November 29, 2004
Genetic Testing Will Remove Mystery About Human Potential
On the Gene Expression blog Canton points to an Australian firm, Genetics Technologies, that is offering a genetic test for potential athletic performance.
The test examines a gene known as ACTN3, which produces a structural protein found in fast-twitch muscle fibres. Research involving elite-level athletes from the Australian Institute of Sport has shown that the different forms (“variations”) of the ACTN3 gene may be associated with an improved ability to excel in either sprint/power events, or in endurance events. So whether you’re an athlete, or young athlete-to-be, the ACTN3 Sports Performance Test will help direct you toward achieving your maximum natural potential.
This test does not discriminate good athletes from bad athletes. ACTN3 Sports Performance Testing is designed to assist athletes with identifying the type of events, distances or sports in which success is more likely. The association of different genetic variants with power / sprint versus endurance events appears to apply in a wide range of sports, including track and field, swimming, cycling, rowing, judo, etc. Testing may also assist athletes in tailoring their training for optimal performance within their sport of choice.
The cost for this test is $110 Australian which is about $87 US. This test does not measure all the factors that go into determining potential for all types of athletic performance. Most of the genetic contributors to athletic performance still await discover. Rather, this test measures just one gene that affects the performance of fast-twitch muscle fibers. It will take the identification of probably thousands of more genetic alleles that influence athletic performance before genetic testing will achieve its full potential to predict individual athletic performance limits.
Canton objects to the test for potentially robbing people of the motivation to rise above their genetic limitations.
But what, exactly, are they offering you that can't be determined without this miracle of modern technology? A fundamental part of living life is figuring out your aptitudes. Being guided by statistics towards one sport or another doesn't save you time -- it just robs you of the opportunity to beat the statistics and be a marathon runner who has an abundance of fast-twitch muscle fibers.
But step back a bit and look at it from the perspective of those who have the ideal genetic variations for, say, sprinting. As a result of widespread genetic testing someone with less than optimal genetic variations for sprinting is going to have a harder time competing successfully even if that person never gets tested and has no idea what their genetic potential is. Why? Genetic testing is going to make it easier to find more people who have great genetic potential for a sport so that they can be steered toward that sport. As a result genetic testing will make it difficult for those with less than ideal genetic variants for a sport to compete in that sport.
I realize many people love to see someone prevail over daunting obstacles and tough odds. But the identification of all the genetic variations that contribute to athletic performance in combination with mass genetic testing is going to lead the identification and encouragement of large numbers of people who now are never trying seriously to perform in sports. Therefore people best suited for a sport will enter it in far greater numbers and those who now face tough but occasionally surmountable odds will face impossible odds.
What I said doesn't just hold for sports. Surely there are genetic variations that influence ability to excel in opera singing, ballet dancing, musical composition, musical performance, writing, engineering, and a great many other pursuits. It even seems very probable that there are genetic variations for the ideal special forces soldiers not only for athletic performance but also for handling extreme physical and mental stress. The identification of those genetic variations that contribute to many types of human performance will lead to genetic aptitude tests that will be used in combination with biotechnological instruments (e.g. scanning devices such as MRIs and CAT scanners) of how a person physically developed to provide a much more accurate picture of that person's performance potential. These tests will constituent what will be, in effect, biological aptitude tests. in combination with existing conventional aptitude tests these tests will steer people with specific types of greater potential more accurately toward the fields of human endeavour for which they have natural gifts.
Of course the identification of genetic variations that affect athletic performance will provide starting points for the development of drugs, gene therapies, cell therapies, and other treatments that will boost athletic performance and raise the potential for individual humans to achieve in a large range of areas. So just as we become more able to predict our potential we will be able to raise our potential as well. These biotechnogically raised levels of performance will also be to known limits, albeit higher limits. So there will be less mystery about our individual potential regardless of whether we decide to enhance ourselves.
The thing that scares me the most about genetic testing is the potential for insurance agencies to deny medical insurance to people based on their genetic profile- for example, higher disposition towards breast cancer. This is already being discussed within the halls of insurance agencies and ethics committees, but the technology is coming whether we prepare for it or not. The question is can we contain the use of this information to the point that genetic identity does not become the new racism?
The problem is that anyone who gets genetically tested and therefore knows they have a higher risk for some disease will decide pay for more extensive insurance policies and anyone who knows they are at lower risk will opt for less insurance. The insurers will end up with more money going out and less coming in. They will have to raise rates and in some cases exit the business.
In the longer run the insurance companies will be able to say "Hey, you have this risk. If you pay x thousands out of your own pocket for a gene therapy to fix the risk then we will insure you".
