Physicians as guardians of genetic knowledge.

摘要

The genetic revolution in medicine, envisaged since the completion of the draft sequence of the human genome over a decade ago, is moving forward at a painfully slow pace. Although truly personalised care is, perhaps, still decades away, private companies have been quick to exploit the genetic information that has become available from the Human Genome Project. The past 5 years have seen a proliferation of personal genetic tests, which promise to predict risk for an array of complex conditions such as type 2 diabetes and Parkinson's disease, determine drug or food metabolism, or uncover carrier status for inherited diseases. And although the predictive power of some of these tests is questionable, they have been offered directly to consumers, who send off a swab of saliva or a blood sample (and USdollar200-dollar2000, depending on the test) in return for their genetic risk profile. Last week saw a new development in the regulation of these tests in the USA. An expert advisory panel of the US Food and Drug Administration (FDA) recommended that direct-to-consumer (DTC) genetic tests be subject to medical supervision; interpreted, and possibly also ordered by doctors, rather than by the lay public. The FDA has so far indicated that it might require physicians' involvement for some, but not all, types of genetic test.