Monthly Archives: December 2012

Criminomics: stopping crime before it starts

Criminomics Bears Fruit: 2037 Murder Rate Lowest Since 1964

 

Dylan looks like any normal six-year-old. He is bright and a little mischievous, has many friends, and is praised by his teachers as a model student. But his normalcy is only skin deep. In his cells lies the DNA of a murderer.

Though Dylan has gene variants that give him a more than 90% chance of premeditated mass murder, he will never commit a crime. Thanks to early intervention by doctors, Dylan’s criminal tendencies were identified before birth. Rather than abort the fetus, however, Dylan’s parents agreed to an intensive program of medication and counseling that will all but ensure that Dylan will lead a happy, normal, peaceful life.

Dylan is one of the success stories of the Criminal Genome Project, or CGP, the effort to sequence the complete set of genes involved in murder and other antisocial behaviors. The controversial science on which this project is based—criminomics—is winning converts, now that the latest crime figures are in. Last year, the annual murder rates in 8 American cities dropped to double digits for the first time since the middle of the twentieth century. In Washington, DC, only 90 people died by gunshot last year, down from 103 in 2036. Experts attribute the drop to criminopathy, a medical and public-health approach to crime based on criminomics. The criminomic method uses high-speed genome sequencing to to identify criminal tendencies at birth and begin treatment early in life. Clinical trials for criminal-gene therapy, which would eliminate antisocial tendencies permanently, are underway and, though preliminary, are showing promising early results. The first criminopathic patients are just hitting their 20s now—and the peace is deafening.

The CGP is run by Dr. Bart O’Day, a criminomicist at the Baler Agricultural and Behavioral University in the Republic of Texas. O’Day wrote the grant proposal that funded the project after a tragic shooting at an elementary school in Connecticut in 2012 in which 20 children and 6 adults were killed by a lone gunman. Thankfully, such a crime has since become unimaginable, thanks to the efforts of O’Day and his colleagues.

“It was an obvious thing to do,” O’Day said. “In the years just before the CGP, we had sequenced the cancer genome, the influenza genome, the pseudome, the schizome, and the retardome. The criminome was just lying in wait for us. So the science was there. All we needed was the motivation.”

In fact, the motivation had been there for 150 years. In the 1870s, the Italian criminologist Cesare Lombroso defined a “criminal type,” characterized by distinctive facial features and, ironically, the excessive use of tattooing, which he used in one of the first systematic attempts to prevent crime by biological methods.[1] About the same time, the Victorian polymath Francis Galton developed “composite photography,” in which he superimposed images of faces as a means of identifying the “criminal type.” “If criminals are found to have certain special types of features, that certain personal peculiarities distinguish those who commit certain classes of crime,” observed Edmund DuCane, one of the leading criminologists of Victorian England, “the tendency to crime is in those persons born or bred in them, and either they are incurable or the tendency can only be checked by taking them in hand at the earliest periods of life.”[2]

With the creation of the science of genetics after the turn of the last century, vaguenesses such as “inborn tendencies” and “heredity” hardened into “genes.” In 1914, the American psychologist Henry H. Goddard wrote, “The criminal is not born; he is made.” Goddard traced criminality to mental retardation, or “feeble-mindedness,” in the term of the day. By compassionately treating feeble-mindedness, Goddard believed one could prevent crime. The feeble-minded type, Goddard wrote, was “misunderstood and mistreated, driven into criminality for which he is well fitted by nature. It is hereditary feeble-mindedness not hereditary criminality that accounts for the conditions.”[3] Goddard believed he had found a single Mendelian gene for feeble-mindedness. By breeding it out of the population, he thought he could eliminate crime, as well as poverty, prostitution, and much illness. Though the feeblemindedness gene has been discredited, Goddard’s belief that crime is a genetic disease rather than a perverse exercise of free will has transformed our criminal justice system.

