Tag: behavioral genetics

Bioethics News

One of the Fastest Growing Fields in Science Still Makes a Lot of People Very Uncomfortable

July 25, 2016

(Quartz) – This week, Robert Plomin, professor of behavioral genetics at King’s College London, published a paper showing that a child’s educational success can be predicted by their genes. Genetic data from 20,000 DNA variants across several genes collectively account for 10% of the differences in children’s educational achievement age 16. At the most extreme ends of this genetic variation is an entire exam grade difference—from A to B grade for those with the highest polygenic score, to B to C grade for those with the lowest.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Irving Gottesman, Psychologist Who Upended Views on Schizophrenia, Dies at 85

July 11, 2016

(The Washington Post) – Irving Gottesman, a psychologist whose groundbreaking studies of twins in the 1960s helped reveal a genetic link to schizophrenia, a finding that upended the prevailing but deeply flawed view of the disorder as a consequence of bad parenting, died June 29 at his home in Edina, Minn. He was 85. His death was announced by the University of Minnesota, where Dr. Gottesman founded a center for the study of behavioral genetics in 1966. The cause was an apparent stroke, said his wife, Carol Gottesman.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Roundtable Discussion: Identifying Priority Ethical Questions in Neuroscience Research and Applications

An in-depth roundtable discussion involving both members and presenters wrapped up today’s Washington, D.C. meeting of the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission).

Today’s meeting was in response to President Obama’s request, as part of the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative, that the Bioethics Commission review the ethical issues associated with the conduct of neuroscience research and implications of its findings.

Amy Gutmann, Ph.D., Chair of the Bioethics Commission, kicked off the session by requesting that panelists, “pick one piece of advice you’d like us to take into account.”

The following are highlights from the discussion that ensued:

“We need to think about… things such as education plans to help physicians and practitioners think through what they’re going to do when they have a young person come in their office and say, ‘Hey, I’d like this cause it would help me get through my test.’…We look at [cognitive enhancement] too narrowly and we need to treat it as a complex issue. ” – Rear Admiral Peter J. Delany, Ph.D., LCSW-C, Director of the Center for Behavioral Health Statistics and Quality at the Substance Abuse and Mental Health Services Administration (SAMHSA).

“I think one might characterize bioethics as the effort to try to prevent that which should not be done and enable that which should be done. Traditionally, I think the emphasis has been much more on the former—preventing that which should not be done. But, particularly within the enhancement arena, I think there is a big opportunity to start playing the second role:  to try to enable that which should be done.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The FDA Proposes Roadblocks to Laboratory Diagnostics

The American laboratory industry and its ability to serve patients is being challenged by a Food and Drug Administration (FDA) proposal that will create a new bureaucracy to regulate some of the most important tests that labs perform.

On July 31, the FDA issued a 60-day notice that it planned to issue proposed guidance that would give the agency the authority to regulate clinical laboratory tests developed in certified and accredited clinical laboratories around the country. Laboratory developed tests (LDTs) are best-in-class diagnostics that are developed at individual labs. They are commonly used when there is no FDA-approved test or when a lab makes improvements over an existing kit. LDTs are not sold to other labs or to the public; they are only used by the lab that develops them.

Treating LDTs as medical devices will reduce access to life-saving tests. LDTs are currently regulated by the Center for Medicare and Medicaid Services (CMS) under the authority of the Clinical Laboratory Improvement Amendments (CLIA). Since its inception in 1987, CLIA has been very effective. The FDA, on the other hand, has no native expertise in the regulation of lab tests; it will need to create a massive and redundant bureaucracy to oversee these tests now regulated by CMS and through local and state regulations.  

The Scope of Bureaucratic Expansion

If issued, this authority would require that the thousands of highly complex clinical laboratories in the United States, most of which reside in hospitals, submit information to the FDA about hundreds of thousands of distinct tests.

The agency has not yet clearly explained how it will oversee all of these LDTs.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Alzheimer’s Disease, Biomarkers, and Suicide: Why We Need to Think About All Three Together

Recently, I spoke with a seasoned health care reporter who was interested in Alzheimer’s and biomarkers because of his own family’s history of this disease. He started by asking, “Why would anyone not want to take this test?” – to “know,” so they could “plan”  – and then soon acknowledged that he was not at all sure whether he himself would want to live with this knowledge, for years or decades, before the onset of symptoms.

