Putting the person into personalized medicine (redux)

Giving a bump to this essay from 2011 for my students in “Individuality in medicine from antiquity to the genome age.” Also took the opportunity to edit it lightly and fix a couple of formatting/coding glitches. (Sorry about the apparent broken image at the top–it doesn’t show up in the editor, so I can’t figure out how to fix it. Any broken sentences, however, are my own fault.)

https://scienceblog.com/genotopia/29/putting-the-person-in-personalized-medicine/

Risks of a genetic approach to crime prevention

I have a piece in the Hartford Courant‘s special set of editorials on the Sandy Hook tragedy. The headline-writer missed the point–I am not asking whether genetics could help in understanding and preventing such violence. Of course it can yield at least a partial explanation. My concern is the risk of any prevention program grounded in that genetic understanding. That way leads us toward pre-emptive medication of a class of “future criminals”–a frightening prospect indeed.

Adam Lanza
Adam Lanza [photo from The Blaze]
Here’s the piece.

The piece was written two weeks ago. Yesterday, Wayne Carver, the Connecticut Medical Examiner who ordered the genetic analysis, called it a “fishing expedition.” He continued, “but that doesn’t mean you don’t look.” Why doesn’t it? Only because you don’t see the risks as being greater than the benefits, however tiny they may be. My argument is that the risks are greater than we realize.

And in summary…

A quick thank you to the 126,000 or so eyeballs that fell upon these pages in 2012, and especially to fred bortz, misha, kw, and others who commented on my posts. Pushing boundaries and buttons can be a thankless task. So thank you. It really does help to have some encouragement in this.

According to WordPress, I am becoming known across teh Intertubes as a expert on “genotopia, dorkins, and thalassophilia.”

I also briefly fooled an MD (but not a nephrology social worker), ribbed and made friends with a genome exhibitionist, found pink ribbons in disturbing places, invented several new genes, and summoned an old eugenicist from the dead.

 

Hey, it’s a living–oh, wait…

Here’s the whole report:

http://jetpack.me/annual-report/20690792/2012/

 

 

Criminomics: stopping crime before it starts

Criminomics Bears Fruit: 2037 Murder Rate Lowest Since 1964

 

Dylan looks like any normal six-year-old. He is bright and a little mischievous, has many friends, and is praised by his teachers as a model student. But his normalcy is only skin deep. In his cells lies the DNA of a murderer.

Though Dylan has gene variants that give him a more than 90% chance of premeditated mass murder, he will never commit a crime. Thanks to early intervention by doctors, Dylan’s criminal tendencies were identified before birth. Rather than abort the fetus, however, Dylan’s parents agreed to an intensive program of medication and counseling that will all but ensure that Dylan will lead a happy, normal, peaceful life.

Dylan is one of the success stories of the Criminal Genome Project, or CGP, the effort to sequence the complete set of genes involved in murder and other antisocial behaviors. The controversial science on which this project is based—criminomics—is winning converts, now that the latest crime figures are in. Last year, the annual murder rates in 8 American cities dropped to double digits for the first time since the middle of the twentieth century. In Washington, DC, only 90 people died by gunshot last year, down from 103 in 2036. Experts attribute the drop to criminopathy, a medical and public-health approach to crime based on criminomics. The criminomic method uses high-speed genome sequencing to to identify criminal tendencies at birth and begin treatment early in life. Clinical trials for criminal-gene therapy, which would eliminate antisocial tendencies permanently, are underway and, though preliminary, are showing promising early results. The first criminopathic patients are just hitting their 20s now—and the peace is deafening.

The CGP is run by Dr. Bart O’Day, a criminomicist at the Baler Agricultural and Behavioral University in the Republic of Texas. O’Day wrote the grant proposal that funded the project after a tragic shooting at an elementary school in Connecticut in 2012 in which 20 children and 6 adults were killed by a lone gunman. Thankfully, such a crime has since become unimaginable, thanks to the efforts of O’Day and his colleagues.

