“Pandora’s box is already open”

(Gènéthique, January 29, 2015) – During preparations for the European Forum on Bioethics that is being held in Strasbourg from February 2-7, 2015, Professor Israël Nisand, president and founder of that forum, published an editorial on the change in perspective brought about by predictive medicine. 

Predictive medicine, relying on genetics and the laws of probability, dreams of being able to announce the genetic mutations that will affect an individual and thus to predict the risks that he or she will develop one or another disease. This dream seems attractive. Witness the Myriad Company, which back in the early 1990s launched tests for predispositions to breast and ovarian cancer, which were then “popularized” by the actress Angelina Jolie. In 2013 Myriad sold $613 million worth of genetic tests. 

Possibility of detecting predispositions in preborn patients

Indeed, [Nisand argues,] “It won’t be long before it will be possible to read the genome of embryos from the first trimester of pregnancy on” by means of a simple blood sample. As soon as that becomes possible, how could anyone not resort to the procedure? “The right of parents not to know does exist, of course. But who will make use of it when this type of momentous ‘prenatal checkup’ is available and strongly recommended by the industry…so as to have a child in good health?” 

In the name of the right to know

“Large-scale marketing of tests to the general public will explode in the next two years, on the pretext that people have the right to know what their genes contain.” Israël Nisan thinks that the exponential development of predictive medicine poses a problem, because these predictions remain uncertain:  there are multiple risk factors, and these include data, such as the “environmental” factor, that are difficult for science to measure. Consequently “the results of genetic analysis will therefore be probabilities” and only likelihoods. 

Professor Nisand concludes as follows: “When, thanks to predictive medicine, we are able to know all the potential weaknesses of our fragile bodies, crunching on the fruit of the tree of knowledge, we will have taken one more step out of paradise.” 

Israël Nisand is professor of gynecology and obstetrics at the University of Strasbourg and head of the Division of Gynecology and Obstetrics at the University Hospitals in Strasbourg. He is a specialist in pre-implantation diagnosis (PID). He is also founder and vice president of the European Forum on Bioethics. The theme of the 2015 Forum, the fifth in an annual series, is “Money and Health.” It will study conflicts of interest and healthcare scandals. Among the topics discussed will be abortion, euthanasia and palliative care, conscientious objection, and also predictive medicine and medically assisted procreation. 

The above originally appeared in French at www.genethique.org. It has been translated by Michael J. Miller.