This reporter, like other reporters who work in or follow policy in states that have provisions for what is called physician-assisted suicide, or physician-assisted death, or physician aid-in-dying (there is no perfect or value-neutral term, and policy and people in states where this practice is legal may use more than one term to describe it), was aware that an Oregon-style provision requires the act of self-administering a lethal dose of medication to be a “voluntary” act. Therefore, a person nearing death due to Alzheimer’s would not have equal access to this end-of-life provision because this person would have already lost the capacity to make a voluntary decision, and also to self-administer.  While discussions about “loss of capacity near the end of life” tend to focus on the last hours, days, or perhaps weeks of life, when a person is dying of cancer or heart disease, loss of decision-making capacity and other cognitive functions in a person with Alzheimer’s may occur years before the person’s death.

Talking about end-of-life decision-making solely in terms of the right to refuse life-sustaining treatment can also fail to grasp the situation of the person with Alzheimer’s, or that person’s surrogate decision-maker, because there may be nothing to “stop” – unless the person has a life-threatening comorbid condition.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

A Decade’s Worth of Gene-Environment Interaction Studies, in Hindsight

In the early 2000s, Avshalom Caspi, Terrie Moffitt, and their colleagues published two papers (here and here), which suggested that we could finally begin to tell rather simple but evidence-based stories about how genetic and environmental variables interact to influence the emergence of complex phenotypes. It’s hard to exaggerate the level of interest those papers generated. According to Google Scholar, they’ve now been cited more than 7,000 times.  To put that in perspective, Watson and Crick’s paper on the structure of DNA has been cited only about 9,500 times.    

In 2011, however, Laramie Duncan and Matthew Keller published a paper in the American Journal of Psychiatry, which told psychiatrists about the results of their meta-analysis of the 103 gene-environment interaction (GxE) studies that had been done in the first decade of this millennium. The news wasn’t good. According to Duncan and Keller, the results of their meta-analysis “were consistent with the existence of publication bias, low statistical power, and a high false discovery rate.”

This month, Laramie Duncan published a piece with Alisha Pollastri and Jordan Smoller in the American Psychologist that aims to inform psychologists about the results that Duncan and Matthew broke to psychiatrists in 2011. The new piece is called “Mind the Gap: Why Many Geneticists and Psychological Scientists Have Discrepant Views about Gene-Environment Interaction Research.” A franker, tad-longer title would have been, “Psychologists (and Everybody Else) Need to Get Up To Speed on What Psychiatric Geneticists Already Know: Gene-Environment Interaction Research Hasn’t Panned Out Yet.” Or as the new piece puts it, “the first decade of cGxE research has produced few, if any, reliable results.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Genetic Testing in Torts Litigation – Justice or Injustice?

Genetic testing to identify the susceptibility of individuals to developing specific disorders or to confirm diagnoses is becoming increasingly common in clinical settings, where it raises a string of ethical and medical dilemmas, including about the scope of its use, its reliability and safety, and the management of confidentiality and disclosure of genetic information. Now, genetic testing is making its way into the courts–and it may be cause for concern. A recent decision by the Court of Appeal of Alberta, Canada ordering a woman to undergo a genetic test for Huntington’s disease (HD) shows how genetic tests can advance – or obstruct –justice.

In this case, Tammy Adacsi, a woman in her late thirties, sued the landlords of a house she was staying in after it caught fire. Three people died in the fire. Ms. Adacsi survived but was hospitalized for several months, after which she claimed that her debilitating injuries prevented her from ever working again. In response, the landlords requested that Ms. Adacsi be ordered to submit to a blood test to determine whether she is a carrier of the mutant gene for HD, an inherited neurodegenerative genetic disorder that causes uncontrolled movements, emotional problems, personality changes, and a decline in thinking and reasoning abilities. According to court records, HD runs in Ms. Adacsi’s family and medical professionals have indicated that some of her symptoms may be due to the disorder, and not the house fire.

Ms. Adacsi’s objected to the test, saying that it would cause her severe panic, stress and anxiety, and further her pain and suffering.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.