“It was an obvious thing to do,” O’Day said. “In the years just before the CGP, we had sequenced the cancer genome, the influenza genome, the pseudome, the schizome, and the retardome. The criminome was just lying in wait for us. So the science was there. All we needed was the motivation.”

In fact, the motivation had been there for 150 years. In the 1870s, the Italian criminologist Cesare Lombroso defined a “criminal type,” characterized by distinctive facial features and, ironically, the excessive use of tattooing, which he used in one of the first systematic attempts to prevent crime by biological methods.[1] About the same time, the Victorian polymath Francis Galton developed “composite photography,” in which he superimposed images of faces as a means of identifying the “criminal type.” “If criminals are found to have certain special types of features, that certain personal peculiarities distinguish those who commit certain classes of crime,” observed Edmund DuCane, one of the leading criminologists of Victorian England, “the tendency to crime is in those persons born or bred in them, and either they are incurable or the tendency can only be checked by taking them in hand at the earliest periods of life.”[2]

With the creation of the science of genetics after the turn of the last century, vaguenesses such as “inborn tendencies” and “heredity” hardened into “genes.” In 1914, the American psychologist Henry H. Goddard wrote, “The criminal is not born; he is made.” Goddard traced criminality to mental retardation, or “feeble-mindedness,” in the term of the day. By compassionately treating feeble-mindedness, Goddard believed one could prevent crime. The feeble-minded type, Goddard wrote, was “misunderstood and mistreated, driven into criminality for which he is well fitted by nature. It is hereditary feeble-mindedness not hereditary criminality that accounts for the conditions.”[3] Goddard believed he had found a single Mendelian gene for feeble-mindedness. By breeding it out of the population, he thought he could eliminate crime, as well as poverty, prostitution, and much illness. Though the feeblemindedness gene has been discredited, Goddard’s belief that crime is a genetic disease rather than a perverse exercise of free will has transformed our criminal justice system.

The decisive step was in reframing crime in terms of public health rather than justice. In the early1990s, the National Institute of Alcohol, Drug Abuse, and Mental Health (today subsumed under the National Institute of Genomics) undertook a massive Violence Initiative based on similar principles. It pursued a public health approach to urban crime, which, proponents recognized, was based on biology (and therefore, ultimately, genes).[4] Uncontroversial at first, liberal opposition to the effort mounted, ultimately leading to the canceling of a scientific conference on genetic factors in crime in 1992.[5] This first Violence Initiative died a rather brutal and noisy death. Yet work on the biological basis of crime continued apace. In 1995, a Danish twin study identified the first crime gene, and more were identified shortly after the turn of the century.

But it was high-speed genome sequencing, combined with sophisticated methods of correlating complex behaviors with DNA sequence, that finally provided the technological breakthrough to stop crime before it starts. After the 2012 school shooting, it took a full year for O’Day’s team to sequence the criminal genome (today it could be done in an afternoon). But in 2014, they published paper describing 112 gene variants that together account for more than 99% of predisposition to murder. The genes were patented and licensed to pharmaceutical companies, and seven new targeted therapies were quickly added to the standard psychiatric armamentarium of anti-depressants and anti-psychotics. The federal Violence Initiative was reinstated in 2015 as the Institute of Crime Prevention (ICM), a branch of the National Institutes of Mental Health.

The first mandatory screening for criminal tendencies was put in place in Washington, DC, in 2018. Other states quickly followed; today, only West Dakota and North Virginia lack screening laws. Convicted murderers were the first to be screened. The ICM then tied crime screening to the back-to-school vaccination requirements for students in secondary and primary schools. Most states now test babies at birth, with blood from the standard heel-stick. Babies born with greater than 50% chance of committing murder have their standard RFID chips, implanted in every child at birth, encoded with the designation “Precrim.”

Individuals identified as precriminal are placed under the care of a criminopathic physician, assigned a health care worker, and given criminal prophylaxis: a treatment regimen tailored to their genetic and environmental circumstances. In all cases, this involves a combination of medications and counseling designed to maintain equanimity, promote sociality, and minimize the risk of triggers, including certain music and video games. Teachers and the parents of friends can discretely scan the child and take steps to minimize conflict and quickly intervene should violence erupt. Most states now prohibit the guardians of precrims from keeping firearms in their homes. NRA members oppose such bans, pointing out that since precrims can be dosed so as to ensure docility with a wide margin of safety, prohibiting guns in precrim homes is overkill.

