Predictive Medicine: a Goal for Genetic Screening

Abstract

Newborn screening for inborn errors of metabolism, as it is commonly practised, is preventive medicine. The fact that it is also a form of genetic screening has caused extended statements on the problems of newborn and genetic screening to be published by the World Health Organization (WHO 1968, 1972), the National Academy of Sciences (USA) (Comm. for the Study of Inborn Errors of Metabolism 1975), and the American Academy of Pediatrics (1977). Therefore, on the occasion of this International Symposium on Newborn Screening for Inborn Errors of Metabolism, it would be redundant to offer general recommendations for newborn screening. Moreover, to make particular decisions about newborn or genetic screening in specific populations is the privilege of their constituents, not of a stranger trying to predict what is to come in genetic screening. Faced with this conflict, I begin my task at this symposium with the assumption that the goal of genetic screening is predictive medicine; the argument follows. The participants in the symposium are all converts to newborn screening; whether we become apostles for genetic screening in predictive medicine depends on our view of the argument.