23andMe /How Does it Work ?
23andMe , aptly named after the 23 chromosomes in a human body cell, has been developed as the “over the counter” genetic screening tool, accessible to all. The service includes a mail- order “do-it-yourself” DNA collection kit containig a saliva collection tube which is then mailed back to the company labs where your DNA is extracted and analysed. In a mere matter of weeks you can receive your results on your online register account- simple! And all for the very affordable price of just £125. These results will tell you about your inherited risk for diseases such as Parkinson’s disease and breast cancer. You will also be informed if you are a carrier for sickle cell anemia and cystic fibrosis, among a number of other conditions.
Once the DNA is extracted from your saliva, the sample is placed upon a “detection chip” which contains probes that detect particular variations of interest.
The principal idea of 23andMe is that the individual taking the test can learn his risk-level of getting a disease and make preventive life choices, allowing individuals also to make preemptive life choices in case they want to start a family. In reality, however, how likely is it that any changes we make to our lifestyle will lower our disposition towards Parkinson’s disease, for example? Where is the benefit in knowing your chances? Also, if you are a carrier of Cystic fibrosis there is one chance out of four of your child having the full condition, if your partner is also a carrier. There is also a perfectly good chance that you will have a healthy child, yet, knowing you are a carrier may discourage you from ever having a child at all.
This is the danger: once you receive the results, what can you really do with them? Who really wants to know that they are likely to go deaf in old age and what can you do to change what is in your DNA? Is it worth living in the gloom of an unconfirmed prognosis? Wondering when is going to be “your day”, the day you receive the news that in 20 -30 years’ time you won’t be able to remember who you are, what day it is, who your son is.
On the other hand, the identification of mutations in the BRCA genes can indicate an 85% risk of developing cancer. In which case the chances are significant enough to have a preventative mastectomy. However, if there are any concerns of this, you should see a medical professional who will provide you with a full examination and support you once you have received the news. 23andMe cannot offer this support.
Claira Hermet, YouTube personality and radio presenter, discovered at the age of nineteen that she had an 85% chance of developing breast cancer. Having had already lost her mother and her sister to the disease, at the age of 27 she has now decided to undergo a preventative mastectomy. This here is an example of genetic screening put to good use as there is a good enough chance that Claira will develop the disease in order to warrant medical action. Furthermore, as a preventative measure, a mastectomy is likely to significantly lower one’s risk of disease
What is revolutionary, but potentially counterproductive about 23andMe is how simple it is for people to access their genetic information. Many unwitting souls will send away their samples in simple curiosity, wanting to know a little more about themselves. They are aware of the potential results, but there is always the attitude of “ it won’t happen to me”. When they receive their results, they could discover, for example, that they have an increased risk of heart disease. The increase may only be slight and may not even affect them at all, but that individual will still be concerned over this detail that is likely to bear minimal danger. There is a huge risk here of “scare mongering”, causing undue worry to many people who don’t know how to interpret the results or what to do about them. These results are not diagnosies but some people may treat them like so.
What is even more controversial about 23andMe is the accuracy of these results, a matter that has so frequently been placed under scrtutiny. As described above, the chip is designed to target a select number of variant genes of interest. However, looking at the variant type of a single isolated gene is a very poor indicator of how your set of genes influences you. You would need to look at the entire groups of genes to get any actual idea of their influence, as in reality all of your genes work together to “programme “how you function. The results provided by 23andMe are therefore likely to be highly misleading. Furthermore, their “odds calculator”, which determines your likelihood of developing a condition is based on the assumption that you are of European ancestry and are 40-79 years of age. If you are of any other ethnicity it is likely that none of these results will apply to you at all.
23andMe / A Step Too Far
With all of these genetic tools available today there seems to be a strong urge to predict one’s future and prevent all adverse events from happening. Screening for genetic disease factors can be a lifesaving tool, if preventive measures, like mastectomys can be offered. However, there is no point in morbidly searching your genome to identify a number of traits that ‘may’ increase your chances of developing a disease. Some things are better left unknown, it’s simply not possible to control every aspect of your health so we need to stop concerning ourselves with this.
There is no denying that what science has enabled us to do is impressive but just because we are now able to do something does not necessarily mean it is a good thing to do. Sometimes we need to evaluate the real benefit or negative effects of new science tools before we employ them – or in this case, make them so widely available. Novel biomedical tools have been a huge triumph in science, in many cases greatly improving the health of the individuals. This, however is a step too far.