From a Genetic Predisposition to an Interactive Predisposition: Rethinking the Ethical Implications of Research on Gene-Environment Interactions
The concept of gene-environment interaction, or G×E, refers to cases where different genetic groups respond differently to the same array of environments for a particular phenotypic trait. In a widely acclaimed study from 2002, researchers found a case of G×E for a gene associated with neuroenzymatic activity (low vs. high), exposure to childhood maltreatment, and the development of antisocial personality disorder (ASPD), or sociopathy. Cases of G×E are generally characterized as evincing a genetic predisposition to the trait under consideration; for example, individuals with low neuroenzymatic activity are generally characterized as having a genetic predisposition to ASPD. Bioethical commentators in turn have asked: Should parents test their embryos or fetuses for this genetic predisposition to ASPD in order to screen against the gene associated with low-MAOA activity? Should the state test all newborns for this genetic predisposition to ASPD in order to identify and treat individuals with the gene associated with low-MAOA activity from birth?
I first show that the concept of a genetic predisposition fundamentally misconstrues the ASPD study. That concept is appropriately applied only to cases of G×E that result in a change of scale, but the ASPD study resulted in a change of rank. For cases of G×E that result in a change of rank, I introduce a new conceptinteractive predisposition. Then, I show how this switch from a genetic predisposition to an interactive predisposition reconfigures old questions and raises new questions in the confines of the ethical discussions about the implications of such studies. For the ASPD study, attempts to screen against the gene associated with low-MAOA activity potentially fall prey to the myth of pre-environmental prediction, and attempts to screen all newborns for the gene associated with low-MAOA activity with an eye towards early intervention will have to face the interventionists dilemma. Moving beyond the ASPD study, traditional cost-benefit analyses involved in deciding whether or not to undertake the genetic testing of a child will have to be reweighed when the disease/disorder of concern results from an interactive predisposition rather than a genetic predisposition.
Advisor:Erik Parens; Lisa Parker; Kenneth Schaffner; Mark Wicclair
School:University of Pittsburgh
School Location:USA - Pennsylvania
Source Type:Master's Thesis
Date of Publication:01/16/2008