Responsible prediction of gene expression: mitigating genetic risk profiling

ended

Environmental factors are crucial to physical and mental health—they impact even the expression of our DNA. The study of epigenetics provides better understanding of gene-environment interaction. Environmental influence can come from outside and inside the organism but one environmental factor that is typically overlooked is people’s knowledge production and beliefs. PredicGenX responds to the scientific worry that predictions about genes are likely to be reflexive i.e., they impact the eventual outcome. Scholars have raised concerns that beliefs about genetic information affects genetic risk to match that information—a so-called self-fulfilling prophecy not unlike the placebo and nocebo effects. Studies showed that receiving one’s genetic risk profile can change physiology independent of actual genetic risk. Moreover, the current trend to focus on risk, biomarkers, and early diagnostics produces 'knowledge' which is inevitably based on undetermined information, given that gene expression is not fixed. Asserting genetic information as determined when the assertion itself has potential impact on genetic expression is especially alarming considering the popularity of direct-to-consumer genetic testing and precision medicine. Understanding the direct impact of genetic predictions on gene-expression, its vulnerability to feedback loops, and their moral implications is crucial, urgent, yet currently lacking. With this project, I aim to fill that knowledge gap. Through qualitative fieldwork and philosophical analysis, I will theorise the different ways in which reflexive (epi)genetic prediction manifests and—while detailing a descriptive account of the different models—offer an analysis of the epistemic and ethical implications of their reflexivity on research and practice, and the meaning for therapeutic intervention.