Combined, these methods have proven remarkably effective. Murder rates began dropping as soon as the programs were put in place, but as the first neonatal precrims hit their teens, rates began to plummet. The rates of other violent crimes have also begun to fall, though somewhat more slowly: rapes are down in most states, as are armed robberies and even grafitti and illegal dumping. Scientists at the CGP explain these results by hypothesizing that many criminal behaviors share a common genetic mechanism, possibly related to emotional intelligence.

For all its success, the program has its opponents. Eugene Galton, a member of the Galton dynasty of scientific criminologists, recognizes the benefits of the criminopathy program but thinks the social costs are too high. “Liberty is too high a price to pay for safety,” he says. “We’re ceding our free will to an iatrocracy—a government by the doctors.”

Such philosophical musings carry little weight with inner-city residents who now sleep more peacefully, without the constant pops of gunfire that once punctuated the night. Dylan’s mother sees safety as the best kind of freedom: “I prefer a war with drugs to a War on Drugs,” she says. “I love my son; I’d rather put chemical bars around his mind than steel ones around his body.”


[2] Galton, “Composite portraits,” 143.

[4] Extrapolating slightly from Breggin, Reclaiming our children, p. 52.

[5] New York Times, Sept. 5, 1992, front page. See also Allen, Garland E. “Modern Biological Determinism: The Violence Initiative, the Human Genome Project, and the New Eugenics.” In The Practice of Human Genetics, 1-23, 1999.

 

Taking counsel (Review of Stern, Telling Genes)

I just read Alexandra Stern’s fine new history of genetic counseling, Telling Genes (Johns Hopkins, 2012; $40 cloth/$25 paper/ $15 Kindle). Though Alex is my friend, I review her book here because her subject relates so closely to the themes of Genotopia. Alex and I played leapfrog around some of the same archives as we researched. Telling Genes and The Science of Human Perfection are complementary—and I mean that in the nicest possible way. With that warning of possible conflict of interest, I want to examine her history of genetic counseling with the same “critical and sympathetic” analysis (3) that she applies to the history of genetic counseling itself.

Like medical genetics, the history of genetic counseling is intimately bound to that of eugenics. And like medical geneticists, genetic counselors have been trying to shake off these eugenic associations for many years. Stern, though highly sympathetic to today’s genetic counselors, won’t let that historical firewall stand. Unflinchingly, she drives home the eugenic connections in every chapter.

One of the most contentious issues in this history is where the history begins. Almost all genetic counselors today are Master’s level professional GCs. A Whig history of genetic counseling, then, might argue that the history began in 1969, with the founding of the first Master’s degree program in genetic counseling at Sarah Lawrence College. In contrast, a radical interested in showing the continuities with the darkest side of eugenics, might argue that the history began in 1910, with the founding of the Eugenics Record Office at Cold Spring Harbor. ERO staff advised people about many of the same things—likelihood of disease, of perpetuating family traits, of a particular racial parentage—that GCs still do today.

Stern takes a middle ground, beginning the history in 1941, with the founding of three independent research and counseling institutes for medical genetics: the Heredity Clinic in Ann Arbor, MI; the Family Record Office and Department of Medical Genetics at Wake Forest, and the Dight Institute of Human Genetics, in Minneapolis. These were conceived as Eugenics Record Offices attached to medical schools; collectively, they are known as the heredity clinics. At one of them (the Dight), the term “genetic counseling” was coined, by director Sheldon Reed, in 1947. Beginning here with these hybrid institutes—part ol’ time eugenics office, part modern genetic counseling facility— allows Stern considerable interpretive room. She allows the ambiguity and the tensions between individual and population to hang in the air, creating that kind of awkward pause in a conversation that makes a reflective person stop and think.

