Thursday 30 October 2014

Can we eliminate genetic disease through better awareness?


This was the question posed at a heretics meet last week. The group consisted of scientists but also other academics, so it was interesting to hear the various arguments and points of view that were sparked by the idea. 

The speaker, a good friend of mine, had named his talk sterilization and stated that he believed that we could considerably reduce the risk of children in the next generation being born with genetic diseases by introducing some simple protocols in the UK. He suggested having the entire population (above the age of 13) screened for genetic diseases to make them aware of their genetic make up and to ensure they are fully conscious of any genes they may be carrying which could be passed on to their potential children. This was the basis of his argument. He went on to state that before people decide to have a baby, the parents could cross their genomes, in a similar way to the way that we do it in Punnet squares at GCSE, to check the likelihood of their child being a sufferer of a given disorder. With this awareness they could then decide whether they would still like to have the child or whether something like IVF, for example, would be a better route for them. He proposed that they should be given 2 chances to have children who were genetic disease free naturally, followed by a chance at subsidised IVF, before they would be told they should no longer reproduce. So sterilisation would only be used in cases where people tried to cheat the system and continued to reproduce despite the fact that the children were suffering from genetic diseases and realistically the use of this title was an attention seeking stunt and he himself admitted that.

Of course the heretics society got hung up on the fact that he had suggested preventing people from having children, which to them seemed unfair, and in fact probably is. However, the main focus of his argument was actually pretty strong. If we consider the cost of sequencing a genome compared with the cost of treating a patient with CF for a lifetime, for example, the healthcare system could definitely benefit from taking measures to reduce the instances of these genetic diseases. Given that it could be fairly simple to determine probabilities in terms of the offspring suffering from the genetic disease. I would like to think that if people were aware of these probabilities, parents would consider this as a factor in their decision to have children. This being taken into account, I think it is likely that we would see a decrease in the incidence of genetic disease in the next generation purely through raising awareness. Of course the process would be expensive to implicate at first but I would see it as being similar to a vaccination program, such as the flu jab, which is offered to those who need it every year. This would be the case with the screening in my opinion. Every child who had turned thirteen in the past year (after the first year, of course) would be screened.

Something to consider, however, would be genetic diseases such as Huntington’s, which would not affect the sufferer until much later in life, but are also known to have no treatment. Some people may opt not to be screened because they would rather not know, and we need to consider that this is their right. However, this would interfere with the whole system and could affect the population in that the disease may be passed on to the next generation in an instance where it may not have been if protocol had been followed. We must think about the balance between ensuring that everyone’s rights are fully taken into account and making sure that the process is effective and of course cost efficient.

But obviously it shouldn’t be all about money. (Even though a lot of the issues in the NHS nowadays are…) We must ask ourselves if we think it is acceptable that children still wake up with Tay Sachs disease when this could have been prevented by a simple screening program to give parents the awareness they need to make informed decisions. We should be conscious of the suffering that comes with most genetic diseases. I watched a documentary recently based in a hospital in Newcastle, which is very local to me, and it really touched me. It followed several children who were in hospital for various different reasons, but one particular boy’s story, who was a sufferer of CF, particularly struck me. This young boy was about 12 and wanted to go to a sleepover at a friends house for his friends birthday, but because of his disease, was unable to sleep without oxygen at home and his friend’s mum didn’t want the responsibility of regulating and monitoring his oxygen through the night. So during his stay in hospital, he worked extra hard and attended physio sessions in order to try to clear his lungs enough, and gain enough fitness to be able to go an entire night with no oxygen. I, personally, had never thought about not being able to sleep without a machine being attached to me, let alone the things that go with that, such as the fact that he couldn’t stay at friends’ houses. As a child who grew up healthy and was always able to do everything I wanted to in terms of physical and mental ability, I can’t imagine living life as a young boy the way he has to. But this is completely unnecessary! We could reduce the risks of people being affected by these issues fairly easily if we were to introduce a simple awareness program to the population.


Of course there are lots of flaws in this idea, as there are in all new concepts, but I really do feel this is something that we could consider, or at least offer to potential parents to reduce the suffering of their offspring.

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