Thanks for the further explanation, I hadn't looked at it in that light. I am still concerned however that Insurance companies will begin to either stack enormously higher fees or outright refuse to cover someone at all based on this information. It was one thing when the question is "smoker or non". I realize the point you are making with the market forces determining what's best for the consumer by requiring gene therapy. I still have concerns that these market forces may simply change health insurance in ways never imagined before, ways I'm not entirely convinced will be positive.
One key principle of ethics that can be used to evaluate societal insurance mechanisms is the following:
[Principle] If a person has a greater risk of a medical malady but that person did not cause the greater risk (by action or inaction) then he or she should not pay a larger insurance fee.
According to this principle if a person was born with a genetic predisposition to a disease such as Huntington's Chorea (a degenerative disorder of the nervous system) then he or she would not be penalized with a larger insurance payment. Similarly, if a child has a genetic defect that leads to Cystic Fibrosis (a disease causing severe lung damage) then the child's parents would not be required to pay a larger insurance fee.
Some believe that following this principle provides a desirable standard of "fairness" because the person facing the higher disease risk was not "responsible". In fact, some argue that the physical and psychological burden is large enough without compounding it by adding a financial penalty. Economically, the principle creates a cross-subsidy in which healthier participants in an insurance plan subsidize less-healthy participants whose ill-health is not due to self-action.
To implement the principle would entail strong legal restrictions on insurance carriers. The government would audit the criteria used to select and price insurance policies. For example, if an insurance company used a computer program to set the price of a policy then the government would restrict the inputs to the program and it would also monitor the outputs. This requires a massive governmental intervention in the market but there are multiple societal precedents. The US government currently prevents the use of criteria such as race, religion, gender, and ethnicity in many transactions. Even if the forbidden data might yield statistically predictive information, by law it must be ignored. Of course, more extreme governmental interventions are common; e.g., many governments have “socialized” medicine. I am not advocating the principle discussed above but I predict that its invocation will become more common as genetic scanning capabilities grow.
1) Being able to predict things like muscle fiber capability will mean that people are directed towards or away from many of the "non-thinking" sports such as sprinting. However, in many sports (especially most team sports), there needs to be a diverse group of bodies and minds.
2) Insurance is a way to help many people benefit from pooling approximately equal risk. If your risk is knowingly higher than everyone else's in the pool, it isn't called insurance any more, it is called a financial transfer to you. Personally, I believe that private insurance should not be forced to transfer money from one person to another, but should stick to insurance.
If the government wants to use its power to force monetary transfers, that is another matter, and perhaps they can stick to taking it from the rich and giving it to the poor.
"In the longer run the insurance companies will be able to say 'Hey, you have this risk. If you pay x thousands out of your own pocket for a gene therapy to fix the risk then we will insure you'" -- but this is a very optimistic prediction; it's quite arguable that we'll ever refine gene therapy to this point. A far likelier 'solution' is widespread pre-implantation genetic diagnosis and the implantation of genetically modified embryos.
I think it's worth running through the insurance arguments with a variation of risk: what if a genetic test predicts a risk increase of 5 percent? Ten percent? Fifty? But in general I *would* advocate the principle Garson describes.
But that's tangential to what I wanted to talk about: a romanticization of genetic testing which ignores not simply the pleasure but the fundamental utility of sport and, for that matter, art.
"Genetic testing is going to make it easier to find more people who have great genetic potential for a sport so that they can be steered toward that sport."
Let's assume, for a moment, though I think it's impossible, that we will in fact be able to not only measure those "probably thousands of more genetic alleles that influence athletic performance," but also the effect of environment upon them -- something which is orders of magnitude more complex than a simple genetic binary.
But why *should* they be steered toward sprinting? So they can win a high school track meet? Certainly not because they might someday become an Olympian -- not unless you're one of those parents who thinks suffocating expectations are a sign of love. If anyone should be 'steered' towards a sport, it's because they *enjoy* it.
Also, the "love of seeing someone prevail over daunting obstacles and tough odds" is far more valuable than the "identification and encouragement of large numbers of people who are never trying seriously to perform in sports." The latter adds nothing to the sum of human pleasure, or at least nothing that can't be added simply by encouraging *all* people to play sports; but the former has great pleasure and utility for both performer and audience, who can use the underdog's feisty triumph as inspiration in their own everyday lives.
A better argument might be made that we might someday identify people with predispositions towards being great doctors or firemen or legislators -- which is hinted at with the 'super soldier' argument. This is not an argument that should be extended to the arts; the value of the arts, both to the individual and society, is far too complex for genetic quantification. But for doctors and firemen and legislators -- not soldiers, unless we can ever select for kindness, compassion and decency -- the argument is more compelling.
Against it I would say simply that we ought never to consider our leaders and experts to be infallible; and the risk of giving them a biological cloak of infallibility, one which could be used to cover corruption or malevolence, outweighs the benefits of replacing social systems of selection that, though problematic, can be reasonably refined: training, accreditation, democratic election.