Finally, a tiny voice of caution speaks out against the genetic testing hype.
The Food and Drug Administration has ordered DNA testing company 23andMe to stop marketing its over-the-counter genetic test, saying it’s being sold illegally to diagnose diseases, and with no proof it actually works.
The heavily marketed test includes a kit for sampling saliva, and the company promises to offer specific health advice. “Based on your DNA, we’ll provide specific health recommendations for you,” the company says on its website. "Get personalized recommendations."
In an unusually scathing letter dated Friday, the FDA says it’s been trying to work with the company to get some sort of evidence that the test can do that with any accuracy.
I had no idea that 23andMe was making any health claims, and that’s deplorable. You can’t do that. That’s naive billiard-ball-biology, and it’s never going to be as simple as testing a few markers and then declaring that you understand physiology.
I prefer the approach of the National Genographic project, where the results are used to infer relationships rather than leaping to biomedical conclusions. We have far more accurate tools for determining your medical condition — it’s direct and involves examining your health, rather than indirectly looking at genes that have a remote connection to your health.
Which brings me to an essay that had me gawping in disbelief. A neuroscientist, James Fallon, noticed the results of a PET scan of his own brain.
“I got to the bottom of the stack, and saw this scan that was obviously pathological,” he says, noting that it showed low activity in certain areas of the frontal and temporal lobes linked to empathy, morality and self-control. Knowing that it belonged to a member of his family, Fallon checked his lab’s PET machine for an error (it was working perfectly fine) and then decided he simply had to break the blinding that prevented him from knowing whose brain was pictured. When he looked up the code, he was greeted by an unsettling revelation: the psychopathic brain pictured in the scan was his own.
OK. If this happened to me, I’d place the most importance on my personal experience — if I were a successful professional with no history of unethical behavior, I’d say “uh-oh…maybe these scans aren’t such a reliable indicator of personality after all.” I would not say, “uh-oh, I must be a psychopath.”
But guess what interpretation Fallon put on it? He got genetic tests.
But when he underwent a series of genetic tests, he got more bad news. “I had all these high-risk alleles for aggression, violence and low empathy,” he says, such as a variant of the MAO-A gene that has been linked with aggressive behavior. Eventually, based on further neurological and behavioral research into psychopathy, he decided he was indeed a psychopath—just a relatively good kind, what he and others call a “pro-social psychopath,” someone who has difficulty feeling true empathy for others but still keeps his behavior roughly within socially-acceptable bounds.
Wow. And then he starts self-rationalizing. He’s aggressive when he plays games, therefore his diagnosis must be true. He admits that maybe this isn’t as clear-cut as he thinks.
But the fact that a person with the genes and brain of a psychopath could end up a non-violent, stable and successful scientist made Fallon reconsider the ambiguity of the term. Psychopathy, after all, doesn’t appear as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders in part because it encompasses such a wide range of symptoms. Not all psychopaths kill; some, like Fallon, exhibit other sorts of psychopathic behavior.
But one thing he doesn’t consider? That maybe PET scans and genetic tests aren’t as robust and interpretable as he thinks. What I find personally chilling is that he so blithely considers a scan or a gene so definitive that he will defend a diagnosis of psychopathy in himself; does he also judge the subjects of his research on the basis of these abstractions rather than on their behavior?