Does Baltimore really need personalized medicine?
Earlier this year, an article in The Baltimore Sun reported the Lieber Brain Institute had partnered with the African American Clergy Medical Association to establish the African-American Neuroscience Research Initiative. The purpose is to expand the number of African American subjects included in genome-wide association studies on mental illness, which to date have concentrated mainly on subjects of European origin.
One of the goals of this initiative is to foster the development of “personalized medicine,” in which treatments are tailored to an individual’s genetic makeup. In an op-ed in The Sun, Daniel Weinberger, CEO of the Institute, and Alvin C. Hathaway Sr., senior pastor at the Union Baptist Church in Baltimore, declared “We must shift the paradigm to ensure that research directly addresses the medical needs of African Americans, particularly related to brain disorders ... The need for such research has never been more clear, and Baltimore is the perfect place for it.”
This is a proposal that deserves more scrutiny than it has hitherto received.
Sure, you can find genetic variation correlating with mental illness, or probably any other trait you can think of. That doesn’t mean any individual is destined to exhibit that trait, or is, as they say in the current parlance, “born that way.”
The “born that way” argument is known more formally as genetic determinism. Genetic determinist views of human nature have not always served African Americans well in the past. Why do some of them seem to think things are going to be different this time around?
While I was researching my book “Madness and Genetic Determinism,” I met with Dr. Weinberger and several of his colleagues, who kindly took time out of their busy schedules to explain their work to me. These are obviously smart, wellintentioned people, but I could not avoid the conclusion that they are all barking up the wrong tree.
The problem with psychiatric genetics is that it seems to regard society as basically sound, but unfortunately plagued by all these people with faulty brains or faulty genes who just can’t fit in. A century of psychiatric genetics research has produced no findings that help the human condition in any way, and in fact has done great harm by diverting attention away from the well-established caused of mental illnesses, which have their roots in child abuse, neglect, abandonment and just about every other category of trauma and loss.
We all live in a world of finite resources. In a city where three hundred people — most of them young black males — die every year by gunfire, in which the mortality rate for black babies is twice that of white ones, schools are closing early because of lack of air conditioning, and too many citizens dwell in rodent-infested hellholes, is “personalized medicine” really what we need?
There is an old saying: “Be careful about what you wish for, you might get it.” The aspiration of all peoples to attain equality must of course be honored, but if African Americans devote their efforts to securing their equal right to be overmedicated, the end result might turn out other than what they are hoping for. Better for all of us — black, brown, white and every other color — to devote our efforts to ending child abuse, poverty, violence, racism and all the other social and economic ills that are known to cause these conditions we call “mental illnesses.”