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41 Jurimetrics 145 (2000-2001)
The Evolution of Predictive Genetic Testing: Deciphering Gene-Environment Interactions

handle is hein.journals/juraba41 and id is 155 raw text is: THE EVOLUTION OF PREDICTIVE GENETIC TESTING: DECIPHERING GENE- ENVIRONMENT INTERACTIONS Richard R. Sharp* ABSTRACT: The evolution of predictive genetic testing is best described as a shift from the detection of rare, highly penetrant disease genes to the detection of more common, less predictive genetic susceptibilities to disease and sensitivities to environmental agents. This paper describes how a better understanding of gene-environment interactions will cast new light on familiar bioethical issues and present a number of unique ethical and social challenges. Three topics are examined in detail: the protection of research participants in environmental genomics, how a better understanding of gene-environment interactions could impact socially identifiable groups, and potential shifts in social priorities and assignments of responsibility for health based on our knowledge of genetic sensitivities to environmental agents. Clarifying these emerging areas of concern, many of which have not received adequate attention in the existing bioethics literature and legal scholarship, is critical to ensuring that the benefits of predictive genetic testing are not overshadowed by unintended misuses. CITATION: Richard R. Sharp, The Evolution of Predictive Genetic Testing: Deciphering Gene-Environment Interactions, 41 Jurimetrics J. 145-163 (2001). *Richard R. Sharp is a Biomedical Ethicist and Director of the Program in Environmental Health Policy and Ethics at the National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709-2233; and an Associate at the Center for the Study of Medical Ethics and Humanities, Duke University, Durham, NC 27710. This work was supported in part by the Division of Intramural Research at the National Institute of Environmental Health Sciences (NIEHS). The views expressed in the paper represent the opinions of the author alone and may not represent the positions of either the NIEHS or the National Institutes of Health. A version of this paper was presented on April 8, 2000, at a conference on Legal Liabilities at the Frontier of Genetic Testing. The author wishes to thank Michael Baram and George Gray for their thoughtful comments on earlier drafts of the paper. WINTER 2001

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