Timeline of genetic counseling
A (very) rough chronology of major events in the history of genetic counseling.

Stern does not, however, narrate the history chronologically. Rather, the history unfolds in a series of oscillations and resonances, in a series of analytic chapters organized by central concepts and problems in genetic counseling. Taking a thematic rather than chronological approach buys her a great deal of analytical substance, but it sacrifices narrative continuity. The arc of genetic counseling over the second half of the twentieth century doesn’t emerge until the end, and the reader must do the work of pulling out the major events and arranging them chronologically. Although the first chapter is titled “History,” it covers mainly the debate in the 1970s over the professionalization of the field. This is the only significant misstep in the book. A brief narrative account of the field—from the establishment of the Heredity Clinics in the early 1940s through the neo-eugenic 1950s, the emergence of genetic screening in the ‘60s, with the first Master’s level program at the end of the decade, through the profesionalization of the 70s and ‘80s, would have set the stage better for her later thematic analysis. I read the book with two graduate students, and both of them felt the lack of a chronological narrative to be a hindrance.

The remaining chapters cash in marvelously, often brilliantly, on the thematic organization. Chapter 2, “Genetic Risk,” looks at Huntington Disease, tracing the “shifting risk calculus” of the disease “as it crossed the transom of genetic testing and genetic counseling” (31). Stern notes that in lieu of effective therapies, more information and more precise diagnostics do not lessen—and perhaps increase—apprehension about the disease. Chapter 3, “Race,” focuses on questions of the population and the individual. Thinking in terms of populations, she argues, carries many tacit racial considerations into human genetics: “Population was never a neutral biogeographic term.” A harrowing and perceptive section on the methods of “racial matching” at the Dight Institute of Human Genetics in Minnesota and the Heredity Clinic in Michigan excavates a remarkable series of notebooks from the director, Sheldon C. Reed. Stern observes Reed simultaneously advocating publicly a liberal stance toward miscegenation as a solution to racial tension and advising adoptive parents on the goodness of fit of mixed-race children into a white family. Reed used an implicit “one drop rule,” At Michigan, James V. Neel—one of the pioneers of noneugenic medical genetics—also classified babies, according to a sort of Pantone series of skin tone. Stern allows this ambiguity to hang in the air, neither damning nor defending their inconsistency. These medical-genetic pioneers helped bring the field forward, but they were flawed, and Stern makes no apologies for them.

Chapter 4, on disability, focuses on the evolution of Mongolism to Down syndrome. In the 1940s, she shows, genetic counseling was built around a code of prevention (97). Gradually that code shifted to focus more on adaptation and adjustment, as families and patients’ rights groups have pressed for the acknowledgment of the disabled. These groups have understandably expressed concern over reproductive technologies and prenatal genetic screening, perceiving mandatory screening laws as an attack on the very existence of the disabled.

In chapter 5, “Women,” Stern relates the history of the founding of the Sarah Lawrence program in genetic counseling. Established in 1969 by Melissa Richter, it was brought to maturity by Joan Marks, who ran the program from Richter’s death in 1974 until 1998. Though mythologized as a moment when genetic counseling at last threw off its eugenic shackles, here too eugenic concerns mingle with sure-footed movements toward autonomy and informed consent. Richter, for all her sunny optimism and prescience, was a “neo-Malthusian,” couching her program proposal in the language of population explosion and mounting genetic “load,” Hermann J. Muller’s term for the accrual of mutations. Richter’s signal contribution was in establishing women as the foundation of modern genetic counseling—a startling echo (unnoted by Stern) of the long tradition of female “field workers” at the Cold Spring Harbor Eugenics Record Office in the teens and twenties. The medical community fought bitterly against the establishment of Master’s level genetic counseling, but the persistence of Richter and others persuaded physicians to cede jurisdiction over this critical but “softer” aspect of genetic medicine.

