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ética y nutrigenómica (2009)20

ética y nutrigenómica (2009)20

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Published by: Sergio L. on Jun 06, 2011
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Uncertainties of Nutrigenomics and Their EthicalMeaning
Michiel Korthals
Rixt Komduur
Accepted: 14 November 2009
The Author(s) 2009. This article is published with open access at Springerlink.com
Again and again utopian hopes are connected with the life sciences (nohunger, health for everyone; life without diseases, longevity), but simultaneouslyserious research shows uncertain, incoherent, and ambivalent results. It is unrealisticto expect that these uncertainties will disappear. We start by providing a notexhaustive list of five different types of uncertainties end-users of nutrigenomicshave to cope with without being able to perceive them as risks and to subject themto risk-analysis. First, genes connected with the human body or nutrients can havedifferent functions in interaction with their environment (for instance, one nutrientcan be healthy for the heart, but can also be a high risk in relation to cancer).Secondly, uncertainties are formed by risk analyses. Will it be possible to calculatea certain risk of getting a certain condition with a certain lifestyle? Will it bedifficult to separate the genetic component and the lifestyle component? How highwill these risks be? How will these risks be handled by the actors? In the case of personal genotyping, it is unclear how frequent an adverse polymorphism willoccur. Will every individual have a certain vulnerability to a certain disease or willit only be applicable to a small group of the population or particular populations?Thirdly, dietary advices are subject to uncertainties and still to be developed pro-fessional standards: some will have adverse outcomes, some will not delay thedisease, and some will assume uncertain associations between nutrients, lifestyle,and genetic vulnerabilities. Fourth, with regard to the usefulness of tests it isuncertain to what extent risks indications about obesity and diabetes and othervulnerabilities really influence people to live healthier and therefore will help toprevent these conditions. Fifth, it is uncertain how and what nutrigenomics productswill be developed and used. Will it be possible to develop more effectively healthimproving products? Or is this too difficult and will nutrigenomics continue to beused in not always justified health claims as a commercial and marketing tool?
M. Korthals (
R. KomduurApplied Philosophy, Wageningen University, Wageningen, The Netherlandse-mail: Michiel.korthals@wur.nl
J Agric Environ EthicsDOI 10.1007/s10806-009-9223-0
Present-day ethics and theories of responsibilities presuppose that uncertainties willdisappear and concentrate on what seems to be fixed and stable in science. Wedevelop provisional thoughts that assume that the dynamic of science to produceuncertainties and dilemmas is endemic, and we stress the need for consumers toinstitutionalize value searching, exploring, and deliberating devices in the healthand food sector to find out the most important uncertainties and correspondinglysocially desirable research priorities.
Health and food
Food ethics
Introduction: Expectations and Disappointments of the Human Genome
Knowledge of the human genome has great potential for human health. It may helpus to understand the origins of diseases and to tackle diseases more precisely byusing medicines that work at the DNA level. Also for the nutritional sciences itpossesses immense possibilities. For decades now epidemiologists have tried to findlinks between health and food. Research at genome level may help to reveal therelation between food and health. It could find the origins of diseases and help toprevent them. It may prove the healthy influence of nutrients. However, thispotential is overshadowed by the enormous complexities surrounding the genomeand the possible applications of genomics or, this paper’s subject, nutrigenomics.The DNA was thought to be the ‘language of God(according to PresidentClinton) and the blueprint of the human body, concealing the secrets of life. If thisblueprint would be uncovered we would ‘‘know’’ for certain. We would be able tosolve the mysteries of our body and be able to prevent many killing diseases (for anexample: Smith2005; Stephenson2008). However, when most of the human genome had been sequenced after 2000, this idea was shattered into pieces. Theworking of the humane genome and its interaction with the environment (likenutrients) are complex, which became already clear after only 22.000 genes wereidentified. Interactions between genes, enormous