Responsibility in the genomic era

The concept of responsibility for health is highly controversial, but it is ever-present in the modern discourse about public health.

No one can deny that individuals sometimes act in ways that increase their likelihood of developing a disease or an injury.

Smoking on a regular basis increases the risk of developing lung cancer. Skiing on a regular basis increases the risk of breaking a leg.

Of course, there are many social and environmental factors that impact on health and few people are fully causally or morally responsible for their ill-health. However, many conditions are linked to human behaviour and a number of ethicists have argued that this fact has relevance for the fair distribution of healthcare resources.

The genomic revolution may well have a significant impact on the responsibility for health debate. Genome wide sequencing might uncover genetic variants that explain why some people can consume a great deal of alcohol without developing liver cirrhosis.

Genome wide sequencing might also provide information that will enable people who have a greater genetic risk of a certain condition (e.g. type 2 diabetes) to amend their lifestyle in an attempt to reduce the probability of getting the disease.

In other words, the way in which we apportion responsibility is likely to be radically affected by the genomic revolution. Reproductive choices may also be affected by more widespread genetic testing and difficult questions about reproductive responsibility will inevitably follow.