Guest:
Hank Greely, Professor of Law, Stanford
Bio and Contact Info
Listen (5:00) What's the best argument for FDA regulation of genetic testing?
Listen (10:50) A health exceptionalist
Listen (7:06) What about a Consumer Reports for genetic testing?
Listen (5:05) A device or a report?
Listen (3:13) Tools in command
Listen (3:43) The genoscenti vs. the general public
Hank Greely is a law professor at Stanford who teaches a course on the FDA and keeps a close watch on the genomic revolution. Hank is concerned with the ethical, legal, and social implications of new biomedical technologies.
We're excited to have Hank join us as part of our series, Regulation and Genomic Medicine. He has developed one of the most clear voices on the question of whether the FDA should regulate genetic testing.
"The best argument for regulating 23andMe is that they're providing health information that is not very good," he starts out in today's interview.
We threw the best arguments against regulation that have come up in this series at Hank. For example, one researcher compared the state of bioinformatics and genome interpretation today with that of the early days of the computer. Was the computer good enough in the 80's, the researcher asked. No, but we still used it, he said.
Hank accepts this argument and agrees that the U.S. has been a more libertarian country than many countries around the world. But we make an exception for health, Hank says. Computers weren't used in the early days, he points out, for guiding cars through traffic.
But is the FDA being overly paternalistic? Are 23andMe's predictions really any different from using data from the Framingham studies?
"In health, I am much more paternalistic than I am with anything else," Hank says. When the information is of really weak power and dubious accuracy, I get still more paternalistic."
Hank is quick to point out that he's not for banning astrology, something that he calls "completely useless." He takes issue with the fact that 23andMe has sold itself as a health company.
"When something wraps itself in scientific and medical guise, and is presented as being scientifically correct, we have the right to demand that it actually is."
What about letting the market bring up the value of genetic testing on its own? Is a genetic test really a device or is it a report done by a professional? And are we doing too much sequencing for sequencing sake? Hank isn't one to avoid tough questions. At the same time, he doesn't deny that some truly impactful technology is here.
"I expect that within 10-15 years there's going to be whole genome sequences in the electronic medical records of most people in this country. If we learn to use them well, interpret them well, convey the information to the patients well, they hold real potential for improving public health. If we do it poorly, they could make things worse."
Podcast brought to you by: Myraqa Clinical Research: The CRO for Point of Care and PMA Diagnostics.