The decisive step was in reframing crime in terms of public health rather than justice. In the early1990s, the National Institute of Alcohol, Drug Abuse, and Mental Health (today subsumed under the National Institute of Genomics) undertook a massive Violence Initiative based on similar principles. It pursued a public health approach to urban crime, which, proponents recognized, was based on biology (and therefore, ultimately, genes).[4] Uncontroversial at first, liberal opposition to the effort mounted, ultimately leading to the canceling of a scientific conference on genetic factors in crime in 1992.[5] This first Violence Initiative died a rather brutal and noisy death. Yet work on the biological basis of crime continued apace. In 1995, a Danish twin study identified the first crime gene, and more were identified shortly after the turn of the century.

But it was high-speed genome sequencing, combined with sophisticated methods of correlating complex behaviors with DNA sequence, that finally provided the technological breakthrough to stop crime before it starts. After the 2012 school shooting, it took a full year for O’Day’s team to sequence the criminal genome (today it could be done in an afternoon). But in 2014, they published paper describing 112 gene variants that together account for more than 99% of predisposition to murder. The genes were patented and licensed to pharmaceutical companies, and seven new targeted therapies were quickly added to the standard psychiatric armamentarium of anti-depressants and anti-psychotics. The federal Violence Initiative was reinstated in 2015 as the Institute of Crime Prevention (ICM), a branch of the National Institutes of Mental Health.

The first mandatory screening for criminal tendencies was put in place in Washington, DC, in 2018. Other states quickly followed; today, only West Dakota and North Virginia lack screening laws. Convicted murderers were the first to be screened. The ICM then tied crime screening to the back-to-school vaccination requirements for students in secondary and primary schools. Most states now test babies at birth, with blood from the standard heel-stick. Babies born with greater than 50% chance of committing murder have their standard RFID chips, implanted in every child at birth, encoded with the designation “Precrim.”

Individuals identified as precriminal are placed under the care of a criminopathic physician, assigned a health care worker, and given criminal prophylaxis: a treatment regimen tailored to their genetic and environmental circumstances. In all cases, this involves a combination of medications and counseling designed to maintain equanimity, promote sociality, and minimize the risk of triggers, including certain music and video games. Teachers and the parents of friends can discretely scan the child and take steps to minimize conflict and quickly intervene should violence erupt. Most states now prohibit the guardians of precrims from keeping firearms in their homes. NRA members oppose such bans, pointing out that since precrims can be dosed so as to ensure docility with a wide margin of safety, prohibiting guns in precrim homes is overkill.

Combined, these methods have proven remarkably effective. Murder rates began dropping as soon as the programs were put in place, but as the first neonatal precrims hit their teens, rates began to plummet. The rates of other violent crimes have also begun to fall, though somewhat more slowly: rapes are down in most states, as are armed robberies and even grafitti and illegal dumping. Scientists at the CGP explain these results by hypothesizing that many criminal behaviors share a common genetic mechanism, possibly related to emotional intelligence.

For all its success, the program has its opponents. Eugene Galton, a member of the Galton dynasty of scientific criminologists, recognizes the benefits of the criminopathy program but thinks the social costs are too high. “Liberty is too high a price to pay for safety,” he says. “We’re ceding our free will to an iatrocracy—a government by the doctors.”

Such philosophical musings carry little weight with inner-city residents who now sleep more peacefully, without the constant pops of gunfire that once punctuated the night. Dylan’s mother sees safety as the best kind of freedom: “I prefer a war with drugs to a War on Drugs,” she says. “I love my son; I’d rather put chemical bars around his mind than steel ones around his body.”


[2] Galton, “Composite portraits,” 143.

[4] Extrapolating slightly from Breggin, Reclaiming our children, p. 52.

[5] New York Times, Sept. 5, 1992, front page. See also Allen, Garland E. “Modern Biological Determinism: The Violence Initiative, the Human Genome Project, and the New Eugenics.” In The Practice of Human Genetics, 1-23, 1999.

