[pf] Genetic cures vs social/environmental causes (Toronto Globe & Mail)

At 22:31 7/7/2000 +1200, David Parker sent to GreenViews NZ:
Subject: Genetic cures vs social/environmental causes (Toronto Globe & Mail)

Published on Thursday, July 6, 2000 in the Toronto Globe and Mail

Looking For Genetic Cures For Disease Lets Us Sidestep The Need To Tackle
The Social And Environmental Causes
   by Gabor Maté

Expressions of near-religious awe and prophesies of dramatic medical
advances  greeted last week's announcement that scientists are close to
deciphering the human genome, the genetic blueprint for the human body.
"Today, we are learning the language in which God created life," President
Bill Clinton said at the White House ceremony marking the truce between two
groups of scientists racing to complete the genome. "This is going to
revolutionize medicine," enthused Stephen Warren, a U.S. medical
geneticist. "We are going to understand not only what causes disease but
what prevents disease."

The actual results are bound to be disappointing, except perhaps to the
profit margins of pharmaceutical companies and to the grant coffers of
researchers. A sober assessment suggests that little can be expected from
the genome program that will lead to significant health benefits in the
near future, if ever. First, our current state of knowledge regarding human
genetic makeup is like citing an incomplete copy of The Concise Oxford
English Dictionary as "the model" from which Shakespeare created his plays.
"All" that remains now is to find the prepositions, grammatical rules and
phonetic indications, then figure out how Shakespeare arrived at story
lines, dialogue and literary devices. "The genome is biological
programming," one thoughful science reporter has written, "but evolution
has neglected to provide even the punctuation to show where genes stop and
start, let alone any helpful notes as to what each gene is meant to do."

Second, contrary to the genetic fundamentalism that pervades medical
thinking and public awareness these days, genes by themselves cannot
possibly account for the complex psychological characteristics, behaviour
or health or illness of human beings. Genes are codes for the synthesis of
the proteins that give a particular cell its characteristic structure and
functions. They are, as it were, alive and dynamic architectural and
mechanical plans. Whether the plan becomes realized depends on far more
than the gene itself.

The activities of cells are defined not simply by the genes in their
nuclei, but by the needs of the entire organism -- and by the interaction
of that organism with the environment in which it must survive. Genes are
turned on or off by the environment.

Only a handful of illnesses is genetically determined. The most we can say
is that some conditions are strongly genetic. Even in the case of
well-known single-gene diseases such as Huntington's, a usually fatal
degeneration of the nervous system, there may be protective environmental
factors; of those who carry the gene, a few live to a ripe old age without
developing signs of the disease.

In the case of schizophrenia, a mental illness it is currently fashionable
to consider genetic, the most that can be shown is that if one member of a
pair of identical twins is diagnosed with it, the other has a 50 per cent
or 60 per cent chance of being similarly diagnosed. Lest people think this
proves even a 50 per cent or 60 per cent genetic contribution, it must be
remembered that identical twins spend nine months in the same formative
uterine environment, and are acted on by identical biological and
psychological influences. So the genetic effect in schizophrenia is less
than half. The rest is environmental.

For the commonest North American afflictions -- heart disease, lung cancer,
diabetes -- we don't need to seek genetic origins. The causes are apparent.
The northwest Ontario Cree suffer diabetes at a rate five times the
Canadian average, despite the traditionally low incidence of diabetes among
First Nations populations. The genetic makeup of the Cree hasn't changed in
a few generations. The destruction of their physically active way of life
by what we call civilization, the introduction of high-calorie diets, and
increased stress are responsible for the alarming rise in diabetes rates.

Among hard-core drug users in Vancouver's downtown east side, virtually
anyone can give wrenching histories of childhood abuse or deprivation. Yet
at a conference on addiction medicine I attended last year, not a single
session was granted to social or psychological issues. Time was devoted,
instead, to the genetic bases of substance addictions and alcoholism, as if
the environment was not of fundamental importance in both causation and
healing.

Given the paucity of evidence for the decisive role of genetic factors in
most questions of illness, why all the hoopla about the genome project?

Science, as all disciplines, has its ideological and political dimensions.
The assumption that illnesses, mental or physical, are primarily genetic
allows us to avoid disturbing questions about the nature of the society in
which we live. If genes -- rather than poverty or man-made toxins or a
stressful culture -- are responsible for diseases, we can look to simple
pharmacological and biological solutions. This approach helps to justify
and preserve prevailing social values and structures. And it's profitable.
The value of shares in Celera, the private company participating in the
genome project, has risen 1,400 per cent in a year.

In Genesis, God fashions the universe first, then nature, and only
afterward shapes humankind from the substance of Earth. God knew, if Mr.
Clinton does not, that from their earliest beginnings humans could never be
understood apart from their environment.

Gabor Maté, a Vancouver physician, is the author of Scattered Minds: A New
Look at the Origins and Healing of Attention Deficit Disorder.

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sent on to Pos Fut by David.
(David MacClement) davd@ihug.co.nz 
http://www.emucities.com.au/member/davd/
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