Skip to main content Accessibility help

The genetic revolution and medicine in the 21st century

  • Kay E. Davies, Angus J. Clarke and Peter S. Harper


We are currently in the midst of a revolution in our understanding of human disease. The greater understanding that has been achieved of many inherited diseases is giving insights into many more common conditions not previously regarded as ‘inherited’. An individual can be identified from a DNA fingerprint obtained from the analysis of a very small DNA sample in a hair root, mouth wash or a blood spot. By the turn of the century, we will know the sequences of most, if not all, human genes. We will have the ‘recipe’ of human life. We may not be able to develop treatments for some years, but we will have the tools for identifying those predisposed to disease. Although the use of genetic tests raises many social, ethical, legal and economic issues, this potential is already with us and we cannot ignore it. Society should already openly be debating the implications of genetic knowledge so that the enormous benefits to human health can be gained without too many suffering from misuse of the technology.



Hide All
1.Hampton, M. L., Anderson, J., Lavizzo, B. S. and Bergman, A. B. (1974) Sickle cell “nondisease”. A potentially serious public health problem. Am. J. Dis. Child. 128, 5861.
2.Marteau, T. M. (1994) Screening for carriers of cystic fibrosis: Psychological consequences are unclear. Brit. med. J. 309, 14291430.
3.Evers-Kiebooms, G., Denayer, L., Welkenhuysen, M., Cassiman, J. J. and van den Berghe, H. (1994) A stigmatizing effect of the carrier status for cystic fibrosis? Clin. Genet. 46, 336343.
4.Koch, L. and Stemerding, D. (1994) The sociology of entrenchment: a cystic fibrosis test for everyone? Soc. Sci. Med. 39, 12111220.
5.Nature (1995) When is prenatal diagnosis “eugenics”? Nature 378, 549.
6. Royal College of Physicians Committees on Ethical Issues in Medicine and Clinical Genetics (1991) Ethical Issues in Clinical Genetics. Royal College of Physicians of London, London.
7.Nuffield Council on Bioethics (1993) Genetic Screening—Ethical Issues. Nuffield Council on Bioethics, London.
8.Boddington, P. (1994) Confidentiality in genetic counselling. In Genetic Counselling: Practice and Principles Chap 10, pp. 223240. Clarke, A. (Ed). Routledge, London and New York.
9.Pokorski, R. J. (1995) Genetic information and life insurance. Nature 376L, 1314.
10.Light, D. W. (1992) The practice and ethics of risk-related health insurance. JAMA 267, 25032508.
11.Harper, P. S. (1993) Insurance and genetic testing. Lancet 341, 224227.
12.Nature (1996) Whose right to genetic knowledge? Nature 379, 379.
13.Harper, P. S. and Clarke, A. (1990) Should we test children for “adult” genetic disease? Lancet 335, 12051206.
14.Clinical Genetics Society Working Party (1994) The genetic testing of children. J. Med. Genet. 31, 785797.
15.Clarke, A. and Flinter, F. (1996) The genetic testing of children: a clinical perspective. In The Troubled Helix: Social and Psychological Implications of the New Genetics Chap 7, pp. 164176. Marteau, T. and Richards, M. (Eds). Cambridge, Cambridge University Press.
16.Michie, S. and Marteau, T. M. (1996) Predictive genetic testing in children: the need for psychological research. Brit. J. Health Psychol. 1, 314.
17.Chadwick, R. and Levitt, M. (1996) EUROSCREEN: ethical and philosophical issues of genetic screening in Europe. J. Roy. Coll. Phys. Lond. 30, 6769.
18.Rozmahel, R., Wilschanski, M., Matin, A., Plyte, S., Oliver, M., Auerbach, , Moore, A., Forstner, J., Durie, P., Nadeau, J., Bear, C. and Tsui, L.-C. (1996) Modulation of disease severity in cystic fibrosis transmembrane conductance regulator deficient mice by a secondary genetic factor. Nature Genetics 12, 280287.
19.Baird, P. A. (1990) Genetics and health care. Perspect. Biol. Med. 33, 203213.
20.Clarke, A. (1995) Population screening for genetic susceptibility to disease. Brit. med. J. 311, 3538.
21.Stott, N. C. H., Kinnersley, P. and Rollnick, S. (1994) The limits to health promotion (editorial). Brit. med. J. 309, 971972.
22.Lefebvre, R. C., Hursey, K. G. and Carleton, R. A. (1988) Labeling of participants in high blood pressure screening programs: implications for blood cholesterol screenings. Arch. Int. Med. 148, 19931997.
23.Davison, C., Frankel, S. and Smith, G. D. (1992) The limits of lifestyle: re-assessing “fatalism” in the popular culture of illness prevention. Soc. Sci. Med. 34, 675685.
24.Davison, C., Macintyre, S. and Smith, G. D. (1994) The potential social impact of predictive genetic testing for susceptibility to common chronic diseases: a review and proposed research agenda. Sociology of Health & Illness 16, 340371.
25.Cloninger, C. R., Adolfsson, R. and Svrakic, N. M. (1996) Mapping genes for human personality. Nature Genetics 12, 34.
26.Harper, P. S. (1995) DNA markers associated with high versus low IQ: ethical considerations. Behavior Genetics 25, 197198.
27.Chapple, J. C., Dale, R. and Evans, B. G. (1987) The new genetics: will it pay its way? Lancet i, 11891192.
28.Clarke, A. (1990) Genetics, ethics and audit. Lancet 335, 11451147.
29.Clarke, A. (1991) Is non-directive genetic counselling possible? Lancet 338, 9981001.
30.Clarke, A., Parsons, E. and Williams, A. (1996) Outcomes and process in genetic counselling. Clinical Genetics (in press).
31.Alper, J. S. and Natowicz, M. R. (1992) The allure of genetic explanations. Scientists find them more attractive than social explanations. Brit. med. J. 305, 666.
32.Lippman, A. (1992) Led (astray) by genetic maps: the cartography of the human genome and health care. Soc. Sci. Med. 35, 14691476.
33.Harper, P. S. (1992) Genetics and public health. Brit. med. J. 304, 721.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed