This is an exploratory paper of the ethical implications for genomic research and mental illness with specific reference to Singapore. Singapore has a unique context due to its social and political systems, and although it is a relatively small country, its population is religiously and culturally diverse. The issues that we identify here, therefore, will offer new perspectives and will also shed light on the existing literature on psychiatric genomics in society. We contextualise issues such as risk and stigma in (...) the identification and diagnosis of psychosis in the way they relate to Singaporean society, and use a current study as a case example. Genomic research has the potential to change significantly he practice of clinical medicine if, as expected, fast and inexpensive sequencing becomes a reality. It will likely also change how society thinks and acts in respect to multi-factorial diseases, conditions, traits, and syndromes that have a genetic component. Genomic research already raises a number of ethical concerns relating to the privacy of individuals, including the disclosure of research results and incidental findings, surreptitious tests, third party access to data, and the re-emergence of genetic determinism. These issues are potentially exacerbated when genomics - the study of whole genomes to understand complex illness and behavioural traits - is applied to psychiatric research, because of the stigma that is often attached to mental illness. In this paper, we discuss some of the issues that have arisen in the context of a study in Singapore that is currently investigating the genomics and biomarkers of psychosis. We argue that although a genomic study rarely creates data that is directly useful to the participant, it can have incidental benefits to the individual who is identified during the study as being at high risk of developing psychosis and its related states. Understanding these potential benefits requires us to examine the implications that this type of research may have on public understandings of genomic data and risk. (shrink)

This is an exploratory paper of the ethical implications for genomic research and mental illness with specific reference to Singapore. Singapore has a unique context due to its social and political systems, and although it is a relatively small country, its population is religiously and culturally diverse. The issues that we identify here, therefore, will offer new perspectives and will also shed light on the existing literature on psychiatric genomics in society. We contextualise issues such as risk and stigma in (...) the identification and diagnosis of psychosis in the way they relate to Singaporean society, and use a current study as a case example. (shrink)

Social scientists and Indigenous people have voiced concerns that media messages about genetics and race may increase the public's belief in genetic determinism and even increase levels of racism. The degree of genetic determinism in media messages has been examined as a determining factor. This study is the first to consider the implications of this area of scholarship for the indigenous minority in Australia. A search of the last two decades of major Australian newspapers was undertaken for articles that discussed (...) Indigenous Australians and genetics. The review found 212 articles, of which 58 concerned traits or conditions that were presented in a genetically deterministic or antideterministic fashion. These 58 articles were analysed by topic, slant, and time period. Overall, 23 articles were anti-deterministic, 18 were deterministic, 14 presented both sides and three were ambiguous. There was a spike in anti-deterministic articles in the years after the Human Genome Diversity Project, and a parallel increase in deterministic articles since the completion of the Human Genome Project in 2000. Potential implications of the nature of media coverage of genetics for Indigenous Australians is discussed. Further research is required to test directly the impact of these messages on Australians. (shrink)

Although he died in 2008, prolific science novelist Michael Crichton – acting as a ‘ghost-writer’, so to speak – continues to add new titles to his oeuvre. Notwithstanding the death of the author, his novel-producing machinery refuses to come to a full stop, - although in this case Richard Preston (a science novelist in his own right, author of, among others, The Hot Zone, on viral infections) was recruited to finish the book. MICRO – a title that almost reads like (...) the acronym of the author’s name - has all the ingredients of the standard Michael Crichton formula. (shrink)

There is a major trade-off between improvements in longevity, general health, fitness and quality of life due to regular intense physical activity on the one hand and possible cardiac risks on the other hand, whether for participants in leisure time sports activities or for highly trained athletes. Cardiac complications and sudden death in sports, even though rare, but dramatic, events, are mainly observed in those suffering from inherited, often latent diseases with a strong genetic background, unknown to the subjects. Sedentary (...) lifestyle together with more than one risk factor may also contribute to cardiac events in persons beginning to exercise for the first time or recommencing intense physical activities after a long pause. Manifestations of inherited cardiac diseases with a typical genetic component may occur in children or adolescents, but also in adults. For many inherited cardiac diseases there is a large body of knowledge on the genetic origin, therefore, genetic testing may be a valuable tool for diagnosis and prevention of underlying diseases, especially as genetic testing has become much cheaper over the last few years. The present paper describes cardiac diseases with genetic disposition and related genetic testing and presents recommendations for genetic examinations. Testing should be of benefit for sportsmen and women but also for family members to prevent fatal cardiac events. These recommendations will consider benefits for the sports person, and ethical reflections as well. (shrink)

Genetic research in sports has a history of more than 40 years of endeavouring to find out which genetic factors can predict the performance of an athlete. With increasing knowledge of the human genome and availability of genetic testing the market of direct-to-consumer genetic tests has exploded in recent years. There are tests for genetic variants for medical and general health issues, but there are also 'lifestyle' tests, including tests for indicators for sport performance. The human gene map for fitness (...) and performance includes hundreds of genes that play a role in cardiorespiratory endurance, muscle strength, exercise tolerance, body composition and energy metabolism. However, there is currently no evidence that genotyping an individual is superior to traditional physiological tests in predicting athletic performance. The impact of genetic test results is much higher in certain medical conditions which are associated with significant health risks when performing competitive sport. These are generally rare inherited disorders, mostly resulting in cardiovascular dysfunction. There are major ethical issues as to whether genetic or clinical pre-participation screenings should be applied to the population in order to prevent disease or death during sport. Some of these issues will be addressed in this article. (shrink)