The University entered a new era in the field of genetic research Monday with the formal launch of its Institute for Genome Sciences and Policy. During a day-long program that culminated with a panel discussion moderated by President Nan Keohane, officials from a diversity of backgrounds inaugurated the $200 million institute, which promises to catapult Duke to a prominent role in genome research and public policy.
The discussion was immediately preceded by a keynote address from panelist Dr. Richard Klausner, director of the National Cancer Institute and Medical School '77, who discussed the importance of genetic research but also explained some of the complexities involved in the relatively new field.
"The practical applications of genomics permeate all aspects of our culture and how we express ourselves," he told a crowd of about 300 gathered in Reynolds Theater. "The single most important and dramatic discussion in biology in the next century will play itself out at this type of institution."
Describing some of the specifics of cancer research, Klausner exalted the ability of genetic information to determine cancer risks. Cancer is caused by a "genetic instability," he explained, that results in diseased cells after a series of six to 10 stages. Using a person's genetic information, he continued, doctors are able to better determine a patient's susceptibility to certain cancers.
While he praised the value of such technology, Klausner warned about some of its pitfalls, including the public's ironic tendency to put too much value on genes."Genetics in virtually all cases is about shifting our understanding of risk, not about determining absolute fates," he said. "Genomic information is just one filter of probability."
This sentiment was echoed during the panel discussion. Recognizing the importance of genetic research, the participants focused on the ethical problems it raises for society, including the possibility of discrimination based on cancer risk. "If we joined every other industrialized nation in the world and guaranteed health insurance, that wouldn't be a problem at all," said Henry Greely, professor of law and genetics at Stanford University.
However, Greely added that even under the current system, insurance costs would only rise a small amount because even if genetic information reveals a greater risk for cancer, that risk is still usually very small.
"We have to worry about how we worry about this problem," he said. "If we get protective legislation, I'd say the cure is worse than the disease by reinforcing the idea that genetics determine our fate."
The issue of whether employers should have access to genetic information also raised concern among panelists. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, pointed out that such privacy is already a myth because emergency room patients must waive their rights to privacy. "If we think we are going to get privacy from our boss, I think we're kidding ourselves," he said, adding that genetic information also risks the privacy of family members whose genes are related to those of an employee.
Eventually returning to what they described as the public's ignorance about genetics, the experts emphasized the role that the new institute would play in debating ethical questions of genomics.
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