I had to laugh…

I had to laugh. A recent article in Annals of Internal Medicine describes an experiment to determine the “safety and behavioral effect” of disclosing to subjects the pleiotropic effect of the APOE genotype. Pleiotropy describes genes that have more than one effect.  In this case, having the APOE4 version of the gene heightens one’s risk of Alzheimer’s Disease, and also of coronary disease. The researchers concluded that participants could, indeed, handle the information that their genotype also conferred an increased risk of cardiac disease.  I was laughing because, not too long ago, the shoe was on the other foot. In the late 1990s, the pleiotropic nature of APOE4 was a favorite dilemma for bioethicists, for the opposite reason. Most people assumed that it was beneficial to tell people of their increased cardiac risk, given available medication and lifestyle changes, but as Robert Wachbroit wrote, it was ‘medically useless and socially harmful’ to reveal an increased risk for AD. It’s interesting that the perception has flipped, given that we still have no effective interventions for Alzheimer’s Disease.

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