People, Populations, Genetics

Went to the Forum for the Humanities and Medicine, University of Hong Kong on 27 April 2009. Well, long time ago already, have been trying to write it up, but often got distracted by more important tasks (e.g. thesis); but anyway, always like to attend multi-disciplinary conference.

Prof Daniel Chua first declared a ‘no fear zone’ for everyone becoz we are all coming from different background and to encourage discussion, no questions should be regarded as stupid. He also urged the participants to get involved in the discussion while the speaker is just there for providing background information. Instead of acquiring knowledge, everyone should be donors.

First speaker was Dr Robert Peckham (from the Dept of History, HKU) with a topic, Genomic Identities. He mentioned the research in genomics would change a biology lab to computer lab. I didn’t get too much from it his talk.

It was then followed by Dr Ron Zimmern from Hughes Hal, Cambridge, and PHG Foundation and gave a talk on topic, ‘Populations, Genetics, Risk’. He mentioned Nuffield Councils Intervention Ladder.

do nothing

provide information

enable choice

guide choice by changing the default policy

guide choice through incentives

guide choice through disincentives

restrict choice

eliminate choice

Population risk vs individual risk
He asked a few questions, but I can just copy three down:

extent to which it is considered legitmate for a state to attempt to change the behavior of its citizens to improve their health

whether any moral or social distribution exists between the four categories of public health activity

relevance and implication of the distinctions between a nudging & shoring and preferred preference and preference simp-liter

Dr Max Dentsch, Dept of Philosophy, HKU shared a talk on ‘Gene’ and Experimental Philosophy of Science. He split his talk into two main parts: what’s experimental philosophy (xphi)? and what’s applied to philosophy of genetics.
Traditionally philosophy requires one to think for most of the time and question what is intuitively true; whereas xphi must go out and ask people what they think about a case. it’s done systematically. for example, they found different biologists had no significantly different in defining what a gene is. However, when asked with ‘how a gene works?’ the answer varies with different training a biologist receives. This observation matters to interdisciplinary communication and how hard science is packaged for mass consumption. Moreover, xphi may be useful for understanding how different people understand certain key philosophy concept. This is different from psychology where xphi focus on how people think and psychology focus on what’s true about people’s thoughts.

Prof Pak Sham, Dept of Pycharity, HKU, lead everyone to think about “From genomics to humanity”. For example, can having understood how genes work in everyone lead to universal improvement, and can having understood how genes cause difference between people enable us to develop personal genomics. While we haven’t seen much benefits at the moment, we do recognize some of the potential misuse of the genomics information from our history. For example, Eugenics. Plato suggests “marriage number” where “the quality of the individual would be quantitatively analyzed, and persons of high numbers would be allowed to procreate with other persons of high numbers. In theory, this would lead to predictable results and the improvement of the human race.” Galton also observed low fertility among the intelligent. Pak suggested some possible safeguards, that include increasing public understanding, open & balanced debate, legislation and pointed out there is indeed limitation in the prediction of disease risk.

Personal Genomics is analysis of the DNA sequence of an individual to gain information that may be useful for improving the individual health or other benefits, where the levels of genetic analysis include heritability, gene finding and gene function, where the last one aims to find all specific sequence variants that contribute to heritability. Pak mentioned while we are having more understanding to our genome, we have only discovered a small percentage of genetics causes to our disease risk.

The discussion of genetics risk was brought further by next speakers, Prof Richard Fielding and Dr Dennis Ip, from School of Public Health, HKU, with a topic, “New Gene Blues: Fitting genetics to populations”. Fitting genetics for populations is to get genetic ideas from populations. But in any case, genes are not disease but different forms of a gene (e.g. different variants) would give risks or benefits to an individual given a particular environment. So, natural selection is on traits, not genes. A simple question like, ‘Is obesity a disease?’ gives a good illustration. Given high fat diet, a normal person with normally functional gene should get fat. It is the high fat diet (the environment) AND a normal body (genes) give rise to a ‘disease’, NOT a set of defective genes. In fact, population allele frequencies change very slowly. On the other hand, environments can and do change quite rapidly within a generation. The idea of personalized medicine is shifting the responsibility of risk to individual and ultimately bear the cost. More information provided implies no responsibility from the provider, even for drug. and because the responsibility is now shifted to the consumer, many different information are going to be distorted as long as people can make money on them. This may also lead to a shift of responsibility of the public health community from providing the public with epidemiology data, to accessing the validity of information in a market. The speaker ends the speech by asking the audience which way they prefer for their future, “Find your way” vs “Trust your guidance”. I think it’s very difficult to “Trust your guidance” when you know you can do better, but on the other hand, it’s also difficult to “Find your way” for all the ways in life. I think keeping things transparent is going to be more and more important when the world has more and more information, and then “Find your way” and “Trust your guidance” may both work fine :p.

Final talk was given by Prof Suet Yi Leung from Department of Pathology, HKU on “Genetic Testing for Hereditary Disease: Risk, Prevention, Self-Perception”. She shared her experience in using genetic information to help diagnose and then prevent patients from developing colorectal and endometrial cancers. As illustrated by many mendelian disease, genetic information does help in prevention and diagnosis, but how much it can be extended to complex disease is a question. She also shared her recent findings on ‘Heritable somatic methylation and inactivation of MSH2 in families with Lynch syndrome due to deletion of the 3′ exons of TACSTD1′ which has published in Nature Genetics 41, 112 – 117 (2008). I found this study particularly interesting, from which I may learn something to give future direction to my own PhD project.