Dr Phil Hammond, GP and broadcaster

It’s been a big year for genes.The Human Genome Project has provided definitive proof that we’re all practically African apes. In fact, we share most of our genetic material with the earthworm. And it concentrates the mind to know that two out of three of us will die because of our genes. Was it ever thus?

Well no, actually. A century ago, two out of three of us would have died young from some infectious disease or other. The success of public health measures and vaccination programmes has meant that death from ‘outside’ causes is becoming rarer and rarer. Now we have to iron out miniscule faults in our DNA spirals if we want to live longer, healthier lives.

But is the science of genetics overhyped? Optimists believe that illuminating the fundamental workings of our bodies will eventually lead to health and happiness for all, but there are sceptics, too. In his book The Rise and Fall of Modern Medicine, Dr James Le Fanu highlights the spiralling costs of healthcare for limited benefits.

And despite the promise of genetics to uncover the true causes of disease, we are still pretty much in the dark about what causes most of the chronic diseases that monopolise the NHS.

Genes are, however, great news for journalists. In the past few days, I’ve counted 10 big gene stories in the national press and, unlike just about all other health reporting, most of them are positive.We slag off the NHS (even though the majority of patients are satisfied) and throw all our optimism into gene fantasies.

If only it were that simple. Last week’s big story was about the discovery that a common heart defect has been linked to a single gene. Fine, but what next? At present, the best hope is to work out a screening test – with all its attendant anxieties – so as to offer terminations to those affected.

"Gene therapy hope for sick boys" tells of an amazing procedure to patch over a genetic defect to restore muscle function in muscular dystrophy. Alas, so far, it’s only been tried on mice. Stem cells from human embryos have also helped paralysed rats to walk, by forming the cells that produce myelin, the conduction sheath for nerve fibres. But will it work on us?

One of the most famous genetic experiments of all was the cloning of a human ear onto the back of a mouse. When the photo was released, I was phoned by a journalist who asked if it was "to make the mouse hear better."

I am by nature a sceptic, and – although I’m sure that genetics will deliver something good – I worry that technology is advancing faster than our ability to debate the ethics of it. In the United States, researchers have fused male and female embryos in a test tube, to help those with sexlinked inherited disorders. The outrage from the scientific community came too late – after it was done.

In the UK at present there are 200 genetic tests you could have, and there’ll soon be many more. But do people really want to know they’re at risk of something nasty in the future? Will it really improve the quality of our lives – or send us into brain meltdown?

Fortune may favour the brave, but when it comes to genes we should proceed with caution.

Guidelines in Practice, September 2003, Volume 6(9)
© 2003 MGP Ltd
further information | subscribe