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| Volume 46, Number 3, Winter 1998-99 |
by Suzanne Clancy
Is the public ready for the impact of genomic information and technology on the practice of medicine?
“The glib answer is no, but the real answer is yes,” according to Barbara Culliton (then) editor of the Journal of Investigative Medicine, speaking at a AAAS session on Medicine in the 21st Century. (see below)
“I think that through the news media—TV, radio, magazines and the Internet—the public is beginning to get a sense of what medicine will bring,” she said, “and I believe they will be very accepting.”
On the other hand, Culliton believes physicians are under-prepared for the coming changes.
“There is a problem with getting information out to practicing physicians [and] patients may be the ones to educate their physicians,” she observed. “Patients will want information specific to them, and they will seek out the relevant material and bring it to their doctors. [In that way] it may be acceptable for physicians to learn on the job, as long as medical schools teach them what to do with the information.”
Media coverage of genetics often poses profound moral and ethical questions. Culliton is not sure, however, what distinguishes genetics and genomics from other areas of medicine. “The rapid advance forces us to look at issues we should look at anyway,” she said.
For example, there is a great deal of concern about the ability of insurance companies to discriminate against individuals with predispositions to medical conditions. “That’s a valid question,” Culliton agreed, “but there is nothing novel about it. Insurance companies discriminate against everybody they can, whenever they can…We get nowhere by demonizing insurance companies. We need to be asking how can we provide health coverage to all?”
On the issue of “playing God,” Culliton pointed to the history of transplantation surgery. “When the first heart transplant was done, every doctor talked about ethics, the Congress held hearings on the ethics. Now we don’t worry about the ethics, we worry about (organ) availability.”
In response to an audience question about the validity of the funds set aside by the NIH to study the ethics of genetic research, Culliton replied, “It is necessary for the public to know that there are questions of ethics in medicine, of fairness, consent, distributive justice. I just don’t think there is anything unique to genetics in this issue.”
To expedite the dissemination of genetics and genomics news, Culliton announced that she will be joining Celera, Craig Venter’s Maryland-based genomics company, as executive editor of the Celera Genome News Network, a wire service devoted to news relating to genomics and genetic medicine. Celera was formed by Venter, formerly president of The Institute for Genomic Research, and Perkin-Elmer in 1998 with the goal of sequencing the human genome by 2001, two years ahead of the federally funded genome project.