Abstract
While clinical and basic biomedical research focus on diagnoses and cures for common and rare genetic diseases, they are unable to address one of the largest underlying causes for genetic disease: mating within families or other small genetically isolated sub-populations. This interdisciplinary literature study investigates theoretical, moral and practical aspects to solve this major cause for genetic disease from an alternative angle: through cultural change and encouragement of an outbreeding reproductive behavior. Understanding why some communities persist with choosing consanguineous reproductive partners when the modern society has eliminated the economic rationale to do so, and to develop strategies to encourage a cultural change in those communities, is critical for a sustainable long-term solution to reduce the number of new cases of genetic disease and undiagnosed (sub-clinical) but detrimental genetic abnormalities in vulnerable and marginalized groups in modern Western societies.
Highlights
Already Charles Darwin noticed that inbreeding led to genetic problems and he felt personally responsible for the poor health of his children, since he was married to his first cousin Emma Wedgwood and the whole family had a history of multi-generation consanguinity (Berra et al, 2010)
Economic studies have suggested models of a “failed marriage market” which leads to kin marriage as a rational choice (Do et al, 2012). This proximal rational economic choice does lead to ultimate issues with an accumulation of detrimental genetic variants within families, which can manifest as disease or sub-clinical defects (Adams and Neel, 1967; Al Talabani et al, 1998; Al-Gazali and Hamamy, 2014; Barbouche et al, 2011; El Mouzan et al, 2008; Magnus et al, 1985; Morton, 1958; Rezaei et al, 2006; Sheridan et al, 2013)
It is important to remember that only very severe abnormalities are registered by the health care system, which means that genetically perpetuated sub-clinical issues that could lead to poorer well-being, lower intellectual capabilities or other disadvantages that are generally unknown
Summary
Already Charles Darwin noticed that inbreeding led to genetic problems and he felt personally responsible for the poor health of his children, since he was married to his first cousin Emma Wedgwood and the whole family had a history of multi-generation consanguinity (Berra et al, 2010). Evolutionary theoretical models could argue for some positive effects from consanguinity by rapidly selecting for beneficial recessive genetic variants which might benefit the population under a certain environmental selection pressure (Denic et al, 2008, 2011). / Reduce Genetic Disease through Cultural Change come at a great individual cost which can not be acceptable in modern society (Bittles, 2011) It is questionable if inbreeding-accelerated selection as done in artificial breeding of desirable traits give longterm benefits under a complex evolutionary pressure: some traits critical to survival, like immunity to novel pathogen threats, greatly benefits from high genetic diversity and outbreeding (Hoben et al, 2010). Since the problem described here is mainly social and cultural, the dynamics might look different since only limited input (identifying groups with high risk of genetic disease, and factual insights on the risks of inbreeding) from the biomedical field is needed
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