PSYC 3110 Lecture Notes - Lecture 24: Institute For Operations Research And The Management Sciences, Commensalism, Antibiotics

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Lecture 24: Advances in Biotechnology
Today:
- Talking about biotechnology from a social science perspective
Advances in biotechnology lead to:
New treatments and diagnoses for illness
New choices (not necessarily ‘better’)
– New forms and changes in social relationships
• Implications for individuals
– Health behaviours and decision-making
• Implications for policy
Ethics in setting of uncertainty
(moral and scientific)
- There’s a lot of biomedical research going on
- Most research from biomedical approach
- Advances in biotechnology sometimes lead to new choices
For example: When we talked about genetic risks. Choices you have to have a genetic or
not weren’t available before but now are. If you do have a genetic risk and have a risk to
something you have new choices with that information
- These new technologies actually create new relationships among people
- Also change existing relationships
- New technologies have implications for us as individuals and the health behaviours we
engage in and decisions we have about our health
- Have implications for policy
- If you have a genetic mutation that predisposes you to illness how can we use PGD
- These are ethical questions that impact you as an individual but also as a society
- How do new biotechnologies create new implications for implications and challenges
and society
- There are moral questions
- Scientific evidence informs those questions but can’t determine those questions
Studying Advances in Biotechnology
• As a social scientist requires focus on the subtleties of ethics and social science methods
Experience of patients 
Want to understand lived experience of patients
Ethics of particular technologies 
What kind of ethical questions do they raise?
This was discussed with genetic testing (one example
Arise with many new technological advances
‘Anthropological’ studies of laboratory scientists 
We typically think of scientists as the people that are the experts, but a few decades
ago sociologists and anthropologists started to think of science differently
Started to think about science as a human activity.. we need to interact with other
people, requires thinking, and interpretations
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Scientists have biases and emotions. Anthropologists and sociologists started to
observe scientists (What do they do?)
Legal and policy aspects 
Many forms of new technology have to have legal implications
There are legal implications if you use this technology for sex selection
• Also requires reasonable understanding of the science involved 
- These are things that we do as social scientists but the technology we are dealing with
are usually things we aren’t experts in (Professor didn’t study genetics, but is interested
in questions on what these things mean for society)
- You need to understand to some degree the science
- These are things you would study if you are interested in advances in biotechnology but
approach with socieal science methods
1. Direct to Consumer Testing
Dramatic drop in cost of genome sequencing allows for commercial applications 
Several corporations now offer personal genome testing 
Novelty: health care system is potentially bypassed 
- If you think about lecture about genetic risk Professor discussed how it is a sensitive
decision to get genetic testing… you often have to go through genetic counseling
- This means that genetic testing has always gone through a clinical context
- A few years ago a full profit company started offering genetic tests (23 and me)
It is done online, give DNA and we will send you results
- The kind of things these companies offer vary
(Focus today is health testing)
- The degree of scientific support for these testing methods vary
- There may be valuable information you are getting but not all of it is
- Why is this available now?
- Think back to the human genome project
- Now genome sequencing has dropped in price
- Companies like this don’t sequence your full genome
- There are so many implications
- One main one is that they bypass the healthcare system to get health advice
- These are private full profit companies... They sell your data
These companies aren’t doing research they are a company and they aren’t bound by
the same ethics boards
- You think you are buying a test but it isn’t that simple
- What is it that company actually tell consumers about privacy implications? On the
whole they don’t tell you anything
Scientific Controversy
Analytical validity 
“Without transparent quality-control monitoring and proficiency testing, the real-
world performance of these platforms is uncertain.” (Hunter et al., 2008)
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- This refers to scientifically how solid are these tests
- You have no idea how good the science behind this is
- 23 and me sends you a print out with all these different health risks and then they
say for each risk estimate they would give you a 5 star rating on validity
- If they say you are low risk of brain cancer and give you 1 star to indicate some
evidence but not that great
- 5 star rating means lots of evidence
- A lot of other companies don’t do this
Clinical validity
“the ability of the test to detect or predict the associated disorder”
Complex disorders and limited recognition of variants 
- Even if the science is good behind the genetics… how much does a test clinically
predict disease?
- How well does this science translate to the therapeutic context?
- If you don’t have analytical validity you don’t have to carry on
- Say you do have clinical validity do you also have clinical utility?
Clinical utility
Risks and benefits of actually introducing tests into practice
– Available risk management options 
- Means how useful is this information
- How useful is the test?
- These are distinct questions you need to ask before determining whether a genetic test is
useful
- Consumer testing isn’t that great when you consider these 3 considerations
- If you look at how tests are promoted is that the tests will empower you to make better
decisions
- Does having a genetic test motivate you more? That is an interesting question. Evidence
isn’t very strong that it increases motivation. More research can be done.
Regulatory Controversy
• Who should regulate genetic testing?
Medical profession
The market
• Open source metaphors
- Genetic testing is a new technology so we must ask if it is something we should
regulate.
- Some people say we should let market regulate
If it is valuable people will buy it if it isn’t people won’t
Some people argue that people do their own research about genetic testing
Others argue that these things can be damaging if you don’t regulate them
Potential Consequences of DTC
Behavioural changes to increase health 
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