Chapter 6, on ethics, focuses on the shift from directive disease-centered eugenic counseling to nondirective, client-centered counseling. Here Stern takes us back to before the Heredity Clinics, to the psychologist Carl Rogers, who coined “nondirectiveness” in developing a new approach toward counseling victims of violence and abuse. She brings forward much fascinating and new material here, although her inference that Lee Dice and other Heredity Clinicians were borrowing directly from Rogers is circumstantial and, to me, not entirely persuasive. However, her analysis of the erosion of the concept of nondirectiveness is fascinating. She shows, surprisingly, that “nondirectiveness” has had a relatively short life. It didn’t enter the genetic counseling lexicon until the 1980s, and already by the 2000s it had begun to recede as the discipline’s gold standard, in favor of a more nuanced discussion about the strengths and limits of autonomy and consent.

The final chapter shifts categories to look at a recent methodological development: prenatal genetic diagnosis and its uneasy marriage with genetic counseling. This provides her with a vehicle for examining developments in genetic counseling since the 1970s. Her analysis of the rise of amniocentesis is a valuable contribution to literature by Rayna Rapp, Ruth Schwartz Cowan, and Robert Resta, among others. A conclusion briefly examines current-day practices and, in an original analytical move, closes by considering the possibility that the history of genetic counseling may be drawing to a close. As genomic medicine works to treat all disease as genetic in origin, the concept of genetic disease is gradually eroding. If genetics dissolves into biology, what exactly will genetic counselors counsel about? Stern closes with a call for genetic counselors to examine their history as a means of ensuring their future.

Yet if the juggernaut of geneticization continues unabated, there will always be a need for a medical-genetic middleman—or middle-person. Someone with serious genetic training but also skilled in psychology, ethics, and education. Someone whose time is not metered in quarter-hour increments (and billed in C-notes). Telling Genes is unflinching in tracing our hereditarian past, but sympathetic toward and highly supportive of those compassionate professionals who guide the rest of us into an ever more genetic future. It should be widely read, by genetic counselors, by clinicians, by future parents, and by anyone who is or knows someone who is affected by genetic disease.

New findings suggest scientists not getting smarter

Certain critics of rigid genetic determinism have long believed that the environment plays a major role in shaping intelligence. According to this view, enriched and stimulating surroundings should make one smarter. Playing Bach violin concertos to your fetus, for example, may nudge it toward future feats of fiddling, ingenious engineering, or novel acts of fiction. Although this view has been challenged, it persists in the minds of romantics and parents–two otherwise almost non-overlapping populations.

If environmental richness were actually correlated with intelligence, then those who live and work in the richest environments should be measurably smarter than those not so privileged.  And what environment could be richer than the laboratory? Science is less a profession than a society within our society–a meritocracy based on an economy of ideas. Scientists inhabit a world in which knowledge accretes and credit accrues inexorably, as induction, peer review, and venture capital fuel the engines of discovery and innovation. Science has become the pre-eminent intellectual enterprise of our time–and American science proudly leads the world. The American biomedical laboratory is to the 21st century what the German university was to the 19th; what Dutch painting was to the 17th; the Portuguese sailing ship to the 16th; the Greek Lyceum to the minus 5th.

According to this view, then, scientists should be getting smarter. One might measure this in various ways, but Genotopia, being quantitatively challenged, prefers the more qualitative and subjective measure of whether we are making the same dumb mistakes over and over. So we are asking today: Are scientists repeating past errors and thus sustaining and perhaps compounding errors of ignorance? Are scientists getting smarter?

Yes and no. A pair of articles (12) recently published in the distinguished journal Trends in Genetics slaps a big juicy data point on the graph of scientific intelligence vs. time–and Senator, the trend in genetics is flat. The articles’ author, Gerald Crabtree, examines recent data on the genetics of intelligence. He estimates that, of the 20,000 or so human genes, between 2,000 and 5,000 are involved in intelligence. This, he argues, makes human intelligence surprisingly “fragile.” In a bit of handwaving so vigorous it calls to mind the semaphore version of Wuthering Heights, he asserts that these genes are strung like links in a chain, rather than multiply connected, as nodes of a network. He imagines the genes for intelligence to function like a biochemical pathway, such that any mutation propagates “downstream”, diminishing the final product–the individual’s god-given and apparently irremediable brainpower.

