Re07 - Reflections and Other Exercises 7 - Science & Society 3

Science and Society 3 - Gene/c Tes/ng

An important learning goal for our course is to think critically and ethically about how and by whom science is conducted, and to think about the societal impacts of biological research. To that end, please read the linked articles and re;lect on them by answering questions provided.

The readings will cover sensitive subjects and the questions may push you outside your comfort zone. That is ok. Research shows that with a little discomfort comes the greatest gains.

Feel free to post about this assignment (as any other) on Piazza, keeping in mind that for everyone to express their opinions and participate in discussions about sensitive subjects, they need to feel safe, their experiences need to feel honored, and they need not fear retaliation. Thus, it is best to establish ground rules for discussions. The University of Michigan Center for Research on Learning and Teaching offers these rules to establish to foster a more productive discussion:

• Respect one another’s views.

• Criticize ideas, not individuals.

• Commit to learning, not debating.

• Avoid blame and speculation.

• Avoid in;lammatory language.

• Acknowledge that one’s opinions are formed by their unique experiences.

• No hate speech or bullying.

(We added the last two.)

S & S Assigment 3

Based on this paper.

Genetic testing is becoming increasingly popular. Some estimate that one in 25 American adults have gotten personalized genetic tests both in doctors’ of;ices and in direct-to- consumer tests (e.g., 23andMe). There can be profound bene;its to this kind of testing: genetic risk estimates are now available for 10,000 conditions and 16,000 genes, including for things like Alzheimer’s, breast cancer, and obesity.

A recent study investigated the impacts of receiving genetic tests for obesity. We will analyze one of their results: the impact on physiological exercise capacity, as measured by CO2 : O2 exchange rate. Physiological exercise capacity is in contrast to subjective exercise capacity like “this is challenging” or “I feel tired.”

Their study design included the following sequence: Participants were genotyped for actual genetic risk (and not told). Then participants were asked to run on a treadmill to assess baseline exercise capacity. The scientists measured ;ive measures of exercise capacity, here we will only analyze physiological capacity, CO2 : O2 exchange rate. Then participants were randomly assigned to groups and told either that their genotype con;irmed they are “high- risk” for obesity or that their genotype con;irmed they are “protected” from obesity. This random assignment was regardless of their actual genotype, which means that half of the participants had an assignment that matched their genotype and half had an assignment that did not match their genotype. Then participants were asked to participate in the identical running task (on a treadmill) and the same outcome was measured (e.g., CO2 : O2 exchange rate). This ;igure shows a schematic of the experimental design:

In each participant, scientists compared the CO2 : O2 exchange rate before and after the participant was told their genotype. Their results are shown in Figure 1:

Figure 1. Effects of perceived genotype on physiological exercise capacity.

Participants who were told they have a genotype that is protective had a greater increase in CO2 : O2 exchange rate compared to participants who were told they were high risk. In other words, participants who were told they had a protective genotype had a greater physiological exercise capacity – regardless of their actual genotype.

Furthermore, when comparing effects of perceived vs. actual genotype, the scientists found that if participants thought their genotype conferred risk, there was a greater impact on the difference from baseline than if participants actual genotype conferred risk (Figure 2).

Figure 2. Percieved genotype has a greater effect than actual genotype on physiological exercise capacity.

Use the information provided, as well as your moral compass, to answer the following questions. Your answers should be clear and concise. I expect you to answer each in 2-3 sentences. You will be graded on your honest and respectful contribution, not your opinions.

1. This study shows an example of a placebo effect impacting physiological exercise capacity. If scientists had measured subjective exercise capacity (e.g., time until the participant felt tired, or how challenging the running seemed), do you think the placebo effect would be the same, more extreme, or less extreme? Comment on your perception of the placebo effect on physiological exercise capacity vs. the placebo effect on perceived exercise capacity. Do those two seem different to you? Is there one that you “believe” more?

2. The authors of the paper state “In spite of its bene;its, this [experimental] design is ethically challenging. Randomly assigning participants to learn that they have a high or low genetic risk necessitates deception, as some participants must be falsely informed of their genotype in an ethical, yet believable, manner.” Nonetheless, they justi;ied their design by using risk of obesity as the genetic marker, not risk of cancer or other immediately terminal illness, and by limiting the time in which the participants were deceived (1 hour only). What is your opinion about the ethics of this design? Things you might consider include: Are there other factors that you would want to ensure to prevent harm to the participants? Is the ;inding they presented in the paper “worth the potential harm” to the participants? Etc.

3. The paper that presented these results says, “Merely receiving genetic risk information changed individuals’ cardiorespiratory physiology… If simply conveying genetic risk information can alter actual risk, clinicians and ethicists should wrestle

with appropriate thresholds for when revealing genetic risk is warranted.” Said another way, if deceiving participants can elicit positive physiological responses, are there situations in which this deceit is warranted? This is a question that is likely to elicit very strong opinions and opinions that differ dramatically between people. That is ok. Using kindness, your moral compass, and your logic, please tell me what you think.