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Genetics, Health Care and Public Policy: An Introduction to Public Health Genetics. By Alison Stewart, Philippa Brice, Hilary Burton, Paul Pharoah, Simon Sanderson & Ron Zimmern. Pp. 335. (Cambridge University Press, New York, 2007.) £38.00, ISBN 0-521-529-077, paperback.

Published online by Cambridge University Press:  21 May 2010

Nadine Levin
Affiliation:
Green Templeton College, Oxford
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Abstract

Type
Book Review
Copyright
Copyright © Cambridge University Press 2010

Approaching the emerging field of medical genetics with a broad, interdisciplinary lens, Genetics, Health Care and Public Policy explores the issues that arise when genetics is used as a tool to prevent disease and to improve population health. The central theme of the book is that we must be aware of the relationship between genes and the environment, and more importantly, of how this relationship complicates our understanding of the ways that genetic disorders are diagnosed and treated. As the book explores the social and public policy implications for genetic research and testing, it clearly cautions researchers to examine the environmental and social factors that give rise to the actual manifestation of particular genetic diseases.

The book is organized into seven chapters: the first four give an evaluation of the scientific and technological aspects of medical genetics, while the last three give an evaluation of the social and public policy-related aspects of medical genetics. The book begins with an introduction to the multi-sectorial ‘enterprise’ of medical genetics; it follows with an overview of genetic science and technology at the molecular and cellular levels, and then gives an overview of genetic epidemiology at the population level. After an introduction to genetic disorders and testing, the book discusses the organization and development of genetics in the health services, with a specific focus on the United Kingdom. Finally, the book addresses the ethical and social aspects of medical genetics, and also discusses the implications for public policy and the legal system. Each chapter is well organized and contains a concluding section outlining further reading.

Overall, Genetics, Health Care and Public Policy is useful for gaining a broad understanding of the scientific and social aspects of medical genetics, and the book excels at explaining the biological basis of genetic research. Even though its description of genetic epidemiology can be heavy-handed and technical at times, the book provides a substantial overview of the United Kingdom's existing genetics-related health programmes and policies, such as the organization of clinical genetic services, and the provision of population screening programmes for genetic conditions like Down Syndrome and Cystic Fibrosis.

While the book is broad in scope, it lacks specific details and in-depth discussions of the more nuanced questions surrounding medical genetics, such as debates on informed consent, the use of genetic information by insurance companies, and the regulation of genetic testing and therapy. Furthermore, the book would not be adequate to gain a complex understanding of the theoretical issues surrounding medical genetics, such as medicalization, genetic determinism, or the use of genetics in reproductive choice. Despite these drawbacks, the book provides a good introductory text for students looking to gain a strong foundation in the complex field of research and public policy that surrounds medical genetics.