Disappearing Diseases: When Benefit Leads to a Dilemma

An interesting dilemma is raised in a Perspective article in the October 22, 2009 issue of the New England Journal of Medicine. The article titled “When Diseases Disappear-The Case of Familial Dyautonomia” by Barron H. Lerner M.D.,Ph.D.


Dr. Lerner writes “The success of genetic-screening programs raises an intriguing possibility: some dread diseases of the 20th century may soon become history. A representative example is familial dysautonomia, a severe neurologic condition, the incidence of which has decreased precipitously since population screening began in 2001. By giving prospective parents the option of terminating affected pregnancies, screening is doing exactly as was intended, but the disappearance of diseases such as familial dysautonomia should also give us pause. On a practical level, will interest and funding shift away from these conditions, leaving affected adults without advocates or the possibility of scientific breakthroughs? And philosophically, is the disappearance of a disease always an unmitigated good? What does it say about — and to — people currently living with a severe genetic disease when prospective parents would rather abort than bear a child with the same condition?”


Well, what are your answers to Dr. Lerner’s pertinent questions? ..Maurice