Our Complicated Views Toward Genomic Science
Disagreement over the uses of DNA is wide-ranging.
Posted November 1, 2021 | Reviewed by Lybi Ma
In 2005, the federal Food and Drug Administration approved BiDil, a drug for congestive heart failure, with the stipulation that it be prescribed only to members of the “self-identified Black population.“ Dispute ensued, tempers rose. The FDA declared the decision to be “a striking example of how a treatment can benefit some patients even if it does not help all patients.” A Howard University affiliate, however, wrote that the approval “smacks of a kind of influence that science has shown to be untenable . . . . [It implies that] all members of demographics are more similar than different due to inherited biology and that this will not, cannot, change over time.”
BiDil opponents hinted or stated that the FDA was engaging in racialized eugenics; a supporter found it “tragic that thousands of patients are dying because their doctors are not prescribing the drug despite the ease of their identification.” All of these people were liberals, broadly speaking; all were dedicating much of their lives to eliminating racial disparities in medical care and health outcomes.
Consider another dispute over the use of DNA databases in the criminal justice system. Supporters claim that collections of genetic evidence can reduce crime and recidivism, help to determine guilt or innocence, overcome the heartbreak attendant on tens of thousands of unanalyzed rape kits, and lead to the exoneration of falsely imprisoned poor Latinos and Black men. Opponents describe DNA repositories as belonging to “the realm of the Brave New World;” these data “are gathered by the state without consent and are maintained for the purpose of implicating people in crimes. They signal the potential use of genetic technologies to reinforce the racial order not only by incorporating a biological definition of race but also by imposing genetic regulation on the basis of race.” In this case, too, most if not all disputants identify as liberals, concur on the importance of conviction for the guilty and protection for the innocent, and reject racism or the violation of individual liberty or privacy.
These examples can be multiplied in many arenas. They cumulate, along with other evidence, in the finding that disagreement over societal uses of genomic science do not follow partisan or conventional ideological lines; virtually all elected officials endorse forensic DNA databases and almost none have spoken at all about precision medicine. Instead, disputes line up along two psychological dimensions that intersect in a classic 2x2 typology. The vertical dimension focuses on a person’s knowledge of or belief about the impact of genetics on human’ behaviors, traits, or physical conditions. It ranges from an assertion of strong genetic influence on phenotypes to that of genetic irrelevance. The horizontal dimension focuses on a person’s proclivities for risk. It ranges from risk acceptance or even risk-seeking to risk avoidance.
The intersections of the two dimensions comprise four stances toward genomic science. Enthusiasts (top left quadrant) perceive genetics to explain a lot about human phenotypes and are excited about the benefits to be gained from genomic science. Skeptics (top right) agree that genetics explains much of human behavior and traits, but expect deployment of genomic science to be deeply harmful. The Hopeful (bottom left quadrant) perceive genetics to be mostly or entirely unimportant in explaining human phenotypes; forces for change in this quadrant range from religious faith or individual willpower to social policies or simply luck. Finally, Rejectors (bottom right) agree with the Hopeful that genetics does not affect human traits and behaviors, but see no forces for change that will benefit society without risking great harm.
This simple, almost simplistic, typology is surprisingly effective in explaining disputes over or views of societal uses of genomic science. The BiDil controversy follows the vertical dimension: proponents are Enthusiasts, while opponents reject any genetic component of congestive heart failure as verging on racial essentialism, but are Hopeful that social policies could be ameliorative. Disputes over forensic DNA databases, in contrast, follow the horizontal dimension. Both sets of protagonists agree that genetic profiles derived from DNA samples are an effective tool for identifying individuals, but supporters emphasize the databases’ value in promoting criminal justice while opponents point to databases’ capacity to surveil, racialize, and control.
The typology also organizes and (loosely put) explains other complicated mixes of attitudes toward genomic science. For example, dozens of interviews and the coding of thousands of published articles show that not only genomic scientists but also economists and political scientists tend to be Enthusiasts, while cultural anthropologists are disproportionately Skeptics and law professors or scholars of cultural studies are Rejectors. Even more importantly, Americans in general can be categorized into the four quadrants.
Using large representative national surveys in 2011 and 2018, I created indices of the two dimensions that categorize about three-fifths of Americans as Enthusiastic, almost three-tenths as Hopeful, and the rest split evenly between Skepticism and Rejection. The quadrants have distinct profiles. When asked (in open-ended text boxes) if they would be willing to contribute a DNA sample to a medical or (separately) forensic DNA biobank, Enthusiasts wrote things like “justice is worth a swab.” Rejectors wrote, “Get your swabs out of my face!” The Hopeful often sounded like Enthusiasts: “The outcome of this study will help many millions of people’s lives.” Skeptics could almost match Rejectors in risk aversion: “My DNA is my personal property and no one has the right or need to use it. Furthermore, it is not just used for these tests, it is used for things such as the police department and FBI and NSA to track you. It is wrong and unethical to collect and store anyone’s DNA for such purposes.” Attitudes toward risk are more sharply differentiating than perceptions of genetic impact.
Location in the four quadrants is consistently and strongly associated with levels of trust in scientists, corporations, and government actors; endorsement of public funding for genomics technologies; support for developing both somatic and (separately) germline gene-editing technologies; and specific explanations for that support or opposition. The typology even explains views on policies toward climate change, despite its lack of obvious connection with genomic science.
The failure of the typology is almost as revealing as its success. Division among the four quadrants mostly runs out of steam when survey respondents are asked who should govern the use of genomics technologies; but that is because virtually no one has confidence in governance by public officials, community forums, health-related businesses, or the clergy. Doctors and patients are slightly more trusted by Enthusiasts and the Hopeful.
“Who should govern the use of genomics?” When expert and mainstream Americans are asked this question, the modal response is: “None of the above.”
Short of that unsettling endpoint, however, cognitions about genetic influence and, especially, affect toward risk-acceptance or -aversion—but not political partisanship, ideology, race, religion or religiosity, gender, age, or education—are closely associated with Americans’ views of using genomic science. The typology makes sense not only of general stances of trust or excitement but also of intense and richly developed disputes over particular policies. Whether that pattern persists in the face of our seemingly inexorable expansion of partisan polarization remains to be seen.