There was no room full of "undecided voters," no Jim Lehrer to run the show and not a single flustered or strident presidential candidate. But when experts squared off yesterday on two issues of access to genetic information, the debate was feisty nonetheless.
The debate, sponsored by the North Carolina Association for Biomedical Research and the N.C. School of Science and Mathematics, examined two questions in which biotechnology meets social concern: Should police be able to take DNA samples from criminals? And should health insurers be prohibited from using genetic information to set coverage and rates?
Paul Ferrara, who, as the director of the Virginia Division of Forensic Science, has appeared on 60 Minutes and Dateline NBC, advocated a system like Virginia's, where all convicted felons are required to provide blood samples that are converted into genetic fingerprints. These fingerprints, which are comprised of genetic sequences at 13 noncoding regions in the DNA, are then listed in an electronic database.
Virginia's databank has proved to be a crucial crime-solving tool, Ferrara asserted. He said Virginia's police have found over 200 "hits"-cases where DNA evidence from the crime scene matched database DNA, helping to solve crimes where the police had no suspects and no other evidence from which to create a profile of the perpetrator.
Deborah Ross, a lawyer at the American Civil Liberties Union of North Carolina, countered that a system of genetic sampling in the justice system, especially of those arrested and not yet convicted of a crime, is invasive, unconstitutional and vulnerable to abuse.
"There are too many private interests that want access to that DNA," Ross told the audience of high school students, scholars and public health professionals. "Do you know how much drug companies would love to get their hands on that DNA? Do you know how much researchers would love to get their hands on it? These aren't just scare tactics. This stuff happens."
Ross maintained that the cost of genetic sampling was not only social but financial as well.
"It takes a lot of money to take a person's DNA," she said. "If we want to solve these crimes, how would you want to use the money? Would you want to use it to get a couple hundred hits, or would you want to use it to put more cops on the street to prevent crime?"
The next debate topic-whether health insurers should be allowed to use genetic information to set coverage and rates-pitted Lauren Dame, who in the spring will lecture on health law and bioethics at Duke's School of Law, against Mark Hall, a professor of law and public health at Wake Forest University.
Dame warned that though "genetic information has an aura of inevitability," it is unreliable in actually determining when and whether a person will develop disease. She also argued that the use of genetic information by health insurers may frighten some away from obtaining insurance.
"Genetic information may prove to be a bit of a Pandora's box," Dame said. "Because of the sensitivity of the information, we should be very careful before we use it to classify individuals in any way, especially for uses of health insurance."
Dame said health insurers' access to genetic information would inevitably divide the population into ever-smaller risk pools and undermine the very idea of shared risk. "Do we really want a system that protects health insurance for the healthy and says `tough luck' to the rest?" she asked.
Hall, the Wake Forest law professor, answered that the threat of genetic discrimination in health insurance coverage "is all sort of overblown anyway."
He reminded the audience that genetic information is already used in the insurance system-by automobile insurers, who set differential premiums for male and female drivers.
"You want to pay based on personal risk characteristics, and that's what's considered fair," Hall said. "If you force insurers to stop using the best available information, you force them to use less accurate evaluation methods" to make the same pricing decisions, he said.
Hall recounted how he had conducted a study of the health insurance industry and found no evidence of genetic discrimination occurring anywhere-regardless of state laws prohibiting or allowing genetic discrimination in the health industry. "We treat genetic information as somehow scarier and more threatening than other threats to our privacy, and it's not," he said.
Get The Chronicle straight to your inbox
Signup for our weekly newsletter. Cancel at any time.