The predictions are awesome: In 10 years, there will be genetic tests to predict your chances of getting diabetes, heart disease, asthma, mental illness and several common cancers. In 30 years, you will be able to get your complete genetic blueprint for $1,000. In 40 years, gene-based drug treatments will be available for most diseases. Average life expectancy will reach 90 years.
This is the vision of Francis S. Collins, who heads the National Human Genome Research Institute at the National Institutes of Health. It is a future where people can lead longer, better lives, thanks to the benefits of the genetics revolution in which all the human genes are identified and treatments are genetically designed on an individual basis to stall or prevent illness and disability. The potential is enormous--preventing breast cancer, managing depression, slowing down the aging process.
Collins is an optimist when it comes to science.
But he is a pessimist when it comes to how science may be misused and abused in the future.
In 30 years, he predicts, major anti-technology movements will be active in the United States and around the world. He also foresees widening inequities in who will benefit from genetic advances.
In part, his pessimism is rooted in history. Some people are inherently suspicious of science and technology--and with good reason. The splitting of the atom was followed by the Bomb Scare Era, with people scrambling for fallout shelters. The accident at Three Mile Island reawakened public fears of nuclear power. More recently, the uproar in Europe over genetically manipulated foods has raised the specter of mad scientists "messing with nature."
News headlines about cloning pets and failed gene therapy experiments give the impression of science running out of control. Movies such as "Gattaca" titillate flawed fantasies of genetically designing offspring. Call it the Frankenstein syndrome, a well established public perception that scientists are playing God.
Anything to do with genes is particularly susceptible to the Frankenstein syndrome. It's threatening because of the "genes-R-us" philosophy--the feeling that genes are the essence of our identity. There's the suspicion that changing DNA is akin to changing identity. "It gets people where they live," says Collins.
But to scientists, DNA is not the whole story of identity. "DNA is just a chemical," Collins says. "We're a lot more than our DNA sequences."
The hope is that as the field of genetics produces some tangible benefits in managing and preventing disease, DNA will lose some of its sacred aura--and designing treatments based on genetic information will become less frightening to the public. As Collins explained in an online discussion with The Washington Post: "Knowledge is neither good nor evil--it's the uses we put it to that determines whether the revolution in human genetics, which is getting underway right now in a big way, will be seen by the public as a godsend or a curse."
At the moment, the genetics revolution has stalled after the widely publicized death of a gene therapy patient at the University of Pennsylvania and the general failure of gene therapy to cure disease. After nearly 10 years of experimentation, the ability to insert a new gene into a patient's body to change the course of disease is proving much more difficult than researchers thought.
But the history of medicine is filled with false starts and detours. Remember the early days of heart transplants and the fiasco of the artificial heart? And yet researchers persisted, improving the success rates for transplants and finding better ways to treat heart disease.
The same will be true for genetics. Gene therapy may work only for a few rare diseases--or it may go the way of the artificial heart. But genomics, the science of genes, is much broader than this particular experiment. It holds the promise of finding new ways to reduce the toll of disease, stave off aging and improve memory.
Over the next century we will all be guinea pigs in the genetics revolution. In fact, NIH is likely to conduct a human study to extend the maximum human life span in the year 2030. Maybe that's a study you'd like to sign up for.