Research suggests there are two broad classes of reaction: activism and fatalism. Activists try and take control, and strive to minimise their risk by diet, exercise, or drugs, and by avoiding smoking. Fatalists, on the other hand, hear the prediction as something they can do little about, and decide they will indulge freely in all the things health-educators say are bad for you because they are going to get sick anyway.
The trouble is, it is hard to know who will react which way. There are similar uncertainties about other common disorders that are often suggested as candidates for susceptibility, or genetic risk, prediction. If a gene of major effect in the development of schizophrenia is ever identified, for example, some families may feel they are relieved of blame or guilt for the occurrence of the disorder, while others may interpret a test that shows the presence of the gene as showing that they are to blame after all. Again, we do not really know which is more likely.
When we read about genetics and the future of medicine, we should also think about genetics and the future of health services that must deliver medical care. The advent of predictive medicine, based on more detailed DNA profiling of individual genotypes using technologies like gene chips, rather than screening for one gene at a time, may shift the relationship between doctor and patient. People will be seeking advice on how to manage their susceptibilities or genetic risks, rather than looking for treatment for an already existing disorder.
There are many aspects of predictive medicine that still need development. However, it is a field for medical professionals and researchers to explore and a subject that deserves increased awareness. Doctors and medical institutions with access to invaluable data can use it wisely and continue to uphold that essential medical maxim -- first, do no harm.
