Ignorance is Bliss

… Or is it?

As I was thinking about what to write for this week’s blog, I came across an article about genetic fortune telling and how it’s at the doorstep of disrupting the public healthcare sector. Woah. But before I get into that, let me give you a little background story. As graduation day is looming over my head, I find myself wrestling with a lot of questions about my values, passions, job aspirations, friendships, identity, dreams, future, and how I want to go about my life postgrad. I’ll spare you the details, but let’s just say I’ve been thinking about life in general a lot. Maybe it’s because I’m also taking a Capstone class called Career and Life Planning, where we complete assignments like writing our own eulogies and obituaries. Freaky, right? Nonetheless, it made me question how I want to lead my life in order to achieve true happiness. (You’re probably wondering why I’m telling you all of this and what any of this has to do with genetic fortune telling, but I promise you, I’m getting there.)

Picture credits: gizmodo.com

Enter: The Wall Street Journal article. To briefly summarize what the article discusses, the genetic blueprint of individuals is increasingly able to predict their psychological and physical dispositions. It turns out that most common diseases and psychological traits, such as intelligence, are a result of many genes acting collectively. And thanks to recent technological advances, there now exists a quick and affordable tool called SNP chips, which allow for geneticists to map out hundreds of thousands of DNA differences across an individual’s genome. Over 10,000 SNP associations have been documented across hundreds of both physical and psychological traits, and the sum of effects of these SNPs, called “polygenic risk scores”, can serve as revolutionary DNA fortune tellers. Polygenic risk scores, which range from a spectrum of low to high risk, allow us to predict certain traits from inherited differences in DNA as early as from birth, because these DNA differences don’t alter throughout our lifetime.

When babies are born, they are given a polygenic risk score that offers predictions about their chances of having cancer, developing Alzheimer’s, suffering alcoholism, performing well in school, or countless other traits. According to a study demonstrated in the article, children with the 10% highest polygenic risk scores are five times more likely to go to university than children with the 10% lowest scores. By offering such probabilities (not diagnoses) for individuals’ futures, polygenic risk scores could pose significant benefits. They serve as an early warning system, and shift the focus from treatment to prevention. Rather than waiting until problems emerge and then addressing them afterwards, the predictive power of polygenic risk scoring, although not always accurate, allows individuals to take a different approach. It encourages interventions and preventative measures to stop such probabilities from becoming a reality. So, let’s say you were born with a genetic risk for alcohol problems. The preventative measure is simple: control and limit your alcohol consumption, or just stay away from it completely. Now I know this example is rather straightforward, and other circumstances may not be as black and white, but the biggest takeaway is that genetic fortune telling gives us an early heads up so that we can be more mindful about our daily habits. If you were born with a genetic risk for breast cancer, you can be more alert about potential symptoms and get more mammograms to catch it early on, rather than when it’s too late.

Another posed benefit is found in medicine. Polygenic risk scoring can aid in the invention of medicines that could be used to directly attack the problem at its root. Pharmaceutical companies can use the scores in clinical trials to test the drugs more effectively and precisely. By choosing volunteers with a greater disposition for developing an illness such as Alzheimer’s, they can more accurately test how well the drugs work. Moreover, your genetic report card can help discern which medicine is more suitable and appropriate for you. The field of medicine may never be the same.

As great as these benefits may be, I immediately had one question in mind (well, a few actually). Do I want to live my life knowing that I have a high chance of developing Alzheimer’s or cancer? Do I want to grow up knowing that I might not be as intellectual as my peers and therefore not perform well in school? Do I want to know such things about my children? What if I have a low polygenic risk score for breast cancer and put off my mammograms and end up being diagnosed with it anyways when it’s too late?

I can go on and on about the potential consequences of genetic fortune telling. And so this goes back to my earlier point about how I’ve been thinking a lot about how I want to live my life and be happy. Could I truly live a happy life knowing since birth that I might develop Alzheimer’s? I would probably live everyday in paranoia. It would prevent me from upholding intimate, lifelong relationships with people out of fear that I may forget them one day. It would completely change the trajectory of my life and hold me back from living freely. If I knew I had a high chance of having cancer, I would live in hospital rooms getting screened monthly to make sure I catch it early on. I would avoid all things that would increase my chances of getting cancer, which is basically everything. I would miss out on a “normal” life. If I knew that I was less likely to perform well in school, I might possibly use that as an excuse to study less and become less interested in pursuing higher education. I would be extremely discouraged and think that it is my fate to not succeed in school. I know that’s a really dramatic statement and that our genes are not our destiny, but as a kid, what more do I know?

So my question to you is… Is ignorance truly bliss? Sure, genetic fortune telling poses many life-changing benefits that can offer useful insights, give us early warnings, and enhance the effectiveness of medicine. But do you want to live your life knowing all these things about your prospective future? How do you plan on using this information to help define your outlook on life?

Just some food for thought.

