Misreading the genetic blueprint: implications of genetics-based population screening

Scheduled for completion in 2003, the Human Genome Project will provide unprecedented insight into the genetic basis of human disease. The choice of genomic medicine, however, must be explored, and not assumed to be the next logical step in the evolution of medicine. Genomic medicine epitomizes the dominant scientific paradigm of reductionism, the theory that the whole is best understood by breaking it down into its constituents. This concept makes genetics-based disease prevention problematic as it tends to discount contextual and population determinants in pathogenesis--such as gender, class, and ethnicity--in favour of biological causes. Unqualified acceptance of a genetic guide to disease prevention is an ethical concern as it commits the "individualistic fallacy," and ignores contextual factors that may lead to genetic discrimination, and to the augmentation of social inequities.