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Geneticization and bioethics: advancing debate and research

  • Vilhjálmur Árnason
  • Stefán Hjörleifsson
Scientific Contribution

Abstract

In the present paper, we focus on the role that the concept of geneticization has played in the discussion about health care, bioethics and society. The concept is discussed and examples from the evolving discourse about geneticization are critically analyzed. The relationship between geneticization, medicalization and biomedicalization is described, emphasizing how debates about the latter concepts can inspire future research on geneticization. It is shown how recurrent themes from the media coverage of genetics portray typical traits of geneticization and thus contribute to the process. We look at examples of small-scale studies from the literature where geneticization of medical practice has been demonstrated. Methodological disputes about the relevance of empirical evidence for the geneticization thesis and the normative status of the concept are discussed. We consider arguments to the effect that ideas from mainstream bioethics have facilitated geneticization by emphasizing individualistic notions of autonomy and responsibility while ignoring the role of genetics in the wider social context. It is shown how a concept like geneticization, which can be used to draw the attention of philosophers, social scientists and others to challenges that tend to be neglected by mainstream bioethics, also has the potential to move people’s attention away from other pertinent issues. This may happen if researchers become preoccupied with the transformative effects of genetics, and we argue that a wider reading of geneticization should inspire critical analysis of the sociocultural preconditions under which genetics is currently evolving.

