… 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.)
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.