Institute For The Future

Your Personal Genome Is No Longer Personal

Should college athletes be required to undergo genetic testing to find out they might be at an increased risk for collapsing and dying during vigorous exercise? A couple weeks ago, the NCAA voted to approve just such a policy, though individual athletes can sign a liability waiver to opt out of the tests. What's striking about this new policy is the shift toward institutional responsibility toward personal genetics--pointing to a shift in the sorts of responsibilities organizational leaders are starting to feel toward managing genetic risks at population levels, but also toward some potentially conflicting challenges about the future of anticipatory medicine.

 

Part of the problem stems from two very understandable, but potentially conflicting fears. College coaches and NCAA officials must feel a pretty awesome sense of responsibility for their players' health and wellbeing and do not want to put them at risk of collapsing and dying. Managing a group of 50 or more players on a single team year-after-year-after-year would inherently involve putting a lot of people at risk.

 

On the other hand, college athletes who carry the trait may not want to face discrimination, lose out on scholarships or the chance to go pro, based on what, as best I can tell, appears to be a relatively small risk of a very big problem.

 

According to the New York Times, at least eight student athletes who were known carriers of a sickle cell mutation died suddenly during football practices over the past decade. This sounds high. But, at the same time, "The trait is found in about 8 percent of African-Americans, but in less than 1 percent of white Americans," which means, as best I can tell, that even though the risk of a problem might increase pretty significantly due to carrying the trait, it is also probably still small. Arguably, given the sizeable amount of brain damage most football players incur, just playing football is a much more significant and pressing risk.

 

The bigger story here is that institutions are beginning to think more seriously about using macro-level probabilities in individually targeted ways. In fact the NCAA example isn't isolated: The military has begun using genetic scans, brain imaging and other tests on combat troops to try to figure out which soldiers might be more at risk of developing PTSD.

 

Put differently, public health interventions are getting targeted by genetic mutation. For public health practitioners, or institutional leaders, this poses a new set of questions--and, I would guess, signals a new source of tensions.