Cardoso MCA, Castiel L. Saúde coletiva, nova genética e a eugenia de mercado. [Collective health, the new genetics, and the eugenics of the market.] Cadernos de Saúde Pública [Public Health Notebooks] (Rio de Janeiro, Brazil) 2003 March-April; 19(2):653-662.

Objectives:To analyze advances in genetics in relation to a rise in reductionist emphasis in collective health, as opposed to sociocultural influences.

Methodology:Analytical and interpretive.

Results:The mutable and hybrid body, defined by DNA technology, modifies the body that we are accustomed to contemplate: a socially and culturally constructed body, replete with feelings, emotions, fears, and fantasies. From a sociological viewpoint, the body now comes to be seen as a machine for survival, in which genes are the determining factors.

With advances in molecular biology, in general, and those of genetic manipulation in particular, the field of collective health has found itself in conflict with a possible genomic reductionist approach. Under these circumstances, the principal focus of collective health interventions would similarly fall under a genomic approach, aimed at “individuals” and their “families,” in detriment to the time-honored focus on “populations.” This change would, in turn, remove the emphasis (and resources) on healthcare efforts designed to reduce the incidence of disease stemming from socioeconomic inequalities. Such an occurrence takes on added relevance when considering that the new developments in genetics are in the hands of private companies. The authors analyze the ethical implications that neo-liberal ideas and the logic of globalized markets can imprint on current work in genetics.

Developments in genetics are causing changes in the underlying concepts of public health. Examples include: the genetic bonds tying individuals and their families together; the emphasis on genetic risk; the notion of self-realization, uniting genome and behavior; cost-benefit relationships as the axis of public policies, with predictive genetic tests used in the future as indicators of the cost-benefit ratio; the concept of ethnicity overtaking that of race, but with ethnic bonds being defined more in genetic than in cultural terms; the body capable of being modified through genetic design; the implosion of culture and nature in the face of transgenics; and inheritance taking the place of contagion.

Conclusions:Important advances in genetics can become dangerous tools in the hands of private interests, which subordinate the vision of public health to an individualist outlook, grounded in genetics.

Copyright 2007 University of New Mexico