Approaching Religious Guidelines for Chimera Policymaking

Recent developments in the use of cow egg cells to clone human somatic cells, and the grafting by researchers at several universities of human neurons into mice, bring the notion of the chimera, a mixture of several living organisms, from myth into reality. In his article “Cross‐Species Chimeras: Exploring a Possible Christian Perspective,” Neville Cobbe considers the religious arguments overlying the creation of human‐nonhuman chimeras. In my commentary I focus on the distinction between germline‐ and tissue transplant‐related chimeric techniques implicit in Cobbe's essay and argue that the former poses more serious moral difficulties than the latter if the chimeric product is brought to term. The substantive view of the imago Dei, or image of God, serves as a scaffold by which to judge the permissibility of chimera creation using stem cell and other tissue implants. While useful for judging the rights of such artificially generated beings, I argue that specific criteria such as proportion of tissue uptake, mental capacity, and adherence with the organism's telos are more appropriately considered within a composite image of the living being reflecting its unique integrality. Human co‐creativity with the Divine will inevitably prompt attempts to generate medically useful chimeras. Religious dialogue, combined with the categories of religious moral argument appearing in Cobbe's essay, will help to establish the outline of feasible policy guidelines addressing the complexities inherent in the creation of chimeras.     

The heritability of antisocial behavior: A meta-analysis of twin and adoption studies

In this paper, we describe a quantitative summary of 12 twin (n=3795 twin pairs and 3 adoption studies=338 adoptees) published since 1975 which provided 21 estimates of the heritability of antisocial behavior. Medium to large effect sizes were found for genetic influences across studies, with approximately 50% of the variance in measures of antisocial behavior attributable to genetic effects. Although effect sizes did not vary across different definitions of antisocial behavior (criminality, aggression, or antisocial personality), significantly larger estimates of genetic effect were found for severe manifestations of antisocial behavior. The importance of severity was further underscored by the significantly larger effects obtained in studies using clinic-referred samples compared to the effects obtained in studies using volunteer samples. Demographic characteristics of the samples did not influence effect sizes, although studies using more stringent methodology tended to find larger effects. These results must be interpreted in light of the small literature that was suitable for the meta-analysis due to numerous methodological limitations in existing studies.     

Complexities in Cancer Risk Counseling: Presentation of Three Cases

Complexities abound in the identification and management of families at increased risk for inherited forms of cancer. One of the ways to learn as a profession how best to provide cancer risk counseling (CRC) is to share counseling experiences. Such cases can provide insight into the issues raised by families and ways in which genetic counselors have handled complex situations. Here we describe three CRC cases initially presented at the 1995 American College of Medical Genetics meeting. The first case involves balancing the importance of informing a family of the presence of an inherited cancer syndrome with the family's right not to know. The second case illustrates the difficulties in assisting an individual to make medical management decisions in the face of uncertain risk information. The third case describes the complex interactions with a woman before and after her decision to have prophylactic surgery. (affiliated with Long Beach Memorial Breast Center at the time of counseling)     

Cancer Risk Counseling: How Is It Different?

Fifty-six of 80 (70%) full members of the National Society of Genetic Counselors with interest in cancer genetics responded to a 1994 survey regarding their cancer risk counseling practices. This study was undertaken to describe cancer risk counselors and the services they provide and to identify possible differences from general genetic counseling that warrant further study. Of 56 respondents, 41 (75%) were providing CRC. The components of CRC programs are described. Our results found significant differences between CRC and general genetic counseling in terms of training and experience of genetic counselors providing CRC and length and number of counseling sessions per consultand. 51% of respondents had 1–2 years of working in CRC, compared to 17% with 1–2 years experience in genetic counseling (p<0.05). Over one-third had 10 or more years genetic counseling experience. Counselors were more likely to see individuals at risk for cancer for longer counseling sessions (p<0.05) and for additional sessions (p<0.05).     

