potentially] debilitating disease?"

Even worse is the prospect of someone being asked to "prove" their racial purity with a genetic test -- and this has already happened, in Turkey. President Abdullah Gul is considered by some in the far right to be "soft" on Armenians because he has refused to condemn calls for an apology for the 1915 ethnic cleansing, which is widely regarded as genocide. One politician has called for him to demonstrate that he is not part-Armenian: "These days, scientists use DNA tests, not family trees, to identify ethnic identity."

Such an overtly racist abuse of testing may seem far-fetched here, though there are already tests that purport to demonstrate membership in particular Native American tribes, and indeed to show Jewish ancestry. More pressing is the possibility of misleading medical prognoses, and an early defense against this prospect may be better public understanding about what genomic tests can and cannot do.

In a sense, we have always used genes, very crudely, to help us choose our elected leaders. Two pairs of fathers and sons have held the highest office, for instance, and three Kennedy brothers have run for it. There are many other examples of families with several members elected to Congressional and other offices; the Udalls include two incoming Senators as well as another cousin who just lost his seat and several distinguished ancestors. Burke's Peerage is said to have claimed that every presidential election "has been won by the candidate with the most royal genes." Certainly, there are other factors -- policy can make a difference -- but some people do look on genetic inheritance as a qualification.

However, genomics is a science of statistical possibilities. Genetic tests can almost never tell us with certainty whether someone will come down with a debilitating disease in the next four or eight years. A few medical conditions can be predicted with real confidence from genetic data, but in almost all cases the most that can be said is that there is an increased or decreased chance of hypertension or cancer or some other disease.

Analyzing the effects of tests for multiple conditions complicates everything much further. If you have a 50% increased chance of heart disease but 40% less than normal likelihood of Alzheimer's and 30% less of Parkinson's (these are made-up numbers, as a simplistic example), is that on balance good or bad? Arguably, it's quite hopeful, since you can take effective preventive measures against heart disease through diet and exercise. But what if you have to consider twenty or fifty genetic predispositions: how do you factor them all in?

This demonstrates a major problem with generalized genomic tests, especially if they are to be used for such a complex question as choosing an individual for a particular job. George Church is missing the point when he says that "it is not like we are collecting horoscope data or tea-leaf data. These are real facts, just as real as bank accounts and the influence of political action committees or family members." What do the facts mean? How do you interpret them? The date of birth you give an astrologer is factual; the predictions are a matter of interpretation.

What any particular collection of genetic variants implies is a very tricky question. It's so difficult that the Departments of Health in California and New York have complained about direct-to-consumer genetic tests precisely because consumers do not have the expertise needed to evaluate the data without expert help. They have argued that companies selling gene tests are, in effect, practicing medicine without a license. (The best-known California firms involved have settled this dispute, but others have limited their activities.)

So how would voters and commentators interpret a candidate's gene scan? More than that, how would we make political judgments even if the genomic facts were more or less clear? President Lincoln may have had Marfan Syndrome, which could perhaps have been predicted from a genome scan. He may also have suffered from a form of depression that might have been reflected in his DNA. Would we have been better off disqualifying him? Would the nation even exist if we had?

Certain medical conditions are generally considered important for voters to know -- but even then, the case of Franklin Roosevelt muddies the matter. Hard as it is to imagine nowadays, he concealed from the public the fact that he was paralyzed and used a wheelchair. And he was elected four times and is generally ranked as one of the three best Presidents ever.

What was FDR's greatest strength? Many say it was his temperament. That may be partly inherited -- there are plenty of phlegmatic children of phlegmatic parents -- but there is no known specific gene for temperament, and therefore no genomic test. Even if we could test for a collection of genes associated with calmness in the face of crisis, the answer is very unlikely to be definitive. Stanford's James Gross has pointed out that "genetically identical people can give very different outward impressions because they think differently, they regulate their emotions differently." Genes, in other words, are only part of the story.