IQIQ

Beginning in 1865, the polymath Francis Galton fretted that Englishmen were getting dumber. In his Hereditary Genius (1865) he concluded that “families are apt to become extinct in proportion to their dignity” (p. 140). He believed that “social agencies of an ordinary character, whose influences are little suspected, are at this moment working towards the degradation of human nature,” although he acknowledged that others were working toward its improvement. (1) The former clearly outweighed the latter in the mind of Galton and other Victorians; hence Galton’s “eugenics,” an ingenious scheme for human improvement through the machinations of “existing law and sentiment.” Galton’s eugenics was a system of incentives and penalties for marriage and childbirth, meted out according to his calculations of social worth.This is a familiar argument to students of heredity. The idea that humans are degenerating–especially intellectually–persists independently of how much we know about intelligence and heredity. Which is to say, no matter how smart we get, we persist in believing we are getting dumber.

Galton was just one exponent of the so-called degeneration theory: the counter-intuitive but apparently irresistible idea that technological progress, medical advance, improvements in pedagogy, and civilization en masse in fact are producing the very opposite of what we supposed; namely, they are crippling the body, starving the spirit, and most of all eroding the mind.

The invention of intelligence testing by Alfred Binet just before the turn of the 20th century provided a powerful tool for proving the absurd. Though developed as a diagnostic to identify children who needed a bit of extra help in school–an enriched environment–IQ testing was quickly turned into a fire alarm for degeneration theorists. When the psychologist Robert M. Yerkes administered a version of the test to Army recruits during the first world war, he concluded that better than one in eight of America’s Finest were feebleminded–an inference that is either ridiculous or self-evident, depending on one’s view of the military.

These new ways of quantifying intelligence dovetailed perfectly with the new Mendelian genetics, which was developed beginning in 1900. Eugenics—a rather thin, anemic, blue-blooded affair in Victorian England, matured in Mendelian America into a strapping and cocky young buck, with advocates across the various social and political spectra embracing the notion of hereditary improvement. Eugenics advocates of the Progressive era tended to be intellectual determinists. Feeblemindedness–a catch-all for subnormal intelligence, from the drooling “idiot” to the high-functioning “moron”—was their greatest nightmare. It seemed to be the root of all social problems, from poverty to prostitution to ill health.

And the roots of intelligence were believed to be genetic. In England, Cyril Burt found that Spearman’s g (for “general intelligence”)—a statistical “thing,” derived by factor analysis and believed by Spearman, Burt, and others to be what IQ measures—was fixed and immutable, and (spoiler alert) poor kids were innately stupider than rich kids. In America, the psychologist Henry Goddard, superintendent of the Vineland School for the Feebleminded in New Jersey and the man who had introduced IQ testing to the US, published Feeblemindedness: Its Causes and Consequences in 1914. Synthesizing years of observations and testing of slow children, he suggested–counter to all common sense–that feeblemindedness was due to a single Mendelian recessive gene. This observation was horrifying, because it made intelligence so vulnerable–so “fragile.” A single mutation could turn a normal individual into a feebleminded menace to society.

As Goddard put it in 1920, “The chief determiner of human conduct is the unitary mental process which we call intelligence.” The grade of intelligence for each individual, he said, “is determined by the kind of chromosomes that come together with the union of the germ cells.” Siding with Burt, the experienced psychologist wrote that intelligence was “conditioned by a nervous mechanism that is inborn, and that it was “but little affected by any later influence” other than brain injury or serious disease. He called it “illogical and inefficient” to attempt any educational system without taking this immovable native intelligence into account. (Goddard, Efficiency and Levels of Intelligence, 1920, p 1)

This idea proved so attractive that a generation of otherwise competent and level-headed reserchers and clinicians persisted in believing it, again despite it being as obvious as ever that the intellectual horsepower you put out depends on the quality of the engine parts, the regularity of the maintenance you invest in it, the training of the driver, and the instruments you use to measure it.

