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12 May 2008 04:35 pm

Dissent Of The Day

A reader writes:

Kinsley is fundamentally wrong about genetics and genetic discrimination. He throws in a few points about the unfairness of inherited wealth and other topics, but saying X is bad therefore there no reason Y shouldn't also be bad is a weak argument. Kinsley doesn't even bother to explain how his talent example relates to gene-testing based discrimination. He doesn't because he can't. Here's the continued logic of his example:

Let's say there is a combination of genes for being a cello master. 

Does everyone who has that combination have an urge to play cello from the age of 5 and grow up to play like Yo-Yo Ma? No. Are there people without those genes that can become well-respected professional cellists? Yes. Could there be another, unknown combination of genes that also results in great cello playing? Yes.  Let's say  we can identify the cello genes of Yo-Yo Ma. Would it be reasonable for a high school orchestra to select a cellist with those genes over a cellist without those genes who works harder and plays better merely on the assumption that the genetically superior cellist has the innate ability to be better even if she doesn't show the ability? Would it be reasonable for a professional orchestra to hire based on a genetic test rather than current abilities and potential based on those observed abilities and work ethic?

As for insurance, the issues are more complex than Kinsley writes. What if a genetic test shows someone has a 20% increased risk of developing a disease that will cost millions of dollars to treat? The population incidence of this disease is 1/10000 so the chance this person will get the disease is 1/8333. Based on pure capitalism, the insurers choice is easy. Don't insure this person or charge exorbitant rates. Even though the chance of getting the disease is still small, there is no amount you can charge this person for insurance that would balance out even the small chance of millions of dollars of expenses. Even if getting a genetic test could help improve preventative care, there is no way anyone would get that test without being assured that it wouldn't affect their ability to get insurance. This is more than a hypothetical situation. I do medical research and we sometimes see incidental findings that really don't affect people's daily lives, but might minutely increase risks for future problems. Right now, if we tell a patient about these findings and they do report it to their insurance, they risk losing coverage or having their rates go up. If they don't report it, they can get their insurance pulled when they try to make a claim since it might be lying about one's health even if the claim has nothing to do with the finding. If insurers and employers started to make decisions based purely on genetic information, medical research involving genetics would grind to a halt. This is why this bill passed the Congress and Senate and why Dr. Ron Paul should be ashamed of his vote.

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