 

Taking counsel (Review of Stern, Telling Genes)

I just read Alexandra Stern’s fine new history of genetic counseling, Telling Genes (Johns Hopkins, 2012; $40 cloth/$25 paper/ $15 Kindle). Though Alex is my friend, I review her book here because her subject relates so closely to the themes of Genotopia. Alex and I played leapfrog around some of the same archives as we researched. Telling Genes and The Science of Human Perfection are complementary—and I mean that in the nicest possible way. With that warning of possible conflict of interest, I want to examine her history of genetic counseling with the same “critical and sympathetic” analysis (3) that she applies to the history of genetic counseling itself.

Like medical genetics, the history of genetic counseling is intimately bound to that of eugenics. And like medical geneticists, genetic counselors have been trying to shake off these eugenic associations for many years. Stern, though highly sympathetic to today’s genetic counselors, won’t let that historical firewall stand. Unflinchingly, she drives home the eugenic connections in every chapter.

One of the most contentious issues in this history is where the history begins. Almost all genetic counselors today are Master’s level professional GCs. A Whig history of genetic counseling, then, might argue that the history began in 1969, with the founding of the first Master’s degree program in genetic counseling at Sarah Lawrence College. In contrast, a radical interested in showing the continuities with the darkest side of eugenics, might argue that the history began in 1910, with the founding of the Eugenics Record Office at Cold Spring Harbor. ERO staff advised people about many of the same things—likelihood of disease, of perpetuating family traits, of a particular racial parentage—that GCs still do today.

Stern takes a middle ground, beginning the history in 1941, with the founding of three independent research and counseling institutes for medical genetics: the Heredity Clinic in Ann Arbor, MI; the Family Record Office and Department of Medical Genetics at Wake Forest, and the Dight Institute of Human Genetics, in Minneapolis. These were conceived as Eugenics Record Offices attached to medical schools; collectively, they are known as the heredity clinics. At one of them (the Dight), the term “genetic counseling” was coined, by director Sheldon Reed, in 1947. Beginning here with these hybrid institutes—part ol’ time eugenics office, part modern genetic counseling facility— allows Stern considerable interpretive room. She allows the ambiguity and the tensions between individual and population to hang in the air, creating that kind of awkward pause in a conversation that makes a reflective person stop and think.

GC timeline.001 Taking counsel (Review of Stern, Telling Genes)

A (very) rough chronology of major events in the history of genetic counseling.

Stern does not, however, narrate the history chronologically. Rather, the history unfolds in a series of oscillations and resonances, in a series of analytic chapters organized by central concepts and problems in genetic counseling. Taking a thematic rather than chronological approach buys her a great deal of analytical substance, but it sacrifices narrative continuity. The arc of genetic counseling over the second half of the twentieth century doesn’t emerge until the end, and the reader must do the work of pulling out the major events and arranging them chronologically. Although the first chapter is titled “History,” it covers mainly the debate in the 1970s over the professionalization of the field. This is the only significant misstep in the book. A brief narrative account of the field—from the establishment of the Heredity Clinics in the early 1940s through the neo-eugenic 1950s, the emergence of genetic screening in the ‘60s, with the first Master’s level program at the end of the decade, through the profesionalization of the 70s and ‘80s, would have set the stage better for her later thematic analysis. I read the book with two graduate students, and both of them felt the lack of a chronological narrative to be a hindrance.

The remaining chapters cash in marvelously, often brilliantly, on the thematic organization. Chapter 2, “Genetic Risk,” looks at Huntington Disease, tracing the “shifting risk calculus” of the disease “as it crossed the transom of genetic testing and genetic counseling” (31). Stern notes that in lieu of effective therapies, more information and more precise diagnostics do not lessen—and perhaps increase—apprehension about the disease. Chapter 3, “Race,” focuses on questions of the population and the individual. Thinking in terms of populations, she argues, carries many tacit racial considerations into human genetics: “Population was never a neutral biogeographic term.” A harrowing and perceptive section on the methods of “racial matching” at the Dight Institute of Human Genetics in Minnesota and the Heredity Clinic in Michigan excavates a remarkable series of notebooks from the director, Sheldon C. Reed. Stern observes Reed simultaneously advocating publicly a liberal stance toward miscegenation as a solution to racial tension and advising adoptive parents on the goodness of fit of mixed-race children into a white family. Reed used an implicit “one drop rule,” At Michigan, James V. Neel—one of the pioneers of noneugenic medical genetics—also classified babies, according to a sort of Pantone series of skin tone. Stern allows this ambiguity to hang in the air, neither damning nor defending their inconsistency. These medical-genetic pioneers helped bring the field forward, but they were flawed, and Stern makes no apologies for them.

