Monitoring the worker for exposure and disease: Scientific, legal, and ethical considerations in the use of biomarkers, by Nicholas A. Ashford, Dale B. Hattis, Christine J. Spadafor and Charles C. Caldart, Johns Hopkins University Press, Baltimore, MD, 1990. 224 pages, $19.95
✍ Scribed by Mr. Sheldon W. Samuels
- Publisher
- John Wiley and Sons
- Year
- 1992
- Tongue
- English
- Weight
- 132 KB
- Volume
- 21
- Category
- Article
- ISSN
- 0271-3586
No coin nor oath required. For personal study only.
✦ Synopsis
While biomarkers are hardly new phenomena, recent advances in molecular biology combined with widespread computerization of data bases now make biomarked personal data with genetic import potentially accessible on a massive scale. While limited in predictive value at this time, the data can be easily misinterpreted or misapplied, to the detriment of those tested.
The number of people who are subjects of research studies using or contemplating the use of biomarkers grows exponentially. Yet the linkage of the scientific, legal, and ethical factors, before publication of this book, has not been made in a practical manual for the practitioner. An excellent general treatment of the issues has been available since 1984 with the publication by BNA of Mark A. Rothstein's Medical Screening of Workers. But it was left for Ashford et al. to focus specifically on the very special problems of biomarkers.
If there is any criticism to be made of the Ashford group effort, it is that while they make a strong link between scientific and legal issues, the linkage is weak on scientific-ethical concerns. We expect of these truly expert authors, but do not find, an examination of value-system conflicts inherent in the concepts at the base of the very language used by geneticists in organizing their data and interpreting their work. (Genotypic differences often become identical with genetic "defects"/' 'deficiencies"/"disease.") These concepts, which polarize the thoughts and actions both of scientists and lay peer group leaders, have been and remain unexamined and unquestioned.
At conception, the (huge and unmentioned) human genome project was plagued with controversies of the past. It was, and is, easy to arouse attention to the russenhygiene of the Nazi death camps, and to confuse that tragedy with the possibilities for life of the present project. Just as easily, it is easy to raise new fears based on genetic testing that largely isn't taking place, yet could, and in a few cases is in fact being abused from scientific, legal, and ethical perspectives. [OTA, 19901. It would be unfair to minimize the importance of the long-standing, legitimate scientific concerns. The view that the genetic load carried by human populations may be increasingly deleterious is supported by strong evidence [Muller, 19351. Others, also with significant weight of evidence, reject negative social implications of these data by rejecting the classical theory of population structure that assumes a single