Abraham Lincoln's DNA and Other Adventures in Genetics
The 21st century has begun with an overwhelming outpouring of advances in molecular biology and genetics, and the medical profession has only started to wrestle with the many social and moral questions posed by the startling progress in these fields. Indeed, as Philip Reilly suggests in this straightforward and readable collection of intertwined essays, society as a whole must confront these questions. For laypeople and professionals alike who yearn for a better understanding of genetically engineered crops, DNA fingerprinting, cloning, or gene therapy, here is a valuable addition to a small but critical literature that will frame our public discourse as we decide how to use the burgeoning knowledge of the genome.Like Matt Ridley's approach in his book Genome: The Autobiography of a Species in 23 Chapters (New York, HarperCollins, 1999; reviewed in the June 8, 2000, issue of the Journal), Reilly has assembled an enjoyable series of vignettes that are understandable to the novice but contain lessons for the professional geneticist. The early chapters explain the fundamental tools of the modern genetic detective, such as the polymerase chain reaction, mutation analysis, and the difference between mendelian and nonmendelian inheritance. The lessons are delivered in the course of fascinating historical tales (including an especially enjoyable chapter on Henri de Toulouse-Lautrec) with a hint of Lewis Thomas-like awe and fascination with the power of genetic analysis. We can diagnose diseases that afflicted Abraham Lincoln by analyzing DNA recovered from the shaft of a single hair. Evidence capable of identifying the perpetrator of a crime is invariably contained in tiny molecules of DNA shed from the skin or deposited by the touch of a finger. Reilly is trained in both genetics and law, and these advances are marvels that offer unprecedented investigative powers both for the scientist and for the police detective. At the same time, we are faced with disquieting challenges to our privacy. Do these scientific capabilities mean that the banking of DNA samples from every citizen is inevitable? You will be convinced by Reilly's arguments that we are moving rapidly in that direction unless we educate ourselves and choose to object.In summarizing and simplifying the most complex of recent genetic advances, Reilly addresses the most basic and controversial issues in the field. Is nature or environment the more important determinant of personality, talent, and behavior? Is our mental and physical health determined by our genes? Is there a gene for sexual preference? Should we provide potential parents with the ability to screen fetuses for what they consider to be "favorable" genes, such as those promoting height, strength, or good looks? These questions and many more are framed in fair and provocative presentations using examples that are generally derived from the author's experiences in the laboratory and the courtroom. The many details related to recent events and discoveries lend a timeliness to the discussion. In most cases, we are left without answers but gain important insights and knowledge with which to consider issues. I found myself wanting to know more about the expert opinion of the author, especially regarding the most critical questions, or at least to learn how he thinks we should attempt to resolve these pressing issues. Not until one of the very last chapters do we receive guidance in the opinion that "on balance, it seems the wiser course... to forbid human cloning for any reason." However, we are immediately warned that forbidding it will not prevent it, and we are directed that "the only morally permissible response is to welcome [cloned individuals] into the human family."Here and elsewhere in the book, a certain inevitability pervades the author's predictions -- a hint of determinism that seems to diminish our ability to keep tight hold of the reins and to choose the course we steer. "The use of germ-line gene therapy... is as inevitable as it is welcome." "Designer foods will become a reality." "One prediction does seem certain. Women in large numbers will continue to use genetic (and other) tests to avoid the birth of children with serious disorders." These bold statements are intended to provoke the reader to take an active role in the discussions of public policy and professional ethics that will determine the veracity of Reilly's predictions. They evoke a natural impulse (genetically encoded?) to resist the fates. This may be the most powerful and successful aspect of Reilly's collection: he conveys up-to-the-minute data concerning modern genetics while prodding the reader to become engaged in the task of integrating these discoveries into the moral framework of our society.Jonathan A. Epstein, M.D.Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.--This text refers to an out of print or unavailable edition of this title.