Keywords

bioethics geneticization genetics medicalization responsibility 

References

  1. Árnason V. 2005, Sensible Discussion in Bioethics. Reflections on Interdisciplinary Research. Cambridge Quarterly of Health Care Ethics 14, 322–328PubMedGoogle Scholar
  2. Ashcroft R.E. 2003, Constructing Empirical Bioethics: Foucauldian Reflections on the Empirical Turn in Bioethics Research. Health Care Analysis 11, 3–13CrossRefPubMedGoogle Scholar
  3. Bubela T.M., T.A. Caulfield 2004, Do the Print Media “Hype” Genetic Research? A Comparison of Newspaper Stories and Peer-Reviewed Research Papers. Canadian Medical Association journal 170, 1399–1407CrossRefPubMedGoogle Scholar
  4. Buchanan A., D.W. Brock, N. Daniels, D. Wikler 2000, From Chance to Choice. Genetics and Justice. Cambridge, UK: Cambridge University PressGoogle Scholar
  5. Chadwick, R. and M. Levitt: 1997, ‘Complementarity: Multidisciplinary Research in Bioethics’ in: S. Gindro et al. (eds.), Bioethics Research: Policy, Methods and Strategies. Proceedings of a European Conference (European Commission), pp. 73–82Google Scholar
  6. Clarke A.E., J.K. Shim, L. Mamo, J.R. Fosket, J.R. Fishman: 2003, Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine. American Sociological Review 68, 161–194CrossRefGoogle Scholar
  7. Collins F.S., A.E. Guttmacher 2001, Genetics Moves Into the Medical Mainstream. Journal of the American Medical Association 286, 2322–2324CrossRefPubMedGoogle Scholar
  8. Condit C., N. Ofulue, K. Sheedy 1997, Determinism and Mass Media Portrayals of Genetics. American Journal of Human Genetics 62, 979–984CrossRefGoogle Scholar
  9. Conrad P. 1999, Uses of Expertise: Sources, Quotes, and Voice in the Reporting of Genetics in the News. Public Understanding of Science 8, 285–302CrossRefGoogle Scholar
  10. Conrad P. 2001, Genetic Optimism: Framing Genes and Mental Illness in the News. Culture, Medicine and Psychiatry 25, 225–247CrossRefPubMedGoogle Scholar
  11. Conrad P., J.W. Schneider: 1992, Deviance and Medicalization. From Badness to Sickness. Philadelphia: Temple university pressGoogle Scholar
  12. Department of Health: 2003, ‹Genetic White Paper “Our Inheritance, Our Future, Realising the Potential of Genetics in the NHS”’ Department of HealthGoogle Scholar
  13. Foucault, M.: 1980, ‘Two Lectures. Lecture Two’ Power/Knowledge. Brighton: The Harvester Press, pp. 92–108Google Scholar
  14. Getz L., A.L. Kirkengen 2003, Ultrasound Screening in Pregnancy: Advancing Technology, Soft Markers for Fetal Chromosomal Aberrations, and Unacknowledged Ethical Dilemmas. Social Science & Medicine 56, 2045–2057CrossRefGoogle Scholar
  15. Gibbon S.: 2002, Re-Examining Geneticization: Family Trees in Breast Cancer Genetics. Science as Culture 11, 429–457CrossRefPubMedGoogle Scholar
  16. Hall E. 2005, The ‘Geneticisation’ of Heart Disease: A Network Analysis of the Production of New Genetic Knowledge. Social Science & Medicine 60, 2673–2683CrossRefGoogle Scholar
  17. Halliday J.L., V.R. Collins, M.A. Aitken 2004, Genetics and Public Health—Evolution or Revolution. Journal of Epidemiology & Community Health 58, 894–899CrossRefGoogle Scholar
  18. Hedgecoe A. 1998, Geneticization, Medicalisation and Polemics. Medicine, Health Care and Philosophy 1, 235–243CrossRefGoogle Scholar
  19. Hedgecoe A. 2001, Ethical Boundary Work: Geneticization, Philosophy and the Social Sciences. Medicine, Health Care and Philosophy 4, 305–309CrossRefGoogle Scholar
  20. Hedgecoe A. 2004, Reinventing Diabetes: Classification, Division and the Geneticization of Disease. New Genetics and Society 21, 7–27CrossRefGoogle Scholar
  21. Hildt E. 2002, Autonomy and Freedom of Choice in Prenatal Genetic Diagnosis. Medicine, Health Care and Philosophy 5, 65–71CrossRefGoogle Scholar
  22. Hoedemaekers R.: 2001, ‘Geneticization’ in: R. Chadwick (ed.), The Concise Encyclopedia of the Ethics of New Technologies. San Diego, Cal: The Academic PressGoogle Scholar
  23. Hoedemaekers R., H. ten Have 1998a, Commercialisation of Genetic Diagnostic Services. Medicine, Health Care and Philosophy 1, 217–224CrossRefGoogle Scholar
  24. Hoedemaekers R., H. ten Have 1998b, Geneticization: The Cyprus Paradigm. Journal of Medicine and Philosophy 23, 274–287CrossRefPubMedGoogle Scholar
  25. Hoeyer K.L., R. Tutton 2005, ‘Ethics was Here’ Studying the Language-Games of Ethics in the Case of UK Biobank. Critical Public Health 15, 385–397CrossRefGoogle Scholar
  26. Holtz, T.H., S. Holmes, S. Stonington and L. Eisenberg: 2006, ‘Health Is Still Social: Contemporary Examples in the Age of the Genome’ PLoS Medicine 3Google Scholar
  27. Holtzman N.A., T.M. Marteau 2000, Will Genetics Revolutionize Medicine? New England Journal of Medicine 343, 141–144CrossRefPubMedGoogle Scholar
