Biological Psychiatry, a journal that deals with the more 'nitty-gritty' aspects of the brain, released an editorial this week that bears discussion. The article details the future of psychiatry based on advances being made in genetics today. I have actually written on this topic before but it is so important that I wanted to shed more light, given the new editorial. A Word about your Genes First, I need to give you some very basic background in genetics. Our genes are basically blueprints that are housed inside every cell in our body (with the exception of a few special types of cells). Every cell has an identical copy of these blueprints that are stored in your DNA. Your DNA is made up of a long chain with a g'zillion links, but there are only four kinds of links that make up the chain. Scientists use the letters A, T, C and G to represent the four kinds of links. A single gene can be thousands to millions of links long and humans have about 30,000 or so genes. We all have the same 30,000 genes, but each gene comes in a different variety, depending on the how the links (A, T, C, G) are ordered. But the varieties of the same gene usually only differ from each other by a few of these links. For example, sickle cell anemia patients only have 1 link screwed up in one gene that's it. This 1 link out of g'zillions is responsible for the difference between health and the disease. Sometimes these single link differences are in critical spots in a gene and lead to disease, but most of the time they just add variety like brown eyes vs. blue or sometimes they have no obvious effect at all. These differences in single links between people are what cause us to be genetically different from each other, but there are probably only a couple of million that account for our differences, which is a small fraction of how many links we have. How much do you want to know? Why the long-winded explanation? Because new technologies allow researchers to actually look at most of these links that differ between people and determine exactly which variations you have for all of your genes, known as your 'genotype' sort of a genetic fingerprint. This technology is currently generating huge amounts of data that will allow us to know exactly what your risk is for developing many diseases, based on which gene varieties you have at least that's the hope of medical science. Today research labs can 'genotype' individuals for about $1,000, which is not much considering this is a once in a lifetime expense, since your genes don't change throughout your life. Currently researchers are applying these studies to understand the genetics of many diseases, like manic-depression and schizophrenia to name a couple. But in the near future we will have the affordable technology to genotype everyone. This obviously will bring about a huge number of ethical debates. The good side is that we will be able to diagnose and hopefully prevent disease before it ever takes a foot-hold. However, questions must be dealt with like: Would you want to know if you were likely going to develop a late life disease that you couldn't do anything about? Who should have access to your genotype? Your doctor? Your insurance company? Medical insurance companies currently base costs on average risk across populations. This cost calculation could be much more specific for individuals with genotype information. But this will mean some folks will be uninsurable or costs would be unreasonably high because of high disease risk. Will society allow this? At what time in your life should you get genotyped, if at all? Should parents get the genotype of their child at birth or even while the baby is still in the womb? These are all very real questions that we as a society will have to face. Where will we draw the line? Today's technology is advancing rapidly to make individual genotyping a reality. Still, this is only information about what nature has given you. Even bigger questions and debates will arise if we get to the point where we can alter 'undesirable' genes before birth. But don't worry we are no where near that capability yet or are we? Copyright (c) 2007 The Brain Code LLC
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