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October 09, 2004

Race & medicine - a matter of life & death?

The New York Times Magazine has a long piece titled The Genome in Black and White (and Gray), which focuses on the possible future use of intergroup differences in the medical world. A few weeks ago Abiola pointed me to a new paper where the authors conclude that "...Our results show that when individuals are sampled homogeneously from around the globe, the pattern seen is one of gradients of allele frequencies that extend over the entire world, rather than discrete clusters. Therefore, there is no reason to assume that major genetic discontinuities exist between different continents or 'races.'" Fair enough. I don't tend to agree because I might define "major genetic discountinuities" differently than they do. Once we reject explicit typological thinking and shift toward conceiving human subpopulations as statistical aggregates who themselves must be decomposed into discrete fragments of DNA (when thinking about them genetically), there are many factors to weight when you make an assertion that something is major or it is not major, a simple assessment demands that you expose your assumptions.

Of late I have expressed some skepticism about the idea of tying certain sociopolitical phenomena to evolutionary concepts. My general opinion is that the theory and empirical evidence is too weak and indeterminate to suggest broad definite conclusions, let alone infer prescriptive policies based on that line of thought alone1. On the other hand, I weight the factors differently when it comes to medicine. To me, the evidence for the utility of population clusters in adding to the information base when making diagnoses or immunological matches is compelling2. Even if there are smooth gradients as a function of geography, two individuals who are from disparate locations that are very distant are also likely to be genetically distant. Additionally, even if this avenue of information acquisition turns out to be unfruitfull, I think we should attempt to follow this avenue of inquiry until our costs outweigh the slim possibility of benefits. I simply don't think the downsides, the putative eugenic uses and misuses of the exploration of intergroup differences is plausible today. Racism and ethnic hatred really don't need a helping hand from biology, they are nurtured by many other vital forces3. This implementation of the precautionary principle is analogous to my position on stem cells: since I do not believe that zygotes are human beings, even if fetal stem cells turn out to be a dead end for research, I think we should exhaust that avenue since the downside in my opinion is marginal4. I really don't care how great adult stem cells are, since I don't see a great ethical conundrum in the use of fetal stem cells.

Of course, others differ in how they weigh the potentional risks, benefits and costs. Note that even those who oppose this line of research admit there is something to the basic biology (see Troy Duster's elaboration on this topic in the piece), they simply don't think the upside warrants breaking the recent taboo on exploring intergroup differences. Their interpretation of the precautionary principle is far different, even if they suspect that racial targetted treatments might not lead to the second coming of the Third Reich, they would rather not take that risk.

In the end "the people" will decide I suppose. I suspect that those of us who argue for the medical utility of populational level differences informationally will win out because we appeal to more direct, salient and individual benefits, while our opponents tend to highlight more diffuse and speculative repercussions.

1 - That does not mean that I do not find the culturalist arguments for a "core ethnic group" uncompelling. I am simply rather agnostic and unconvinced on the kin selective arguments.

2 - If need be, I am comfortable with using some non-racial terms to define subpopulations, or perhaps assemble a constellation of variables that basically map on to races though you don't use that word. As long as medical treatment is optimized, if that is the choice we must make, we should choose it if we have no other options that lead not to death. Race is not the issue in the end, medical treatment is, quibbling with words can wait a day.

3 - I think I have made it clear that I tend to think that racism is an emergent property, not an instrinsic/essential property, of who we are.

4 - As I said, I don't believe zygotes are human. If I thought that there was a 10% chance that zygotes were human, I would oppose fetal stem cell research. I'm not God, so I don't know that they aren't human, but my assessment is that the chance is so low that operationally to me I'm pretty sure they aren't human.

Posted by razib at 10:21 PM