A Global Genome? Comparing the Development of Genetic Testing for Breast Cancer in the United States and Britain (2003)
Parthasarathy, Shobita (Author)
Cornell University
Hilgartner, Stephen
Edition Details: Advisor: Hilgartner, Stephen
Physical Details: 232 pp.
Language: English
This dissertation compares the development of genetic testing for breast cancer in the United States and Britain. In the mid-1990s, scientists discovered BRCA1 and BRCA2, two genes linked to inherited predisposition for breast and ovarian cancer. Soon after these discoveries, organizations across the world began to develop diagnostic testing services based on the new information. Meanwhile, patient advocates, scientific and professional organizations, bioethicists, government advisory committees, and the media tried to influence the development of this new genetic technology. These groups viewed BRCA testing as a test case, one that would provide an early glimpse of the future of genetic medicine---in terms of who would provide these technologies, how they would be regulated, and how newly generated genetic information might be used. Based on qualitative research that included interviews, document collection, and participant observation, the dissertation explores how BRCA testing services were built in the US and Britain, the implications of these services for the participants involved, and how the services were integrated into health care in the two countries. It demonstrates how these technologies were constructed differently in different national contexts, and argues that each technology prescribed a particular moral order---specific rights, roles, responsibilities, and authority---for the participants who came into contact with it, such as health care professionals and individuals interested in testing. The specific shapes of BRCA testing in each country also influenced how individuals at- risk for breast and/or ovarian cancer were identified and treated. Despite these differences in the shapes and consequences of their technologies, however, American and British providers integrated the new technology into their respective health care systems in a similar manner; each argued that BRCA testing would be particularly empowering for its users. The dissertation concludes by investigating the response of British health care professionals, scientists, and advocacy groups to Myriad's attempt to expand its BRCA testing technology to Britain. These groups resisted the technology transfer, arguing that Myriad's uniquely American testing service had no place in the British health care system. Despite a world that seems increasingly global, with numerous transnational linkages, national context it seems, still does matter.
...MoreDescription Cited in Diss. Abstr. Int. A 64 (2003): 666. UMI order no. 3081360.
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