With the introduction of next-generation sequencing, the costs have actually dropped much faster than you'd predict if it followed Moore's Law. If it's possible to keep that pace up, then we can expect a $1000 genome in 2014-2015, and a $100 dollar genome two or three years later. My guess is that within 10-20 years we could see the widespread use of genetic screening of embryos for genetic diseases. Right now, this all seems very sci-fi. Like something out of Brave New World, Gattaca, or the Eugenics Wars in Star Trek. But unlike a lot of sci-fi, this stuff isn't fictional because it's technologically difficult/impossible, like a faster than light drive, or a flying car. It's sci-fi because it's too expensive to do right now, but that's going to change rapidly within our lifetimes. The development of tests for Down's Syndrome has already led to a dramatic reduction in the number of children born with the condition, it only follows that the development of new tests will have similar effects with other disorders.
This raises a lot of very thorny questions. Say a fetus tests positive for a mutation that is strongly associated with early-onset Alzheimer's disease. What's the moral choice? Is it moral to abort the fetus and spare them and their loved ones the suffering of Alzheimer's? Or would having that life be better than never being born at all? Or would you be willing to take the bet that in the next 30 to 60 years, they develop the therapies to cure or prevent the disease?
It gets more complicated. What if the fetus tested positive for a gene associated with schizophrenia? It might seem cruel to bring someone into the world knowing that's what they had to face. But this is where the story of genetic determinism put forward by modern medicine breaks down. Schizophrenia has a genetic component, true. What's remarkable is that among identical twins (100% shared DNA) the disease is found in both twins less than 50% of the time. Clearly, there's a very strong environmental component (another striking thing that backs this up is that schizophrenia rates are significantly higher in developed countries than in developing countries). Getting these genes makes you vulnerable, true, but there's a better-than-even chance you won't develop the disease at all. Is a less than 50% chance of developing schizophrenia enough to abort a fetus over?
The issues raised by gene sequencing have been pretty hypothetical up until now. It was too expensive and difficult to look at what genetic cards you'd been dealt. But that's going to change.
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