[Genomic risk and personal responsibility in health]
Luis David Castiel1, Maria Cristina Rodrigues Guilam, Paulo Roberto Vasconcellos-Silva
1Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro (RJ), Brazil. luis.castiel@ensp.fiocruz.br
Abstract:
With the advent of genomic research, a new category of risk has emerged--genetic risk--from which an individual cannot be separated. Among the outcomes of this model is a discussion on personal accountability, according to which an individual may both be exempted from events related to certain states of health ("blame it on the genes") or be blamed for those events ("transmitter of disease"). In addition, the search for genes to explain disease erases the line between what is normal and what is pathological, with a growing tendency towards considering individuals with no or very mild clinical manifestations as being "ill." The great emphasis on genomics may lead to both an exaggerated attention to genetics rather than social and environmental factors and to a reductionism that favors sociobiological explanations for human behavior. In addition, in this scenario, the right to information may paradoxically stimulate some to consume goods and services in order to prevent a hypothetical illness that could occur at some point in time as a result of genetic predisposition-goods and services that may not be available to everyone. It is essential that such issues be considered with the same urgency with which the genomic paradigm is being developed.
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