The Familial Cancer Program of the Vermont Cancer Center: Development of a Cancer Genetics Program in a Rural Area

In response to many scientific discoveries linking cancer in certain families to inherited factors, the Vermont Cancer Center established the Familial Cancer Program (FCP) in December 1993. This multifaceted program combines the expertise of clinicians and researchers in many disciplines, including genetics, oncology, psychology, and molecular biology. The program's goals are identification of families in its region with excess cancer, provision of clinical services to such families, and use of research protocols when available and appropriate. This article describes the experience of setting up a familial cancer program in a rural area and discusses both successes and challenges in such an endeavor.     

An Oral History of the National Society of Genetic Counselors

Master's level genetic counselors formed a professional society in 1979, 8 years after the first master's degree training program graduation. This paper presents an oral history of the early years of the National Society of Genetic Counselors (NSGC), reviews the symbiotic development and definition of a profession and a professional society, and discusses events and achievements attributed to the NSGC since its incorporation. This retrospective historical account is based on personal and collective oral history, NSGC archival material and other sources.     

The Commercialization of Clinical Genetics: An Analysis of Interrelations Between Academic Centers and For-Profit Clinical Genetics Diagnostics Companies

The field of clinical genetics has undergone substantial commercialization, including the development of genetics diagnostics companies. Numerous for-profit corporations now offer genetic diagnostic services; until recently, these clinical services were provided almost exclusively through academic, not-for-profit medical centers. Some of these for-profit corporations have business and/or research relationships with academia. An evaluation of the interconnections between academia and the clinical genetics industry is an important first step in analyzing the risks and benefits of commercialization. We analyzed the personnel and business affiliations of 19 major U.S. for-profit clinical genetics diagnostics companies with universities, academic medical centers, and the scientific and medical genetics communities in a 2-year period, 1991–1992. We noted extensive connections between the for-profit sector and academia. At least 17% of high-ranking personnel and 85% of consultants for the companies had one or more academic ties. At least 68% of the companies had one or more business agreements with at least one university or academic medical center. These results raise many issues regarding the delivery of genetic medicine and the structure and function of academic medical genetics centers.     

A project to strengthen linkages between genetic centers and child welfare services

Genetic centers are reaching out to underserved populations. One of the most vulnerable underserved populations is children receiving child welfare services. Delivering genetic services to this group is particularly problematic because of multiple barriers. The first step in overcoming barriers is developing linkages between the genetic and adoption service systems with the goal of increasing referrals of child welfare clients to genetic services. This paper presents a model of fostering linkages that was developed under the auspices of the Mid-Atlantic Regional Human Genetics Network with support from the Maternal and Child Health Bureau, Genetic Services Branch. Although the project was regional and funded, the model can be applied at the local level.     

EXPLORING THE CONCEPT OF SPIRIT AS A MODEL FOR THE GOD-WORLD RELATIONSHIP IN THE AGE OF GENETICS

Abstract. The cultural impact of genetics focuses the intellectual and moral challenge of science to theology. Many traditional images of God and the God-world relation are inadequate to represent religious ideas in a world whose self-understanding has been transformed by genetics. Such images also lack the power to help in approaching the ethical challenges of this new era. The way conceptions of the God-world relation can be modified in the light of genetic knowledge is explored by examining how far a new conception of Spirit can function alongside contemporary genetic views of human life in nature. The relationship between genetic theories of human behavior and evolution is related to the revised conception of Spirit.     

The Concept of Abnormality in Medical Genetics

This paper explores usage of the concept ofabnormality in medical genetics and proposesdirectives for more careful usage of this concept.The conceptual difficulties are first explored, thena model is developed to assess actual usage, followedby analysis of a sample of genetic textbooks andgenetics literature. It appears that fact andvaluation are often intermingled, that referencestandards used to define 'genetic abnormalities' areoften not clear and that the concept of abnormality isoften used independent of the degree of certainty withwhich the altered genetype develops into a (seriously)harmful phenotype. On the basis of these findings itis argued that more restraint and more careful use ofthe concept of genetic abnormality of medical geneticsis appropriate as well as more agreement on the use ofreference standards.