Abstract
Kong and colleagues raise substantive areas of ethical concern regarding the translation of psychiatric genetic research into clinical and public health contexts. They recognize that psychiatric genomic research itself does not support essentialist claims, but point out that, nonetheless, the translation of genetic research to these new contexts may reinforce essentialist views of mental illness. Underlying Kong and colleagues’ analysis is recognition of the ways in which certain epistemological orientations, embedded within culture and institutional practices, may shape the translation of genetic research. For example, they discuss the ways that the cultural paradigm of the “responsible self” could influence individuals who have a mental illness to feel a responsibility to manage their own genetic risk, thus increasing the experience of stigma and burden. The translation of psychiatric genetics is shaped by societal trends towards biological reductionism in understanding mental illness, and towards valuing biological over social and environmental approaches to mental health. However, in proposing an ethics agenda for psychiatric genetics, Kong and colleagues did not sufficiently examine how psychiatric genetics fits into the broader cultural context of how risk is assessed, perceived and managed by social institutions and individuals. While they address the role of psychiatric genetics in identifying risk, there also needs to be engagement with how cultural attitudes regarding risk will influence translation of psychiatric genetics, as well as how genetics interacts with other tools for risk assessment. Kong and colleagues also ignore one of the main societal institutions for dealing with “risky” behavior and individuals who have mental illness: the criminal justice system.