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The cost of genome sequences and interventions

Wednesday, 5 March, 2008

Two items of note appeared this week on the topic of the cost of genetic research and technology.

The first was a piece in The New York Times called ‘Gene Map Becomes a Luxury Item‘, by science reporter Amy Harmon. Basically just about how costly it is to sequence one’s genome at the moment, and tells the story of Dan Stoicescu, a millionaire paying $350,000 (US, I assume) for his genome to be sequenced by the genomics company Knome. Of interest is that Dr. Stoicescu (he has a PhD, so I’d err on the side of calling him Dr., rather than Mr. as he is referred to in the NYT article)

Of note though is this paragraph:

Biologists have mixed feelings about the emergence of the genome as a luxury item. Some worry that what they have dubbed “genomic elitism” could sour the public on genetic research that has long promised better, individualized health care for all. But others see the boutique genome as something like a $20 million tourist voyage to space — a necessary rite of passage for technology that may soon be within the grasp of the rest of us.

I, for one, am glad that people are paying for genome sequencing. It shows there is a demand, and it allows for the research to progress, so that it may become cheaper for all of us.

The second was an article in the Journal of Medical Ethics by Dr Dov Fox of Yale Law School, titled ‘Paying for particulars in people-to-be: commercialisation, commodification and commensurability in human reproduction‘.

The whole article is worth reading if you can access it, but I would like to draw attention to this paragraph:

It is easy to blur the distinction between a person’s attributes and the person herself. Expressing the constitutive features of offspring in monetary terms prompts us to think about the value children’s traits in terms of measurable data to be compared alongside fungible goods. “How much is an egg from a donor of this height or that SAT score? We could get a plasma TV for that much.” The child who is created with sperm that cost this much or an egg that cost that much, created with embryo enhancement for this amount or fetal surgery for that amount, could know that select biological components of what helped make her the person she is cost, say, about what a beach vacation or new car would have cost instead. She might also discover that her genotype cost more, or less, than her siblings or classmates. More worryingly, people may start to think about her and others like her in these fungible, rankable terms.

I don’t feel that this is likely. Does thinking about the cost of a breast enlargement cause us to “blur the distinction between a person’s attributes and the person herself”? Perhaps, but we all know that we, morally, should not consider that person to be defined by her enhanced breasts. If a child discovered that her dental orthodontic work cost less than somebody else’s, would she worry that she, or at least her smile, is somehow a rank below that of the other person? Again, it is possible, perhaps she would also feel that her smile was already better before any work was done, so the orthodontic work may not have needed to be as costly to achieve the same result, or better.

Therefore I think we can conclude that the monetary value of something is not an accurate reflection of everyone’s desire for that object. Importantly, price (being reflective of desirability) also incorporates other factors like scarcity (more accurately, perceived scarcity) and novelty. Therefore, as with many objects, some enhancements may be more costly not because they are any better functionally, but because they possess some new feature or are of a brand name that isn’t common, and extra is payed for that. One may be able to compare money spent on enhancements, but I think it will be more common to be comparing value for money, or the end result (regardless of cost involved), instead.

I should stop now. I need to try not to get too deeply into free market economics, as I despise them (free markets, not economics) so much. How anyone can assess an economy by measuring how much people desire stuff is beyond me (I think goods should be valued by something measurable like embodied energy, not by estimations of hopes and dreams).

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