Chapter 4, on disability, focuses on the evolution of Mongolism to Down syndrome. In the 1940s, she shows, genetic counseling was built around a code of prevention (97). Gradually that code shifted to focus more on adaptation and adjustment, as families and patients’ rights groups have pressed for the acknowledgment of the disabled. These groups have understandably expressed concern over reproductive technologies and prenatal genetic screening, perceiving mandatory screening laws as an attack on the very existence of the disabled.

In chapter 5, “Women,” Stern relates the history of the founding of the Sarah Lawrence program in genetic counseling. Established in 1969 by Melissa Richter, it was brought to maturity by Joan Marks, who ran the program from Richter’s death in 1974 until 1998. Though mythologized as a moment when genetic counseling at last threw off its eugenic shackles, here too eugenic concerns mingle with sure-footed movements toward autonomy and informed consent. Richter, for all her sunny optimism and prescience, was a “neo-Malthusian,” couching her program proposal in the language of population explosion and mounting genetic “load,” Hermann J. Muller’s term for the accrual of mutations. Richter’s signal contribution was in establishing women as the foundation of modern genetic counseling—a startling echo (unnoted by Stern) of the long tradition of female “field workers” at the Cold Spring Harbor Eugenics Record Office in the teens and twenties. The medical community fought bitterly against the establishment of Master’s level genetic counseling, but the persistence of Richter and others persuaded physicians to cede jurisdiction over this critical but “softer” aspect of genetic medicine.

Chapter 6, on ethics, focuses on the shift from directive disease-centered eugenic counseling to nondirective, client-centered counseling. Here Stern takes us back to before the Heredity Clinics, to the psychologist Carl Rogers, who coined “nondirectiveness” in developing a new approach toward counseling victims of violence and abuse. She brings forward much fascinating and new material here, although her inference that Lee Dice and other Heredity Clinicians were borrowing directly from Rogers is circumstantial and, to me, not entirely persuasive. However, her analysis of the erosion of the concept of nondirectiveness is fascinating. She shows, surprisingly, that “nondirectiveness” has had a relatively short life. It didn’t enter the genetic counseling lexicon until the 1980s, and already by the 2000s it had begun to recede as the discipline’s gold standard, in favor of a more nuanced discussion about the strengths and limits of autonomy and consent.

The final chapter shifts categories to look at a recent methodological development: prenatal genetic diagnosis and its uneasy marriage with genetic counseling. This provides her with a vehicle for examining developments in genetic counseling since the 1970s. Her analysis of the rise of amniocentesis is a valuable contribution to literature by Rayna Rapp, Ruth Schwartz Cowan, and Robert Resta, among others. A conclusion briefly examines current-day practices and, in an original analytical move, closes by considering the possibility that the history of genetic counseling may be drawing to a close. As genomic medicine works to treat all disease as genetic in origin, the concept of genetic disease is gradually eroding. If genetics dissolves into biology, what exactly will genetic counselors counsel about? Stern closes with a call for genetic counselors to examine their history as a means of ensuring their future.

Yet if the juggernaut of geneticization continues unabated, there will always be a need for a medical-genetic middleman—or middle-person. Someone with serious genetic training but also skilled in psychology, ethics, and education. Someone whose time is not metered in quarter-hour increments (and billed in C-notes). Telling Genes is unflinching in tracing our hereditarian past, but sympathetic toward and highly supportive of those compassionate professionals who guide the rest of us into an ever more genetic future. It should be widely read, by genetic counselors, by clinicians, by future parents, and by anyone who is or knows someone who is affected by genetic disease.