  28. Häyry M. 2003, European Values in Bioethics: Why, What, and How to be Used? Theoretical Medicine 24, 199–214CrossRefGoogle Scholar
  29. Illich I.: 1995, Limits to Medicine. Medical nemesis: The Expropriation of Health. London: Marion BoyarsGoogle Scholar
  30. Kerr A. 2004, Genetics and Society. A Sociology of Disease. London: RoutledgeGoogle Scholar
  31. Kerr A. 2005, Understanding Genetic Disease in a Socio-Historical Context: A Case Study of Cystic Fibrosis. Sociology of Health & Illness 27, 873–896CrossRefGoogle Scholar
  32. Kitzinger, J., L. Henderson, A. Smart and J. Eldridge: 2002, ‘Media Coverage of the Ethical and Social Implications of Human Genetic Research’ The Wellcome TrustGoogle Scholar
  33. Levitt M. 2004, Complementarity Rather than Integration. Medicine, Health Care and Philosophy 7, 81–83CrossRefGoogle Scholar
  34. Lippman A. 1991, Prenatal Genetic Testing and Screening: Constructing Needs and Reinforcing Inequities. American journal of law & medicine 17, 15–50Google Scholar
  35. Lippman A. 1999, The Human Genome Project: Perilous Promises? Medicine, Health Care and Philosophy 2, 47–49CrossRefGoogle Scholar
  36. Meiser B., P.B. Mitchell, H. McGirr, M. Van Herten, P.R. Schofield 2005, Implications of Genetic Risk Information in Families with a High Density of Bipolar Disorder: An Exploratory Study. Social Science & Medicine 60, 109–118CrossRefGoogle Scholar
  37. Miller F.A., C. Ahern, C.A. Smith, E.A. Harvey 2006, Understanding the New Human Genetics: A Review of Scientific Editorials. Social Science & Medicine 62, 2373–2385CrossRefGoogle Scholar
  38. Molewijk B., A. Stiggelbout, W. Otten, H. Dupuis, J. Kievit 2004, Empirical Data and Moral Theory. A Plea for Integrated Empirical Ethics. Medicine, Health Care and Philosophy 7, 55–69CrossRefGoogle Scholar
  39. Nelkin D., M.S. Lindee 1995, The DNA Mystique: The Gene as a Cultural Icon. New York: Freeman and CompanyGoogle Scholar
  40. Nerlich B., R. Dingwall, D.D. Clarke 2002, The Book of Life: How the Completion of the Human Genome Project was Revealed to the Public. Health 6, 445–469CrossRefGoogle Scholar
  41. Nye R.A. 2003, The Evolution of the Concept of Medicalization in the Late Twentieth Century. Journal of History of the Behavioral Sciences 29, 115–129CrossRefGoogle Scholar
  42. Oduncu F. 2002, The Role of Non-Directiveness in Genetic Counseling. Medicine, Health Care and Philosophy 5, 53–63CrossRefGoogle Scholar
  43. Petersen A. 2001, Biofantasies: Genetics and Medicine in the Print News Media. Social Science & Medicine 52, 1255–1268CrossRefGoogle Scholar
  44. Popper K.R. 1968, The Logic of Scientific Discovery. New York: Harper Torch BooksGoogle Scholar
  45. Rabinow P., N. Rose 2006, Biopower Today. BioSocieties 1, 195–217CrossRefGoogle Scholar
  46. Racine E., I. Gareau, H. Doucet, D. Laudy, G. Jobin, P. Schraedley-Desmond 2006, Hyped Biomedical Science or Uncritical Reporting? Press Coverage of Genomics (1992–2001) in Quebec. Social Science & Medicine 62, 1278–1290CrossRefGoogle Scholar
  47. Rentmeester C.A.: 2001, Value Neutrality in Genetic Counseling: An Unattained Ideal. Medicine, Health Care and Philosophy 4, 47–51CrossRefGoogle Scholar
  48. Ricoeur, P.: 1970, Freud and Philosophy: An Essay on Interpretation. Yale University PressGoogle Scholar
  49. Rothman B.K. 2001, The Book of Life: A Personal and Ethical Guide to Race, Normality, and the Implications of the Human Genome Project. Boston: Beacon pressGoogle Scholar
  50. Scheer L.v.d., G. Widdershoven 2004, Integrated Empirical Ethics: Loss of Normativity? Medicine, Health Care and Philosophy 7, 71–79CrossRefGoogle Scholar
  51. Skrabanek P. 1994, Death of Humane Medicine and the Rise of Coercive Healthism. Altrincham: Social Affairs UnitGoogle Scholar
  52. Tammpuu P.: 2004, Constructing Public Images of New Genetics and Gene Technology: The Media Discourse on the Estonian Human Genome Project. Trames 8, 192–216Google Scholar
  53. Ten Have H. 2001, Genetics and Culture: The Geneticization Thesis. Medicine, Health Care and Philosophy 4, 295–304CrossRefGoogle Scholar
  54. Väliverronen E. 2006, Expert, Healer, Reassurer, Hero and Prophet: Framing Genetics and Medical Scientists in Television News. New Genetics and Society 25, 234–247CrossRefGoogle Scholar
  55. Weber M.: 1949, The Methodology of the Social Sciences. New York: The Free PressGoogle Scholar
  56. Williams S.J., M. Calnan 1996, The ‘Limits’ of Medicalization?: Modern Medicine and the Lay Populace in ‘Late’ Modernity. Social Science & Medicine 42, 1609–1620CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.Department of Philosophy & Centre for EthicsUniversity of IcelandReykjavikIceland
  2. 2.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway

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