Debate report by Roey Tzezana, MSc student in nano-technology at the Technion, Israel, and FameLab Finalist 2007

25 December 2007

Genetic Screening – Just How Far do We Go?

A public debate was held last Wednesday in Tel-Aviv, concerning the genetic screening and the myriad of ways in which our understanding of the human genome could affect our lives. In just ten years from now, we should be able to analyze our own genetic code for less than a thousand dollars. It is vital to us to understand the possible consequences of this knowledge, and prepare for them in advance.

Over 200 people came to participate in the debate and ask questions of their own. The debate itself was organized by the British Council in Israel in collaboration with the Hemda Science Education Centre in Tel-Aviv. The event is part of the British Council's Beautiful Science project in Israel. Other events under the Beautiful Science initiative which took place this year were the Visualise show – science without words – at the Bloomfield Science Museum in Jerusalem and the FameLab science communication competition, which will run again early 2008.

Arad Nir, a qualified veterinarian and foreign editor and presenter at Channel 2 News, navigated the debate masterfully, directing questions from the audience to the invited speakers who wished to answer them. The first question in the debate, however, was directed at the audience. Nir asked "Assuming each of you could check your genetic code, free of charge, and realize which illnesses lie in wait for you – would you do it?"

Mr. Nir's eyebrows certainly tilted up in surprise as the majority of the audience raised their hand in approval. "We'll get back to that question at the end of the evening," he said, and went on to introduce the four speakers in the debate. Those were Prof. Eitan Friedman, Dr. Yehuda Meltzer, Ms. Gali Ben-Or and UK Prof. Armand Leroi who was invited by the British Council. All four went on to present their approaches early in the debate.

Professor Eitan Friedman, an M.D. and a researcher in the Onco-genetics (a field of medicine concerned with deciphering the relation of cancer to genetics) department in Tel-Hashomer hospital, strongly supports genetic screening. Prof. Friedman claimed that one should not be fearful of one's knowledge of the genetic code. Rather, one should inquire what one can learn from the genetic code about oneself and one's health. From the knowledge derived from knowing his or her genetic code, a person can take intelligent and reasoned decisions about his life.

"Each of us in this room has from five to fifty mutations that will affect our lives," said Friedman. Once people know what their mutations are, they can act correspondingly. People who find out that they have a tendency for addiction can refrain from drugs, alcohol or cigarettes. People who discover that they are in a high-risk category for heart diseases will take care and responsibility for their nutrition and behaviour. By knowing our genetic code we'll even be able to know which mutations and genetic diseases we are passing on to our children, and could even decide whether to abort fetuses with fatal genetic defects.

Friedman's colleague in the panel, Dr. Yehuda Meltzer, was not as enthusiastic. Meltzer is a philosopher and an expert in the philosophy of morality (he is also a publisher and his company published the Harry Potter books in Hebrew). Following Friedman, Meltzer voiced his qualms about genetic screening by pointing out the consequences for insurance companies. If an insurance company can know from a person's genome that he's likely to suffer a heart attack, it will charge a higher premium from that person. The result will be that for some people insurance costs will be so high that they won't be able to afford insurance.

Gali Ben-Or, a lawyer in charge of genetics legislation in the Ministry of Justice’s Legal Department, tried to lay his fears to rest. In the year 2000, the Genetic Information Law was passed in Israel. This law forbids discrimination in insurance or employment as a result of information derived from the genetic code. According to Ben-Or, the law is capable of protecting the common citizen, and no complaint has yet been received against an insurance company, for the use of genetic information.

Meltzer expressed his fears later on, when asking a question of a somewhat personal note. "What would happen if I want to marry again, and my future wife wants to see my genetic chart? And, of course, I want to check hers out!" His main concern was the loss of spontaneity and the loss of intuition in the complicated matter of choosing mates.

Professor Armand Leroi, the UK guest, took his question in stride. Leroi does research in developmental biology and the science of aging, at the Imperial College London, and has authored a popular science book entitled Mutants, where he discusses the variability of the human race. Leroi explained to Meltzer that we pick mates according to their genetics in any case. We notice their beauty, how smart they are, their smell and so on – and all of those are determined by the genes we carry. The only difference, according to Leroi, is that in the future we will be able to read those attributes straight from the genetic chart. The intuition may be lost, but as Friedman said, we could make better decisions about our lives.

Leroi went on to say that we must not appoint any authority to overlook the knowledge about genetic screening. The government cannot be trusted with that kind of information, and neither can the insurance companies, the healthcare market or even the professors of genetics and ethics. The genetic information should remain in the hands of the individual to whom it belongs, and that individual alone should make the decision whether or not to abort pregnancies.

"This is a consumers' market," Said Leroy, "and the market is extremely powerful. I think society will try to restrain it, but it will fail." Leroi revealed a profound understanding of the Jewish mind, saying that, "even the government won't be able to hold back genetic screening and the abortion of babies. Why is that? Simple, because every Jewish mother wants a perfect child."

Ben-Or tried to refute Leroi on that point, protesting that the rules in existence in the various states will not allow reckless screening of embryos. Leroi refused to accept her claim, and explained that the child is in fact the largest investment we make in our lifetime. Many a mother will desire to 'buy insurance' for their child, and make sure he or she is as flawless as possible by checking their genetic code. Some of them would likely agree to fly to foreign states where other rules exist, and where they can abort the developing embryo.

At that point a question was received from the audience, inquiring whether many generations of genetic screening and selections won't lead to a loss of the human variety. Leroi answered the question by saying that there will indeed be a loss of variety, but only if one defines 'disease' as 'variety'. While a genetic disease could be viewed as human variety, it is obviously one we are not interested in. He added he does not believe that the whole human variety – the individual beauty and personality - will ever become lost, simply because we are not all fond of the same characteristics.

Professor Friedman sealed the debate in his finishing remark: "I believe that the beauty, modernity and tools that the genetics grant both society and individuals, are tools that we can't even imagine where they'll take us to. They'll bring us to places that today we can only visit in science-fiction. I do not want to stop the beautiful science."

As the audience began to rise from their chairs, Mr. Nir called a halt to the fray. "One more moment please," He said. "You remember the question I asked you two hours ago, whether or not you would accept a genetic screening of yourself. Most of you agreed to it. After hearing all the opinions in this debate, are you still so eager?"

And when the people of the audience again raised their hands to signify a collective approval of the genetic screening, Arad Nir repeated the question with a twist, and watched in amusement as many hands wilted down. "And just how many of you would agree to it, if it happened to cost you a thousand dollars?"

Apparently, even Jewish mothers have their limits.

Roey Tzezana