Genetics cultural lag: what can social workers do to help?

The phrase "cultural lag" has been used to describe the phenomenon of cultural and social institutions that lag behind technological development (Ogburn, 1964). An example would be the skyrocketing population growth that occurred when societies continued to encourage maximum reproduction, with early marriage and religious sanction for having children, long after infant mortality had been reduced with modern medicine. Today, we have a similar situation developing with regard to the scientific advances in the field of genetics. Scientific advances in the field of genetics are growing exponentially, in large part because of a massive, federally funded effort called the Human Genome Project. Everything, it seems, from diseases like cancer to personality characteristics like shyness, has a genetic basis. Although initial discoveries of a genetic connection to so much of human behavior were greeted with enthusiasm and hope for a quick end to age-old problems (for example, Huntington's disease and alcoholism), more recently, there has been increasing concern that these scientific discoveries may bring on more harm than good. Breast cancer can serve as a good example of some of the promises and the pitfalls of the new genetic understanding. Breast cancer is diagnosed in about 185,000 women a year and accounts for about 45,000 deaths (American Cancer Society, 1998) in the United States. It is the second most frequent cause of death by cancer for women, only recently surpassed by lung cancer. It has been known for many years that breast cancer runs in some families, but only recently has the very labor-intensive process of isolating responsible genes been successful. By comparing the DNA of members in the families who got breast cancer with those who did not, researchers were able to locate two genetic mutations associated with higher-than-average likelihood of getting breast cancer. The two genes discovered so far have been named BRCA1 and BRCA2 (Mild et al., 1994; Wooster et al., 1995). Both are large genes with many possible errors, or misspellings. Scientists are now studying what the implications are for each misspelling - what each means for likelihood of getting breast cancer, for getting other types of cancer, for timing of disease, and for mortality. As more is learned, it is becoming clear that certain errors on the two breast cancer genes are more common than others. For example, several misspellings have been found to be fairly common in Ashkenazi Jews - that is, Jews who emigrated from the Eastern European area (National Cancer Institute [NCI], 1997). From a scientific standpoint, these discoveries are exciting and offer promise for better understanding of how cancers are controlled at the cellular level. It is now thought that these genes work to suppress breast cancer cells and that when they are altered, they are unable to perform this function. Ultimately, it is hoped that effective treatments will be developed from this knowledge. Already, women at high risk of breast and ovarian cancer can be tested to determine whether they have inherited the susceptibility. But there is also cause for serious concern. THE MISUSE OF GENETIC INFORMATION Fears of the misuse of genetic information go back to the "eugenics movement" of the early part of the century, when laws were passed to deny immigrants with what were thought to be undesirable genetic backgrounds entry to the United States. Of course, the Holocaust, resulting in the deaths of 6 million Jews under the Nazis, is the most horrific example. Even fairly recently, genetic testing of African Americans in the 1970s led to many people losing their jobs, being discharged from the military, and losing medical insurance as a result of testing positive for sickle cell trait (Schild & Black, 1984). Therefore, a major fear surrounding the new genetic information now becoming available is that it will be used against the very individual it was designed to help (Hudson, Rothenberg, Andrews, Kahn, & Collins, 1995). …