The geneticist Hermann Joseph Muller was not obsessed with intelligence, but he was obsessed with genetic degeneration. Trained at the knobby knees of some of the leading eugenicists of the Progressive era, Muller–a fruitfly geneticist by day and a bleeding-heart eugenicist by night–fretted through the 1920s and 1930s about environmental assaults on the gene pool: background solar radiation, radium watch-dials, shoestore X-ray machines, etc. The dropping of the atomic bombs on the Japanese sent him into orbit. In 1946 he won a Nobel prize for his discovery of X-ray-induced mutation, and he used his new fame to launch a new campaign on behalf of genetic degeneration. The presidency of the new American Society of Human Genetics became his bully pulpit, from which he preached nuclear fire and brimstone: our average “load of mutations,” he calculated, was about eight damaged genes–and growing. Crabtree’s argument thus sounds a lot like Muller grafted onto Henry Goddard.

In 1968, the educational psychologist Arthur Jensen produced a 120-page article that asserted that compensatory education–the idea that racial disparities in IQ correlate with opportunities more than innate ability, and accordingly that they can be reduced by enriching the learning environments of those who test low–was futile. Marshaling an impressive battery of data, most of which were derived from Cyril Burt, Jensen insisted that blacks are simply dumber than whites, and (with perhaps just a hint of wistfulness) that Asians are the smartest of all. Jensen may not have been a degenerationist sensu strictu, but his opposition to environmental improvement earns him a data point.

In 1990, Richard Herrnstein and Charles Murray published their infamous book, The Bell Curve. Their brick of a book was a masterly and authoritative rehash of Burt and Jensen, presented artfully on a platter of scientific reason and special pleading for the brand of reactionary politics that is reserved for those who can afford private tutors. They found no fault with either Burt’s data (debate continues, but it has been argued that Burt was a fraud) or his conclusion that IQ tests measure Spearman’s g, that g is strongly inherited, and that it is innate. Oh yes, and that intellectually, whites are a good bit smarter than blacks but slightly dumber than Asians. Since they believed there is nothing we can do about our innate intelligence, our only hope is to “marry up” and try to have smarter children.

The Bell Curve appeared just at the beginning of the Human Genome Project. By 2000 we had a “draft” reference sequence for the human genome, and by 2004 (ck) “the” human genome was declared complete. Since the 1940s, human geneticists had focused on single-gene traits, especially diseases. One problem with Progressive era eugenics, researchers argued, was that they had focused on socially determined and hopelessly complex traits; once they set their sights on more straightforward targets, the science could at last advance.

But once this low-hanging fruit had been plucked, researchers began to address more complex traits once again. Disease susceptibility, multicausal diseases such as obesity, mental disorders, and intelligence returned to the fore. Papers such as Crabtree’s are vastly more sophisticated than Goddard’s tome. The simplistic notion of a single gene for intelligence is long gone; each of Crabtree’s 2,000-5,000 hypothetical intelligence genes hypothetically contributes but a tiny fraction of the overall. If you spit in a cup and send it to the personal genome testing company 23AndMe, they will test your DNA for hundreds of genes, including one that supposedly adds 7 points to your IQ (roughly 6 percent for an IQ of 110).

Thus we are back around to a new version of genes for intelligence. Despite the sophistication and nuance of modern genomic analyses, we end up concluding once again that intelligence is mostly hereditary and therefore also racial, and that it’s declining.

Apart from the oddly repetitious and ad hoc nature of the degeneration argument, what is most disconcerting is this one staring implication: that pointing out degeneration suggests a desire to do something about it. If someone were, say, sitting on the couch and called out, “The kitchen is sure a mess! Look at the plates all stacked there, covered with the remains of breakfast, and ick, flies are starting to gather on the hunks of Jarlsberg and Black Twig apples hardening and browning, respectively, on the cutting board,” you wouldn’t think he was simply making an observation. You’d think he was implying that you should get in there and clean up the damn kitchen. Which would be a dick move, because he’s just sitting there reading the Times, so why the heck doesn’t he do it himself. But the point is, sometimes observation implies action. If you are going to point out that the genome is broken, you must be thinking on some level that we can fix it. Thus, degeneration implies eugenics. Not necessarily the ugly kind of eugenics of coercive sterilization laws and racial extermination. But eugenics in Galton’s original sense of voluntary human hereditary improvement.