And sometimes what the genomic data suggest is just flat wrong. For instance, one anemic woman was surprised to discover that she had a gene for hemochromatosis, which involves abnormally high levels of iron in the blood. (Sounds like a country song: Who you going to believe -- the DNA print-out or your lying blood?) James Watson, the co-discoverer of the double helix and one of the few whose genome is public, does not suffer from either of two diseases for which he "has the genes."

Balancing the possibilities revealed by genomics is never going to be the best way to select a President. And learning how to interpret such tests for ourselves, for our own use, will itself be challenging. Sequencing technology will continue to improve; predictive interpretation will too -- but if you're looking for certainty, don't hold your breath.

Meanwhile Secret Service agents bag and trash any glass the President uses while away from the White House, so no one can steal his genetic secrets. It's probably just as well.





CGS issues biotech policy brief for President Obama

Posted by Jesse Reynolds on January 20th, 2009


CGS has released an eight-page brief of biotechnology policy recommendations for the new presidential administration of Barack Obama.

"Responsible Federal Oversight of the New Human Biotechnologies: Opportunities for the New Administration" [PDF] includes

1) Immediate opportunities for policy action;

2) How the Obama administration can reshape the public discussion of human about human biotechnologies to reflect widely shared values; and

3) Human biotech issues that the administration will likely face over the next four years.





A new tune for CAMR? Hopefully so.

Posted by Jesse Reynolds on January 16th, 2009


We here at CGS often call for depolarization of the discourse around human embryonic stem cell research (hESCR) so that concerns unrelated to the status of embryos can be addressed. Yet even when there have been openings for cooling the stem cell wars, some have tried to keep them alive. In the past week, the Coalition for the Advancement of Medical Research (CAMR), the leading national organization for greater hESCR funding, seems to be trying to do both.

Now with President-elect Obama poised to remove his predecessor's restrictions on the federal funding of hESCR, CAMR may be making tentative moves in a new direction. Its president recently made a welcome call for tempering expectations:

A new Obama policy relaxing controls on ES cells should help foster more realistic attitudes about the promise of stem cell therapies, says Amy Comstock Rick, president of the Coalition for the Advancement of Medical Research in Washington, D.C. At a recent meeting, she said, "There's been a shift in understanding" on the part of people in the patient community--they are less inclined to blame all obstacles on the restrictions imposed by Bush and recognize that in any case "the field has an awfully long way to go."

Rick’s remarks can be read as acknowledging the exaggerated claims that have marred stem cell advocacy. However, CAMR has been a key player in fostering less realistic attitudes about the promise of stem cell therapies, both in the past and presently.

It has regularly exaggerated their near-term potential, sponsoring biased surveys (1, 2), and backing many of the pro-hESCR legislative campaigns (1, 2). It was a key partner in opposing even modest reforms at California's stem cell research program, and its then-president Daniel Perry complained that our well-documented report [PDF] on the first year of that program "poisons the atmosphere" because it was "unfair." CAMR vehemently opposed a compromise on cloning-based stem cell research, and downplayed the technical – and thus policy – relationship between this technique and reproductive cloning .

Furthermore, in its 2004 public sign-on letter to President George W. Bush, Perry claimed that "In the past three years since the policy was announced, more than 4 million Americans have died from diseases that embryonic stem cell research has the potential to help." My back-of-the-envelope calculations show that he is claiming that the majority of deaths in the US are from such diseases. I remain skeptical.

Nevertheless, I would welcome CAMR's new tune, if it came from both sides of its mouth. Unfortunately, its just-released white paper [PDF] for the incoming presidential administration is basically the same old song and dance. Here are four of its most overt exaggerations and misrepresentations:

First, the paper obfuscates the various forms of stem cell research, by implying that a recent major development using cellular reprogramming was done with hESCR. In only its third paragraph, the white paper states:

With the knowledge gained in the past decade, stem cell research is more promising than ever. Researchers at U.S. universities, medical centers, and in industry are moving toward safer and speedier drug development and devising hES cell-based treatments. These efforts may move the study of disease from people to Petri dishes. They are growing the cell types that are damaged or die in various forms of disease, such as Lou Gehrig’s disease (amyotrophic lateral sclerosis) and using them for drug discovery.

