David Melzer and Ron Zimmern argue that genetic tests for markers that may not result in symptoms for half a century or more could be new examples of a process of premature medicalisation. This would occur if disease labels were attached to people before it had been established precisely what each test result predicts and whether prevention or treatment for the specific genetic difference was beneficial.

Unless it is established that a genetic variant is a pointer to beneficial action, there is a potential for inappropriate medicalisation through the spread of poorly understood tests, say the authors. The perceptions of risk resulting from such tests may bear little relation to the scientific facts and uncertainties. Inflated ideas about risks could result in people carrying such genes being treated unfairly in many areas, including employment or insurance, they suggest.

The enormous investments needed to exploit genetics may have driven a more exuberant set of claims than usual, designed to appeal not only to the public but also to investors, say the authors. The antidote lies in remaining sceptical and level headed.

Genetic technologies have the potential to be of major benefit to society, but their introduction must be measured, attentive to social and ethical considerations and, most importantly, based on good evidence, they conclude.

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Contact: Emma Wilkinson
ewilkinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
11-Apr-2002