And thus, scientists do not appear to be getting any smarter. Despite the enriched environs of the modern biomedical laboratory, with gleaming toys and stimulating colleagues publishing a rich literature that has dismantled the simplistic genetic models and eugenic prejudices of yore, researchers such as Crabtree continue to believe the same old same old: that we’re getting dumber–or in danger of doing so.

In other words, sometimes the data don’t seem to matter. Prejudices and preconceptions leak into the laboratory, particularly on explosive issues such as intelligence and/or race, regardless of how heredity is constructed. Plenty of scientists are plenty smart, of course. But rehashing the degeneracy theory of IQ does not demonstrate it.

Life imitates satire–and scholarship

Two recent items, one funny, one thoughtful:

  • Over at Cognoscenti, a blog sponsored by WBUR in Boston, Darshak Sanghavi writes about the problems with meta-analysis of clinical trials. I agree with the basic principle that meta-analyses need to be handled with more care than they probably are, but I smiled when I reached the end:

The researchers found the meta-analyses would have led doctors to adopt useless treatments one-third of the time, and to reject helpful therapies another one-third of the time. After this debacle, why would anyone take the findings of meta-analyses very seriously?

Unfortunately, people do. In only the past month, various meta-analyses have been published in all manner of medical journals, arguing the magnesium can cut colon cancer rates, new drugs stop clots in heart rhythm problems, cholesterol drugs reduce cancer, and my recent favorite, that a gene called Pol-9 turns people into Republicans.

Pol-9, of course, was invented here at Genotopia, where truth lies. Sanghavi apparently didn’t get the pun of the specific allele involved being called Bol-X (“bollocks”). Never mind the meta-analysis: here’s the satire.

We live for such moments.

  • Second, over at The DNA Exchange, the genetic counselor Bob Resta has written another trenchant reflection on the profession he loves, titled provocatively, “Resistance is futile: a new paradigm for genetic counseling?”. Genetic counseling began as a way to help patients cope with genetic disease (as well as determine paternity and racial membership). Is the rapidly dropping cost of genetic testing leading to a situation in which everyone is a patient? Is this a good thing?

As I write in The Science of Human Perfection, elite biomedicine is indeed leading directly to such a situation. The Dean of Education at the Johns Hopkins School of Medicine said recently that a principal goal of genetic medicine was to identify “latent disease,” and treat it before it starts. When I asked him who, under that scenario, was a patient, he smiled broadly and said, “We are all patients now.” I find this not a little creepy, and so does Bob.

Full disclosure: Bob’s piece concludes with a nice plug of my book and Alexandra Stern’s new history of genetic counseling, Telling Genes (which I plan to review here soon). Aside from whatever nepotism is called when it’s between colleagues, Bob’s piece is important reading.

UPDATE: Here’s another article on eugenics and genetic counseling, just out today, from blogger Adam Turner.

Exercise your franchise!

…have you?

Pinxploitation: The grand finale

Here’s a level-headed article by Virginia Postrel, who finds that cancer comes in more shades than pink. Who knew?

And here are a few more images to finish out the month. It’s Halloween–and what could be sexier and scarier than breast cancer? If you hurry, you may still be able to run down to Walgreen’s drug store and pick up one of these babies:

And if you need to hold something in place, just use your handy breast cancer stapler (these really do have awkward resonances, don’t they?)

More stationery for the cure…

We got breast cancer snacks:

…and breast cancer juice:

…AAAAnd breast cancer water. Bottoms up! That’s all I got.

Unsexy pinxploitation

Good article in USA today about the way some of the breast cancer awareness promotions grossly sexualize and objectify women. This isn’t awareness–it’s just plain old-fashioned brainless ogling. (Tip of the hat to Andrea Kuszewski)