7 comments

  1. dilillomelissa · · Reply

    Is ignorance bliss, or is knowledge power you ask? As a biology major in my undergrad years, this was a debate we had even before the possibilities of this happening were as realistic as they are today. I completely agree that it would change the trajectory of most people’s lives. I personally would be extremely paranoid. I think for many of the risk scores, such as the intelligence factor, it would become a self-fulfilling prophecy. Today, people use the word grit to describe people who push themselves and have the courage to pursue anything they wish. If people go into their academic careers already knowing they don’t have that DNA combo, they may just not go through the trouble of putting in any effort. On the other hand, I can see where this would be beneficial in being more aware of getting tested for diseases. If this was a method that babies started to be tested for and became the norm, people would be used to just knowing these potential outcomes. We cannot fathom much of this because it’s just not the norm today. I personally would opt out of knowing.

    1. I completely agree with you about the dangers of self-fulfilling prophecies. Either someone gives up because they feel that their future is already written, or they stop pushing themselves because they feel entitled to a particular gift (intelligence, health, etc.). In either case, they allow their potential future to tarnish their present. My other concern is that, while we have a lot of data about how genes correlate to particular traits, we don’t understand why. It could totally be the case that there are environmental triggers to these genes, or that they only work within the context of a larger collection of genes. I’m sure these questions will get answered as time goes on and the science improves, but in my opinion, it’s far too early to let this type of genetic testing explain away people’s behaviors or achievements (both good and bad). The one exception is genetic testing of diseases, which have clear and distinguishable markers and can greatly improve people’s lives.

  2. This reminded me of the age old question: “Would you want to know the day you die?” Some people say yes as it will give them a deadline to accomplish everything they want to. Other say no as they would live in fear of the day. Although this is an extreme example, I feel like this is close to the idea of genetic testing. For me, the idea of knowing that you have a greater risk of a disease is helpful, but in small quantities. I feel as though this could help with prevention, but we must be careful with how we use genetic testing. For me, I would not want the results of the genetic testing to cause me to live in fear.

  3. I was also thinking of the “do you want to know when you die?” question as I read this! Decisions like this are so hard because once you have the information, there is no going back to that blissful state of ignorance, and information like knowing you have a very high risk of cancer will change the way you live your life, whether you wanted the information or not. But also, if I had a higher risk of disease and being aware and proactive about it could possibly help me significantly prolong my life, I would want to know, even if it made me paranoid. It’s a hard line to draw, and I do think it’s a personal one. For me, I would want to know about risks of cancer that could affect me earlier on in life, but for something like Alzheimers that generally doesn’t affect you until later in life (and doesn’t have a cure), knowing that I have a high probability of getting it would just stress me out and wouldn’t be beneficial for me.

  4. This is a really hard question to wrestle with, but if you take a step back from the actual genetic scores, you might see that there are other predictive elements that you become aware of throughout your life. It’s up to you to decide how much control you want it to have over your life.

    For example, both of my grandmothers suffered from Parkinson’s and dementia. While neither disease is hereditary, there are certain genetic markers that may predispose you to one or the other. It’s definitely not the same as knowing that you are likely to be diagnosed with a specific disease, but it is something that lives in the back of your mind. Additionally, I’ve had three family members, all siblings, diagnosed with melanoma, which significantly increases my chances of being diagnosed with melanoma as well. Has this knowledge changed the way I live my life? In some ways – I’m definitely more diligent about wearing sunscreen, and I get yearly screenings from my dermatologist to make sure that everything looks good. Other than that, I’ve come to terms with the fact that there are certain things outside of my control, and will deal with those issues as they arise. On my incredibly optimistic days, I remind myself that I (hopefully) have decades before I deal with any of this, and they may have a cure by then!

    That being said, I don’t know that I would take a test to further determine my probability in being diagnosed with a specific disease. I’m currently quite comfortable with my level of awareness, and will continue doing crossword puzzles and slathering on sunblock as preventative measures.

  5. If you’ve ever seen the movie Gattaca, this may set off red alerts in your mind like it does for me. The earlier we start genetic profiling and fortune-telling, the scarier the implications become. If you find out when you’re 20 that you have a genetic predisposition towards depression, you can start seeing a therapist and take some other preventative measures. If you’re parents find out before you’re born that you’re going to have a genetic predisposition towards depression and they don’t want their child to experience that hardship…you get the idea. I think it really just has to be carefully regulated (like we discussed with healthcare and the new, genetic-profiling-enabled definition of preexisting conditions) , and individuals need to be allowed a high degree of choice about it. I think I personally would want to know what physical things I might be at risk for, but not mental. Definitely one of the big ethical questions of our time!

  6. Yikes, this is some spooky stuff! While I haven’t written my own obituary yet, I’m also graduating and identify with your life contemplation. In my opinion, I think ignorance is bliss at least to a certain extent. It would be interesting if you could choose a package of sorts of the type of information they would provide you with. I absolutely don’t want to know about whether they think I would do well in school and I don’t want to know about an inevitable disease I have no control over. I think that information bears too much weight as we try and live our life and will end up affecting how we conduct ourselves and interact with others. That being said, if there is actionable information that would enable me to take steps to combat thinks like alcoholism before they happen, then that would be useful information. I think it comes down to only wanting to know the things I can have control over. That may be idealistic and would probably be a hard line to draw. It reminds me of a question I’ve been asked before, would you want to know the day you are going to die? I say no, and I think this topic has a similar sentiment, and I seem to fall on the side of ignorance.

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