Future of personal genomics

As personal genomics stands poised to go mainstream, researchers urge caution Friday, 21 September 2007 Giving Nobel Laureate James Watson his personal genome and Craig Venter publishing his own complete genome was just the beginning. In a future that promises similar information to much of the population, ethicists, scientists and physicians are only beginning to understand and consider the possibilities. In a commentary in today’s issue of the journal Science, four experts ponder the implications of this new technology and information and ask the crucial questions that should be answered before the era of personal genomics comes to pass. They combined their different perspectives to consider what is possible now and in the future. Along with that, they look at the ethical and legal issues that will inevitably arise with such technology. Imagine this: you visit your clinician, undergo genetic testing, and then you are handed a miniature hard drive containing your personal genome sequence, which is subsequently uploaded onto publicly accessible databases. This may sound like science fiction, but it is scientific fact, and it is already happening. University of Alberta researcher Tim Caulfield and co-authors highlight the need to proceed with caution when it comes to personal genomics projects that represent research milestones but are also fraught with ethical, social and clinical implications. Caulfield, who is the Canada Research Chair in Health Law at the U of A and professor and research director in public health sciences, is recognized as one of the foremost experts in health law research in Canada. Scientists predict that within five years DNA sequencing technologies will be affordable enough that personal genomics will be integrated into routine clinical care. Companies are responding by offering their services for ancestry tracing, forensics, nutritional advice and reproductive assistance. It won’t be long before companies are able to offer Facebook-like social networking services centred around our genomes.

• Once we have our personal genomic information, what will we do with it and how might this information be used outside the medical context?
• How will physicians educate patients about the significance of genetic risk information?
• Will already-strained health-care systems be able to cope with the inevitable influx of “worried well” patients seeking follow-up investigations for genetic risks that are not clinically meaningful?

Caulfield and his colleagues pose these questions and warn that the routine generation of individual genome sequences will pose challenges to our health-care system. They argue that only clinically meaningful genomic test results should be integrated into medical decision-making — however, this will require clear standards, multidisciplinary collaboration and careful consideration of the ethical, social and clinical implications. Drs. Amy L. McGuire of Baylor College of Medicine, Mildred K. Cho of Stanford University in Palo Alto, California; Sean E. McGuire of The University of Texas M.D. Anderson Cancer Center and Timothy Caulfield of the University of Alberta in Edmonton, Canada, participated in this study. ......... ZenMaster

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