Whose DNA is it anyway?

By Sarah Arnquist

News of the California Health Department's mailing of cease and desist letters to 13 direct-to-consumer genetic testing firms, such as 23andMe, Navigenics and DeCodeMe, has sparked intense debate over balancing regulations to guarantee quality and individual rights to genetic data.

Here on THCB, Matthew Holt called the move the "first establishment challenge of Health 2.0."

"This is a case where the regulations are running way behind the technology, and the trade protection organizations of health care providers are, I’m sure, whispering in the ear of the regulators," Holt wrote.

Why all the fuss now?

CA regulators say doctors must be involved in ordering and deciphering the genetic tests, which currently are offered directly to consumers. Currently, customers pay about $2,500 at Navigenics for an initial one-year membership -- and then an annual fee of $250. 23andMe and DecodeMe both charge about $1,000 for permanent access.

Thomas Goetz, a blooger at Wired and Epidemix, wants doctors to stay uninvolved. He compared the genetic tests to pregnancy tests and thinks the state shouldn't meddle with his DNA.

"The assumption that there must be a layer of 'professional help' is exactly what the new age of medicine bodes -- the automation of expertise, the liberation of knowledge and the democratization of the tools to interpret and put to use fundamental information about who we are as people. Not as patients, but as individuals. This is not a dark art, province of the select few, as many physicians would have it. This is data. This is who I am. Frankly, it's insulting and a curtailment of my rights to put a gatekeeper between me and my DNA."

Dr. Steven Murphy over at Gene Sherpa, however, argues that doctors must be involved and for more regulation to ensure the quality and integrity of genetic testing. "Medical Genetic testing will and should fall in the realm of health care and practitioners," Murphy wrote.

The California officials' move was predictable, Murphy says, and points out research from Burrill & Co. that found “makers of these tests might have more success penetrating the market by working through doctors rather than trying to make the case for their products directly to the consumer.”

Murphy felt bombarded by commentators with strong opinions on the subject and wrote several follow-up posts defending his position. Murphy is a clinical genetics fellow at Yale University and founder of a personalized medical practice. He says his opinions that the average person and many general physicians cannot understand genetics is not arrogance but merely the truth.

"I am just shocked and awed that some in the public think that they can do this on their own without professional help. Do you build your own home? What about fight your own court cases? Some do their own taxes ... but only when it isn't complicated. Trust me, this IS COMPLICATED!"

On his blog, Murphy provides a helpful timeline for genetic testing, going back to 1994 when JAMA published an article discussing the psychological implications of genetic testing.

State regulators gave the testing companies two weeks to prove they are in compliance with state law. Stay tuned for the outcome.