Genomic Messages: How the Evolving Science of Genetics Affects Our Health, Families, and Future

Genomic Messages: How the Evolving Science of Genetics Affects Our Health, Families, and Future

by George Annas, Sherman Elias


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Genomic Messages: How the Evolving Science of Genetics Affects Our Health, Families, and Future by George Annas, Sherman Elias

Two leaders in the field of genetics—a bioethicist-health lawyer and an obstetrician-gynecologist geneticist—answer the most pressing questions about the application of new genetics to our universal medicine and what personalized medicine means for individual healthcare.

Breakthroughs in genetic research are changing modern medicine and pharmaceuticals. But what are these changes and how do they affect our individual care? Genomic Messages examines these groundbreaking changes and the questions they raise: What kind of specific medical innovation do we have to look forward to now and tomorrow? How will this “flood” of genetic messages change our lives, our interaction with our physicians and our healthcare system?

Groundbreaking and provocative, Genomic Messages fuses the often conflicting worlds of medicine and law to provide information and insight that will impact the health choices of every one of us, from how medicine is practiced to concepts of privacy, confidentiality, and informed consent. Ultimately, it reveals how genetic information is changing how we think about ourselves, our health, and our future.

Product Details

ISBN-13: 9780062228260
Publisher: HarperCollins Publishers
Publication date: 06/28/2016
Pages: 304
Sales rank: 787,214
Product dimensions: 5.30(w) x 7.80(h) x 0.80(d)

About the Author

George Annas, J.D., M.P.H., is Warren Distinguished Professor at Boston University, chair of the Department of Health Law, Bioethics, and Human Rights at Boston University School of Public Health, and professor in the Boston University School of Medicine and School of Law. He is a member of the Institute of Medicine and a fellow of the American Association for the Advancement of Science. He is cofounder of Global Lawyers and Physicians, and his research has focused on the rights of patients and the regulation of research on human subjects.

Sherman Elias, M.D., was professor emeritus of obstetrics and gynecol-ogy and clinical genetics, and the retired chair of Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine. Elias served as president of the Society of Gynecologic Investigation, director of the American Board of Obstetrics and Gynecology, and vice president for clinical practice of the American College of Medical Genetics. He chaired both the ethics and genetics committees of the American College of Obstetricians and Gynecologists. His research focused on reproductive genetics, including prenatal diagnosis using fetal cells and nucleic acids from maternal blood.

Table of Contents

Introduction xi

1 The Coming Flood of Genomic Messages 1

What is genomic information?

What is genomic privacy?

Why is DNA like a book or a recipe?

What is genomic medicine and why might it change how we think?

Can we strike a "genetic balance" in our health care?

2 Personalized (Genomic) Medicine 23

What is a genetic family history and why does it matter?

How can personalized medicine become impersonal medicine?

How did genetically isolated populations help DNA researchers?

Why will genomic medicine require electronic health records?

3 Nature, Nurture, and the Microbiome 45

How do twins help us understand that it's nature and nurture?

How do genomics and the environment affect the fetus?

How do genomics and the environment work in diabetes?

How does your microbiome affect your health?

4 Pharmacogenomics 67

How have racism and stereotyping plagued genomics?

What does warfarin tell us about pharmacogenomics?

How do foods and genes interact?

Why is it unlikely that your physician will use your genome to prescribe drugs?

What will pharmacogenomics look like in the future?

5 Reprogenomics 87

Why is reprogenomics based on genetic relationships?

What are the social policy issues in reprogenomics?

What new issues do embryo and stem cell research create?

Is regulation of the fertility industry necessary?

6 Genomic Messages from Fetuses 111

How does prenatal diagnosis work?

What are karyotypes and microarrays?

Is whole-genome sequencing of fetuses in our future?

Are new consent models needed for whole-genome sequencing in fetuses?

7 Genomic Messages from Newborns and Children 139

When is whole-genome sequencing of sick children indicated?

What is newborn screening and how does it work?

Why shouldn't all newborns have their DNA sequenced?

8 Cancer Genomics 161

Is cancer a genetic disease?

How can the "hallmarks of cancer" suggest novel treatments?

Why does cancer sequencing hold promise for personalized medicine?

How is cancer treatment evolving?

What can breast cancer teach us?

9 Genomic Privacy and DNA Data Banks 191

How do "big data" and "big DNA banks" affect our privacy?

How do criminal DNA data banks work?

How do commercial DNA data banks work?

How can we make informed consent to DNA data banking meaningful?

Can companies patent our DNA?

10 Genomics Future 217

How does genomics affect how we see death and our future?

What are "species-endangering" experiments?

What are "posthumans" and "transhumans"?

How can we tell the difference between genomics fact and fantasy?

How can individuals influence the genomics research agenda?

Acknowledgments 243

Appendix A DNA and the Human Genome 245

Appendix B Limitations of Screening Tests 249

Notes 253

Glossary 275

Index 279

About the Authors 288

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