Second, CAMR plays the race card by asserting that Bush's funding limitations are shortchanging minorities:

Federal restrictions on hES cell lines are a social justice issue. The Federal lines do not represent the diversity in our society. If hES cells have the potential to change the future of medicine, our Federal government has imposed restrictions that might lead to minorities being left out of that future. The same Federal government that insists on enrolling diverse patients in any clinical trial to ensure that new medicines work in everyone, insists that researchers do all work on hES cells that are from a small number of sources.

There is an argument that the twenty or so federally-approved human embryonic stem cell lines do not contain enough genetic diversity to represent the world's population. But there is much more genetic diversity among people of the same racial or ethnic group than there is between such groups. So while some people may be underserved by the current lines, there is not much reason to believe that they will be significantly correlated with race.

Third, CAMR goes on to misrepresent cloning-based stem cell research (a.k.a. SCNT):

“SCNT is the only known procedure for completely and normally reprogramming a cell,” says John Gearhart, University of Pennsylvania. Because SCNT is more efficient than iPS cell technology for reprogramming cells, and can be done without inserting new genes, continued studies of SCNT could help scientists find the linchpin to make reprogramming factors more efficient and effective. SCNT will also provide fundamental insights into how an egg reprograms that will teach a great deal about basic biology.

Calling cloning-based stem cell research a "known procedure" that “normally reprogram[s]” a cell in an “efficient” way is a stretch, considering that the technique has failed to produce human stem cells despite almost a decade of work. Meanwhile, cellular reprogramming is producing disease-specific pluripotent lines after just a couple years.

Finally, the tone of the document is captured by a highlighted pull quote from Hans Kierstead: "10 years ago, human embryonic stem cells offered hope. Today they offer solutions." I am unsure to what solutions he refers, considering that the first clinical trials for human embryonic stem cells, planned by him and his biotech patron Geron, have been promised "next year" for at least five years ago (1, 2). Nevertheless, the paper cites these impending trials at least four times.

Granted, CAMR's new white paper emphasizes hESCR's potential for better drug testing and "disease in a dish" studies over cellular replacement. But coming on the heels of promise after promise of “personal repair kits.” Keep your eye on the stem cell ball, indeed (1, 2).

It’s not clear how much CAMR is committed to the more responsible tone its new president has adopted, and the “more realistic attitudes about the promise of stem cell therapies” she recommends. Let’s hope the hyperbole of the white paper represents a relapse rather than a road map.

Previously on Biopolitical Times:





Synthetic biology hackers announce "self-imposed moratorium"

Posted by Marcy Darnovsky on January 14th, 2009


An article in the current issue of New Scientist opens with the story of a woman in Cambridge, Massachusetts "who works as a synthetic biologist for a biotech company by day" and in her spare time at home, in a small closet, "recently concocted vials of an entirely new genetically modified organism."

According to "Rise of the garage genome hackers," scientists including George Church - the Harvard geneticist and biotech / synthetic biology entrepreneur - are encouraging these sorts of do-it-yourself adventures. So is the group DIYbio, which describes itself as an "Institution for the Amateur," along with the science fiction website io9.com, which is sponsoring a contest for "mad scientists with homebrew closet labs, grassroots geneticists, and garage genome hackers."

New Scientist has the sense to ask whether this is such a good idea. Richard Ebright, a biochemist at Rutgers University in Piscataway, New Jersey, notes:

Without any oversight from an institution, colleagues or peers, the probability that a cataclysmic entity might be constructed by someone unaware of known cautions is significant.
But not to worry. DIYbio says that it has called for "a self-imposed moratorium" on homebrew synthetic biology experiments, "until researchers can show that what they are doing is safe."

Jim Thomas of ETC Group, which has been tracking developments in synthetic biology, is not reassured. His comment:
I nominate this as the lamest piece of voluntary governance so far this year.




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