Direct-to-consumer personal genome testing presents a major challenge to healthcare systems because it distorts and confuses notions of diagnosis and screening and capitalizes on ignorance about causation for commercial ends. The reach of the Internet and the impact of globalization make this a global problem. In meeting this challenge we should be wary of calls to improve public and professional understanding of genetics, as they assume that the problem is ignorance so the solution must be education (the so-called 'Deficit Model'). We suggest that the problem is ultimately one of how to regulate testing in a poorly regulated free-market system where profits can be made in ways that generate costs for individual consumers and health systems. The global financial crisis has highlighted the social risks created by such systems, and the bioethics community should adopt a perspective that is wide enough to see the parallels in healthcare. There is scant empirical research into direct-to consumer personal genome testing (DTC-PGT), so we welcome the findings reported here (McGuire et al. 2009), notwithstanding the methodological limitations of the survey. The findings suggest that among people who build social networks online, a substantial proportion may consider using PGT for the purpose of gaining knowledge about disease in their family, and many would consider the results to somehow constitute a medical diagnosis, and would seek physician advice. If these findings are true, should we be concerned? And if so, on what grounds?
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