The home page for 23andme.com states the words, “Get to know you. Health and ancestry start here.” You can order the take home “DNA spit kit” for just $99.00. Scrolling down brings you to a story of a young mother who has had stomach issues all her life and decided to get genetically tested and found she has Celiac’s disease. The DNA spit kit will analyze your DNA to scan for genetic diseases and they advertise that this will potentially change your life. 23andMe does a simply wonderful job at promoting their product. The website is bright, its colorful and it has a simple lay out. It is clear to consumers that this company has made millions of dollars and is quite successful. I was intrigued while watching the story of the young woman because of the involvement her doctor had in her genetic screening procedure. I expected no doctor involvement and this was my main concern with the website. It is healthcare delivered directly to the consumers, without the typical doctor in between to act as a liaison, which can lead to problems.
I wonder how many people actually have this experience with 23andMe. What would be my incentive to get this genetic testing done? Can’t I just get this done through my doctor? I recall a few weeks ago visiting my doctor who asked me about the history of breast and ovarian cancer in my family. She told me that I have the option to get tested to see if I have a gene that could make me more susceptible to breast cancer in the future. I declined, but I’m assuming I can get this done through my doctor and that she was not going to forward me to the 23andMe website. So what is the incentive to by-pass the doctor and deliver health services directly to the consumers? I think it is mostly an issue of money and insurance companies. I am not completely convinced that this service is a benefit to the community if it can just be done through your doctor. Furthermore, upon reading the articles on genetic testing, it is clear that these procedures are not exactly accurate and reliable techniques to actually predict later-in-life diseases or illnesses.
The website gives us three positive aspects of genetic testing: it can tell you if you are a carrier for a specific disease, it can tell you about your potential health risks, and it can outline potential responses to drugs. How much of this do we want to know? I think I would like to know if I will have a reaction to a specific drug, but I don’t think I would want to know that I would someday develop Alzheimer’s or Parkinson’s disease. It is my personal opinion that I think this type of knowledge would damage my current mental state, cause my life in general to be less productive and successful, and damage my current relationships with friends and loved ones. My outlook on life would be dismal and pessimistic because I would know my eventual fate.
Another thing I found scary about the website is that they give a very explicit list of what you can expect to be tested on. The list of “traits” is especially concerning because this is not healthcare or medically related at all. I think in the future this would lead to a society in which we are able to genetically select certain traits for our children. I think that pretty soon we will start to discriminate on the basis of genetics, and 23andMe.com only will exacerbate the discrimination.
Healthcare is Everywhere 
I recently learned about this website myself and immediately thought it was a bad idea. My biggest concern with a lack of physician presence is the interpretation of results. Genetic testing, especially for couples determining their future child’s risk, is a very serious process. Within that process is genetic counseling which allows for couples to receive the interpretation of their results and the risks for their future child; however, this is given by an expert. I am afraid that the public, without a real knowledge of genetics, would make life-changing decisions based on the results from the website. In addition, the website does not offer any support after receiving potentially bad news, whether that be in the form of advice or empathy. I think using this website for genetic testing will lead people to making poor decisions and to feeling isolated.
Genetics testing certainly seems to be gaining ground, both in mainstream health care and in popular culture. I agree with Alex’s comment. I think that, while finding out whether one has some kind of disease that is genetically based is absolutely up for every individual to decide if they want to know, it should definitely be done in the presence of a physician. The role of the physician is supposed to be the trusted professional who guides patients, both through the decision making process that follows the news of a genetic disease, as well as through the decided course of treatment or disease management. I think that the implications of not having a physician there to guide patients can be severely negative for the patient, both physically and mentally. As a consequence, if this product is already available and it does not include the presence of a physician, it is of special concern, I think, how accurate these things are.Can you imagine if this test gave false positive results for a fatal disease to a patient? Would they seek out doctor counseling, or would they go into some kind of depression and/or destructive behaviors? I am all for the movement to make genetic testing more available for patients who want it done, but only under the supervision and guidance of a medical professional.
I remain very critical of 23&Me, but I do understand the draw of it – especially for adoptees like myself with no health history. In most states of the United States, it is illegal for adoptees to retrieve their original birth certificates. This makes it nearly impossible for many adoptees to obtain their own medical records from the hospital they were born in, because in many cases, they don’t know where it is, the name of the hospital, or the names on the birth certificate of either parent. Being able to possess your own original, unaltered birth certificate is something that I think should be a basic right for every human being. People who are non-adopted can hold this essential piece of paper in their hands (or as you have experienced, simply ask their doctor about their family health history). For adoptees, though, their original documents are government owned and locked away, as well as critical medical information.
I agree with the points made above, though I can definitely see why this kind of testing is appealing to many people. Those who have lost relatives to the same disease would probably want to know if they possessed a gene leading to these same diseases. However, I think this is a dangerous path to tread. If the testing is inaccurate or done without doctor guidance, people could make very misinformed decisions based on this test. What does one do when they discover they possibly have genes for a certain disease? Will it change their outlook on life completely? It’s scary to me that I could know that I have a high chance of having a certain disease in old age at my current age, as I wouldn’t know how to prevent it or slow its coming.
I also wanted to note that I think this may be (though probably more physician-guided) what caused Angelina Jolie to receive a mastectomy this summer. This decision may have been incredibly beneficial for her family so I don’t want to write the testing off entirely; however, the public should remember the Jolie has access to many highly-qualified physicians assisting her in this decision. For this reason, I’m sure her decision had a great amount of input from professionals that others may not have at their disposal.