amounts of genes reacting on onenutrient and opposing reactions of genes triggered by the same nutrient make thechallenges of nutrigenomics overwhelming (Piatigorsky2007). Besides that it israther difficult to test the health effect of nutrients and therefore certain diets andproducts, it also turns out that it is hard to determine the boundary between illnessand health on the genetic level. Nutrients have to interact during a stage in which thebody at that moment of time does not give any signals of illness yet (Van Roost2005). The literature on the influence of nutrients on health is therefore replete withcontradicting evidences (Davis and Milner2004). It is no wonder that some foodscientists express their scepticism about the scientific basis of health claims:
theFood and Drug Administration’s oversight over health claims has eroded, and theUnited States now allows ‘qualified health claims’ for which there is hardly anyevidence, as long as a disclaimer is included.’’ (Katan2004, p. 181; compare Aggettet al.2005)Besides these complexities and uncertainties of the experimental results of nutrigenomics, nutrigenomics’ interaction with society is largely unknown. How
M. Korthals, R. Komduur
will professional groups, like dieticians, supermarkets, general practitioners,respond to the development of nutrigenomics, its complexity and uncertainties?How will they influence its applications? Will the projected end-users be ableto integrate nutrigenomics products and services, whatever they may be, in theirdaily life?This short history of nutrigenomics shows us a rise and fall of expectations andcertainties (for similar cycles see Brown and Michael2003). The development of the science presents a dynamic in which ‘‘organized skepticism’’ (Merton1968)follows ‘‘organized utopianism’’ (our wording, MK): taken for granted truth andcertainties are destroyed or better, are unmasked as (un)truths and uncertainties. Thepersistent intellectual dispute among competing research teams in which establishedtruths fall prey to critical scrutiny is an indication of the mature evolution of thescientific understanding of the world. Scientists claim the right to make promises
mistakes; that is the core of the scientific ethos (Merton1968; Kuhn1962; Pinch2000).This oscillating history shows that during the period of emerging paradigms ordisciplines scientists are in need of an organizing utopian idea that rallies theirenergy and directs their attention. Organized utopianism (promises) seemsnecessary too and will give occasion to mistakes and false promises; organizedskepticism will unmask them later. The history of science is full of these (laterdiscovered) mistakes, which in some cases can turn out to be big problems or evencatastrophes. Examples of serious mistakes made in agriculture and food sciencesare the use of lead, of radioactivity, and DDT in agriculture and food, and the claimthat all vegetable oils are seen to be healthy (Bryson2003, Chaps. 7, 10).Nutrigenomics is thus surrounded by internal and external uncertainties and it isfor end-users wise to better prepare themselves for a genomics future withfundamental uncertainties than to expect that in the long run the uncertainties willdisappear. The issue of uncertainties of genomics has been tackled earlier, e.g., fromthe perspective of policy making (Gottweis2005; Pinch2000), science management (Pinch2000; Brown and Michael2003) and theory of science (Brown and Michael 2003; Jasanof2005). Here we will concentrate on the impact of the uncertainties of  nutrigenomics on citizen/consumers by exploring the fruitfulness of an ethicalperspective that focuses on how citizens/consumers’ cope with fundamentaluncertainties.Many ethical approaches to genomics or broader biotechnology have taken thedevelopment of genomics towards certainty for granted. They view the uncertain-ties of genomics as temporary, and discuss norms of how to regulate or even banthe expected products of this science without delving into the intricacies of thescience. A good example is Fukuyama’s proposal in his
Our Posthuman Future
(2002, p. 212) to put ‘‘brakes’’ on biotechnology. In this article we will concentratenot only on the products but on dynamics of genomics that constantly producesuncertain and dilemmatic situations. We will assume that such uncertainties arehere to stay. What do they mean for consumers and citizens? How should citizens/ consumers live with these dynamics of uncertainties of products and services of nutrigenomics, some of which are rather fundamental? How to select the morecertain results from the hypes and the misleading ones? How to attribute
Uncertainties of Nutrigenomics and Their Ethical Meaning

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