Genetic Fixation in a Polluted Environment
by Regina Kenen
Nurture vs. Nature
Although the nature vs. nurture controversy does not ever get completely resolved, most natural and social scientists agree both biology and environment create destiny. The hotly debated questions are: Which is the dominant factor and where should the research emphasis and resulting social policy focus? The shifting emphasis on nature arid nurture appears to be cyclical. Currently, the search for genetic answers, however, is not limited to the detection of diseases, but also for the explanation of IQ, aggression and various human behaviors. As Dorothy Nelkin puts it so well, "Biological predisposition is not necessary to explain why a child who suffers racism and violence, without much hope of escape, might become indifferent to human life." (Nelkin, "Biology is not Destiny." NY Times, Sept. 28, 1995.)
In the 1960s and 1970s, with the emphasis on civil rights, women's liberation and the Great Society, environmentalists gained the public's attention. Now, the emphasis has shifted and the geneticists are calling the shots. The media has embraced genetics and though the vast majority of the population also favors environmental protection, their thinking about the human species is framed in genetic terms. One important downside to this genetic perspective is that an individual's genetic makeup can lead to job and insurance discrimination, (Genetic testing and insurance. The Ad Hoc Committee on Genetic Testing/Insurance Issues. American Journal of Human Genetics.^) In contrast, enlightened environmental and social policies help society as well as the individual. The Council for Responsible Genetics has been documenting these cases.
Women as child bearers, and contributors of half the genetic makeup of their offspring, may either benefit from genetic advances or bear the brunt of excessive genetic determinism. As women are the ones who decide whether or not to use prenatal genetic testing and diagnosis, they are the ones who are also likely to be chastened and stigmatized for not using these options of preventing a child with a genetic condition. In the case of AFP triple screen for spina bifida and Downs syndrome, many pregnant women can no longer even exercise choice as this blood test is performed without their knowledge as part of a package of prenatal blood work.
Genes and Environment
Currently, geneticists are searching for the genes responsible for the onset of, or susceptibility to, common diseases such as cancer, cardiovascular disease, and diabetes. These diseases are thought to arise from the interaction between several genes and the environment. We hear more about the less common familial types of these diseases in which genes play a major role, e.g., mutations in BRCA1 and HNPCC which are involved in particular types of breast and colon cancer that run in families and for which genetic screening tests have been recently developed. However, these tests will not be able to provide definitive answers. They will only be able to identify increased or decreased risk for getting the disease. For most common adult onset disorders, however, genetic defects associated with these diseases are probably not inherited, but acquired through exposure to environmental carcinogens or because of errors in DNA replication or repair. Even in families having an inherited mutation, the role of the environment is not likely to be negligible. Familial clusters of cancer may also occur because of common exposures to carcinogens and/or shared cultural and lifestyle patterns. It is possible, therefore, that women as a group may benefit from identification of breast cancer genes, but may be harmed at the same time by the comparative lack of attention to environmental components of breast cancer.
Research Frontiers and Corporate Profit
Research in cancer genetics focuses to a large extent on two types of genes —oncogenes and tumor suppressor genes. Functionally, oncogenes act to increase the rate of cell division. Tumor suppressor genes are often referred to as cellular brakes, acting to block tumor development. In general, there are two copies of tumor suppressor genes active in normal cells. Even in some families where there is an inherited mutation of a tumor suppressor gene, cancer is not likely to develop until there is a second mutation as a result of a non-genetic cause. Currently, some environmental molecular biologists are investigating the differences in gene mutations caused by different environmental insults, e.g., the effect of smoking on the p53 gene. Furthermore, developmental biologists are increasingly concerned about xenoestrogens used in the manufacture of some pesticides and plastics. These foreign estrogens mimic human estrogen and can cause harmful reproductive effects on the males of many species. Although the effect of these foreign estrogens on human males and females is controversial, the recent BBC special on xenoestrogens entitled "Attack on the Male" made a very convincing case for further research in this area.
Despite these specific environmental investigations, in general, the role of the physical and social environment is receiving scant attention. The field of applied human genetics has become big business. Millions of dollars of venture capital has poured into new genetic technology firms and commercial interests are pressing for use of their tests. These companies support the genetic explanatory model which overemphasizes personal responsibility for health and maximizes corporate profit rather than a model premised on social and governmental responsibility in providing equitable health care to all social classes and minority groups.
Pharmaceutical firms and companies developing new genetic tests also try to define what is considered to be "normal" and attempt to change what is considered to be a normal variation into something abnormal that can be fixed with one of the companies' products. For example, Genentech, one of the leading biotech companies, supported the idea that shortness was a defect in its campaign to promote use of its synthetic human growth hormone. The number of children with a pituitary deficiency was too small to provide much of a market, so that healthy short people were now identified as being ideal recipients of this hormone, despite the evidence that it probably would not change their ultimate height and the possibility of side effects (Werth. How short is too short? Marketing human growth hormone, in Schwartz, Howard, ed., Domi- Issues in Medical Sociology. New : McGraw Hill, 1994, pp. 249-255.)
A Shortsighted Perspective
At the same time as more and more couples embrace genetic screening tests, prenatal and preimplantation diagnosis in seeking the perfect child, the Republican Congress and State legislatures are attempting to limit welfare and Medicaid safety net programs that protect the health of poor mothers and their future children. The fact that many more American children's health has beendamaged by poverty and deprivation rather than by genetic conditions has been well documented. The same kind of shortsightedness is shown in the war against cancer. While legislators appropriate money to research genetic causes of breast and other cancers, these same legislators are attempting to cut back on other preventive health measures such as environmental and workplace protection. Thus, genetic screening for susceptibility to common diseases may "distract attention away from environmental factors contributing to disease, for which social and political measures may be more appropriate than individualized susceptibility screening and lifestyle modification" (Clarke A. Population screening for genetic susceptibility to disease. British Medical Journal. 311 (July 1,1995): p. 35).
For further information, or to receive a copy of geneWatch, the bulletin that raises social issues in genetics, contact: The council for Responsible Genetics (CRG) 5 Upland Road, Suite 3, Cambridge, MA 02140, (617) 868-0870, fax (617) 491- 5344, e-mail firstname.lastname@example.org.
Regina Kenen, Ph.D., M.P.His a Professor of Sociology at Trenton State College and serves as liaison between the Council for Responsible Genetics and the Network.