Celebration and shame

BMJ 2000; 321 doi: (Published 01 July 2000) Cite this as: BMJ 2000;321:0

The completion of the first draft of the human genome may be the most important medical discovery since the BMJ began, more important than the discovery of the circulation of the blood or of antibiotics (p 7). Mike Dexter of the Wellcome Trust, which funded the British part of the genome project, has gone even further, suggesting it's more important than the invention of the wheel: “I can well imagine technology making the wheel obsolete. But this code is the essence of mankind, and as long as humans exist this code going to be important and will be used.”

The description of the human genome should lead to greater understanding of life and disease, new treatments, and new methods of diagnosis. Ultimately medicine may be transformed from being primarily about the management of disease to being concerned with identifying and ameliorating risk. All this is, however, likely to take a while, and the new understanding will bring problems as well as benefits. It's thus perhaps unfortunate that the understandable excitement of scientists has led to excessive hype and promises. “It is now conceivable,” said President Clinton, “that our children will know the term cancer only as a constellation of stars.” People may live for a thousand years, and we may arrive, said one of the leaders of the project, at a “total understanding of not only human beings but all of life.” Let us hope that this hubris does not lead to nemesis.

British scientists played an important part in the human genome project, but England (not, importantly, Britain) has also been in the news for bad reasons. It has been disgraced by its football hooligans creating havoc in Belgium. The one comfort is that these hooligans are different from the rest of us English: they are a separate population. Those of an epidemiological bent (most BMJ readers?) will be suspicious. England probably has more violent, drunken, and racist hooligans than other countries because English society celebrates violence, indulges drunkenness, and is racist. These hooligans are probably not a different population: they are more likely to be the tail end of a normal distribution.

The racism inherent in English society manifests itself in the way we deal with refugees and asylum seekers. The media publish negative and racist images of them (p 5), forgetting that many of the English have forebears who were refugees. Yohannes Fassil describes what it was like to arrive in the United Kingdom as a refugee from Eritrea 15 years ago (p 59). An accompanying editorial examines the poor health of refugees and the poor services that Britain delivers to them (p 5). The authors suggest that far from denigrating refugees we need to find ways to develop and use their skills to their own and the community's advantage.


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