New technologies, greater understanding of human genome bring promise of personalized medicine

New technologies and greater understanding of the human genome bring the promise of "personalized medicine," the unraveling of genetic diseases and much more. But the new frontier brings with it grave ethical and societal questions, as well, according to Dr. Raymond G. Gesteland, University of Utah vice president for research.

Gesteland discussed not only the promise, but also the potential peril, of genetics and technology last week as he presented the Gould Distinguished Lecture on Technology and the Quality of Life at the U.

The "explosion of information," including the 3.1 million "letters" of genetic information in each cell, brings the promise of better understanding of diseases people might be prone to or already carry, but it also brings "dilemmas" about what to do with the information, said Gesteland, who is also the Helen Lowe Bamberger Colby Distinguished Professor of Human Genetics.

Gesteland predicts that eventually people will be able to purchase their own genetic story "for a mere $1,000" and then know if they're prone to certain diseases. Genetic information will help doctors in the future determine which medications are most likely to work better for individuals.

And for each question the genes answer, others will arise.

Should parents be able to buy the genome sequence of their newborns?

If you are likely to get a disease and there's no treatment or cure, do you even want to know? And should your insurance company be privy to the information?

Using genetic information to tailor drugs, called pharmaco-genomics, has huge potential to target diseases in ways that work for individuals. Gesteland cites the example of a blood thinner, warfarin (Coumadin), in which the status of two genes "can adequately predict what the dose should be."

He pondered possible outgrowths of the technology and genetic knowledge: "Mall medicine," where you can stop by, leave a blood sample and a credit card and get information on your "latent talents, neuroses, frailties and risks," but may not find much advice when you need answers.

Or a visit to the doctor, who could call up your genetic sequence and look for variants that indicate disease, pick a drug for your sub-disease and check for efficacy and potential adverse reactions.

It all sparks questions, he said, not only medically, but in terms of forensics, liability, insurability and genetic selection, among others.