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Debate - Genome Screening: A Pandora’s Box

November 2017: Professor Tim Aitman, CGEM Director, and others, debated the motion that the UK should have whole genome sequencing.

The flyer advertising the genome debate

To illustrate the pros and cons of genome sequencing the whole of the UK population, the Edinburgh Medical School and the Medical Students Council hosted the third in the series of Edinburgh Medical Debates on Tuesday 14 November. The motion of the debate was “This house believes that the UK should have whole genome screening”.

Prior to the debate, the audience were polled on their stance on the motion. 53% (78 people) of the audience voted against the motion, 35% (52 people) voted for it, and 12% (17 people) abstained. Next, each panellist presented their argument for or against the motion, and their presentations were followed by a Q&A session. Then the audience were polled again to see whether their stance on the motion had changed.

The proposition managed to sway some opinions, as 46% (66 people) voted for the motion, but the opposition very narrowly won, with 49% (69 people) voting against. Only 7 people (5%) abstained after the debate, indicating that the debate was useful for helping people to decide and take a stance. The fact that the final vote was so close indicates that population-wide genome screening is still a very contentious topic.

“For” arguments included:

  • Whole-genome sequencing is technically feasible and its cost is decreasing
  • It would enable early intervention for people carrying high-risk genetic variants
  • It would increase opportunities for research to advance our knowledge of genetics and provide better healthcare to society
  • In terms of privacy, most people do not consider the contents of their genome more private or important than their medical, sexual and mental health history, which are routinely collected and stored securely

“Against” arguments included:

  • Making it mandatory would be a violation of basic human rights
  • The genome sequence of one person also provides information on the genomes of their blood relatives, so consent cannot be given on a purely individual basis
  • Due to our incomplete understanding of genetics, no meaningful feedback could be given to most of the population and resources would be better spent addressing known drivers of population health and disease
  • Sequencing would lead to overdiagnosis and overtreatment, with no guarantee that people would respond in a predictable or healthy way if they found out that their genetics predisposed them to certain conditions

The debate was chaired by Professor Alison McCallum, Director of Public Health and Health Policy, NHS Lothian.

Two panellists argued for the motion:

  • Professor Tim Aitman, Director: Centre for Genomic and Experimental Medicine, MRC IGMM
  • Miss Catherine McGarry, Year 1 MBChB Student

Two panellists argued against the motion:

  • Professor Graeme Laurie, Professor of Medical Jurisprudence, University of Edinburgh, and Founding Director of the JK Mason Institute for Medicine, Life Sciences and the Law
  • Professor Sarah Cunningham-Burley, Professor of Medical and Family Sociology, and Dean of Molecular, Genetic and Population Health Sciences, Edinburgh Medical School, University of Edinburgh

Links

Edinburgh Medical School

Professor Tim Aitman research group