You and Your Genetics

You are distinctly Neanderthal, you have an elevated risk of getting colon cancer, and quite possibly your Dad is not your Dad….“Happy Christmas!”

One of the stranger xmas present suggestions that I have run into this season is a through-the-post, personalised genome readout. The special gift offer (reduced from £125 to £99 for a limited period only) comes from Californian genetics start-up 23andMe and is also available in the UK from high street giant Superdrug. Its snappy marketing slogan for Christmas is “Give the Gift of Knowledge”. The packet bears the product’s equally clever strap line “Welcome to You”.

So what will your lucky gift recipient actually get? Apart from the feeling that they have received a genuinely unusual present, they will also enter into a sociologically intriguing area. After sending off a small saliva sample, they will soon gain access to a personalised genome report with information grouped into two conceptual areas: “Health” and “Ancestry”.

There are readouts on relative susceptibility to common cancers and other long-term conditions: potential drug reactions; inherited physical traits; and carrier status for recessive conditions, which may come ‘out’ in your children. There is also data on your ‘matches’ with genetic relatives in the company’s huge database of other test results. “Welcome to You”? or “Beware of What You Wish For”?

It would appear that, over the years, 23andMe have not had a particularly smooth ride from regulatory bodies, and the company is evidently well aware of the potential downsides. So a brief scroll down the home page leads you to the warning:

“Because genetic information is hereditary, knowing something about your genetics also tells you something about those closely related to you. Your family may or may not want to know this information as well, and relationships with others can be affected by learning about your DNA.”

That statement is a quite accurate summary of the underlying reasons for several decades of painstaking research by anthropologists, sociologists and psychologists. It’s not as if our disciplines haven’t seen this coming. Neither have medical colleagues, ethicists and genetic counsellors been at all backward in engaging with social scientists and embracing their insights into the personal and cultural implications of delivering genetic information to individuals.

The relationship between predictive medical genetics, counselling and the academic social sciences has been very close, very productive and resulted in some seriously socially-informed clinical approaches. This has been a huge area of scientific endeavour and, if it were possible to summarise all the findings in one easy-to-digest phrase, it would be something like: “Take great care – this stuff is dynamite”.

One of the main issues is (of course) that much of this information is speculative and probabilistic. For example, not everyone with gene sequences linked to breast/ovarian cancer goes on to develop disease. And not everyone who suffers with breast/ovarian cancer carries a genetic sequence. If you haven’t already got a strong family history, the genuine value of knowing your ‘status’ in such areas is questionable – both practically and ethically.

These questions are the subject of two traditional English proverbs: “a stitch in time saves nine” and “ignorance is bliss”. We know that they are mutually exclusive – one prescribing a rather ‘protestant’ approach to knowledge and prophylaxis, the other advising a more happy-go-lucky style.

But my observation is that we usually choose one or other of these proverbial routes in any given context or mood. This 23andMe Christmas present will surely thrust some people into an uncomfortable encounter with where they stand on the relationship between probabilistic knowledge of vulnerability and willingness to change lifestyle and behaviour. After all, you may not really enjoy eating butter or sipping a glass of wine ever again!

Turning to identity, it is hard to know how many people in contemporary Britain are actually not the genetic offspring of the people they call “Mum and Dad”. Leaving known adoption on one side, it is probably fair to say that the vast majority of us really did issue from the woman we call “Mum”. There will obviously be the odd case of “opera buffa” style maternity ward mix-ups and, indeed, a few people brought up by grannies (as Mum) because their actual mother is the person they have always thought of as an older sister. It’s a bit of a retro tale, but probably still goes on.

But how many of our Dads are actually not our genetic parents? Both the biological mechanics and the socio-cultural context of sexual activity in modern and post-modern society make it actually quite easy for “Dad” not to be Dad. So percentages might be fairly high. Mummy and/or Daddy may have had a more colourful past than you had imagined. That would be a different subject for the traditional Christmas family argument!

Recognising this, the 23andMe website contains another caveat:

“In rare cases, participation may reveal that you are related to someone whom you didn’t expect, or that you are not related to someone in the way that you expected. Consider this before you opt in to this feature.” Deeper into the site, there is a whole page of warnings.

But there is a fun side too – who wouldn’t want to know that they share a “lineage” with a famous person from history? And knowing how Neanderthal I am? That might even make it onto my wish-list for Santa!