Technology and resources generated by the Human Genome Project and other genomics research are already having

a major impact on research across the life sciences. Some current and potential applications of genome research include

Molecular medicine Energy sources and environmental applications Risk assessment Bioarchaeology, anthropology, evolution, and human migration DNA forensics (identification) Agriculture, livestock breeding, and bioprocessing

Molecular Medicine

Improved diagnosis of disease Earlier detection of genetic predispositions to disease Rational drug design Gene therapy and control systems for drugs Pharmacogenomics "custom drugs"

Technology and resources promoted by the Human Genome Project are starting to have profound impacts on biomedical research and promise to revolutionize the wider spectrum of biological research and clinical medicine. Increasingly detailed genome maps have aided researchers seeking genes associated with dozens of genetic conditions, including myotonic dystrophy, fragile X syndrome, neurofibromatosis types 1 and 2, inherited colon cancer, Alzheimer's disease, and familial breast cancer. Medical researchers also will be able to devise novel therapeutic regimens based on new classes of drugs, immunotherapy techniques, and avoidance of environmental conditions that may trigger disease, and possible augmentation or even replacement of defective genes through gene therapy. Progress in molecular biology has enabled us to better understand human genetic disease, and has helped enhance the quality of life. This has been possible with technical developments to detect genetic disease presymptomatically. Introduction
Bioethics is a broad term and a very broad field of study. Bioethics can be defined as that discipline dealing with ethical issues raised by new developments in medicine and biological science. In the past (about 50 years ago), bioethics was used to solve simple ethical problems using Hippocrates postulates and Christian humanism. With advances in technology and cultural revolution, the traditional approaches of bioethics fail to account for certain complex events. Bioethics, as a separate formal field of study is roughly around 25 years old and one origin is the 1962 publication of Life magazine (3). Modern approaches to bioethics are derived from disciplines like philosophy, theology, medicine and law. The four cardinal principles that underline bioethics are confidentiality, beneficence, justice and autonomy (4). Medicine and other benefits of science have reached many social, cultural and religiously diverse groups and acceptance of these benefits have triggered wide variety of responses, and has

generated good public interest. In such a scenario, bioethics accounts for changes in both understanding and meaning. Application of bioethics involves three players: Physicians to practice beneficence, society to defend justice and patients to be granted autonomy. Many professionals need to be involved to accomplish these goals. A universal bioethical law is the need of the day. We wish to discuss three issues involving bioethics: presymptomatic genetic testing, prenatal diagnosis, and genetic manipulation. The information gained by molecular testing could be also misused.. Ethical difficulties due to molecular presymptomatic testing arise at three different levels, in society, in employment and in insurance. Presymptomatic Genetic Testing: Predictive and presymptomatic types of testing are used to detect gene mutations associated with disorders that appear after birth, often later in life. These tests can be helpful to people who have a family member with a genetic disorder, but who have no features of the disorder themselves at the time of testing. Predictive testing can identify mutations that increase a person's chances of developing disorders with a genetic basis, such as certain types of cancer. For example, an individual with a mutation in BRCA1 has a 65% cumulative risk of breast cancer. Presymptomatic testing can determine whether a person will develop a genetic disorder, such as hemochromatosis (an iron overload disorder), before any signs or symptoms appear. The results of predictive and presymptomatic testing can provide information about a persons risk of developing a specific disorder and help with making decisions about medical care. Presymptomatic molecular diagnosis is important in identifying carriers in populations, which could enable us to stop manifestation of disease prior to its occurrence. Molecular diagnostic tests are available for several diseases, such as Huntington's disease, cystic fibrosis and sickle cell anemia.

Gene tests: (also called DNA-based tests), the newest and most sophisticated of the
techniques used to test for genetic disorders, involve direct examination of the DNA molecule itself. Other genetic tests include biochemical tests for such gene products as enzymes and other proteins and for microscopic examination of stained or fluorescent chromosomes. Genetic tests are used for several reasons, including:

carrier screening: which involves identifying unaffected individuals who carry one copy of a gene for a disease that requires two copies for the disease to be expressed Preimplantation genetic diagnosis: Preimplantation genetic diagnosis (PGD) is a test that screens for genetic flaws among embryos used in invitro fertilization. With PGD, DNA samples from embryos created in-vitro by the combination of a mother's egg and a father's sperm are analyzed for gene abnormalities that can cause disorders. Fertility specialists can use the results of this analysis to select only mutation-free embryos for implantation into the mother's uterus. Prenatal diagnostic testing: Prenatal diagnosis is the
identification of disease of the fetus. The three main purposes of prenatal diagnosis are:1) to inform and prepare parents for the birth of an affected infant if any;2) To allow

in uterus treatment for postnatal treatment, if required; 3) To indicate termination of an affected fetus.

newborn screening Presymptomatic testing for predicting adult-onset disorders such as Huntington's disease and also for estimating the risk of developing adult-onset cancers and Alzheimer's disease Confirmational diagnosis of a symptomatic individual forensic/identity testing

Method of Gene testing: In gene tests, scientists scan a patient's DNA sample for mutated sequences. A DNA sample can be obtained from any tissue, including blood. For some types of gene tests, researchers design short pieces of DNA called probes, whose sequences are complementary to the mutated sequences. These probes will seek their complement among the three billion base pairs of an individual's genome. If the mutated sequence is present in the patient's genome, the probe will bind to it and flag the mutation. Another type of DNA testing involves comparing the sequence of DNA bases in a patient's gene to a normal version of the gene. Cost of testing can range from hundreds to thousands of dollars, depending on the sizes of the genes and the numbers of mutations tested. Uses of gene testing? : 1. used to clarify a diagnosis and direct a physician toward appropriate treatments, 2. while others allow families to avoid having children with devastating diseases or 3. Identify people at high risk for conditions that may be preventable. 4. On the horizon is a gene test that will provide doctors with a simple diagnostic test for a common iron-storage disease, transforming it from a usually fatal condition to a treatable one. These tests are targeted to healthy (Presymptomatic) people who are identified as being at high risk because of a strong family medical history for the disorder. The tests give only a probability for developing the disorder. One of the most serious limitations of these susceptibility tests is the difficulty in interpreting a positive result because some people who carry a disease-associated mutation never develop the disease. Scientists believe that these mutations may work together with other, unknown mutations or with environmental factors to cause disease. For what diseases are gene tests available? : Currently, more than 1000 genetic tests are available from testing laboratories. Some Currently Available DNA-Based Gene Tests

Alzheimer's disease* (APOE; late-onset variety of senile dementia)

Ataxia telangiectasia (AT; progressive brain disorder resulting in loss of muscle control and cancers) Inherited breast and ovarian cancer* (BRCA 1 and 2; early-onset tumors of breasts and ovaries) Hereditary nonpolyposis colon cancer* (CA; early-onset tumors of colon and sometimes other organs) Congenital adrenal hyperplasia (CAH; hormone deficiency; ambiguous genitalia and male pseudohermaphroditism) Cystic fibrosis (CF; disease of lung and pancreas resulting in thick mucous accumulations and chronic infections) Duchenne muscular dystrophy/Becker muscular dystrophy (DMD; severe to mild muscle wasting, deterioration, weakness) Fanconi anemia, group C (FA; anemia, leukemia, skeletal deformities) Fragile X syndrome (FRAX; leading cause of inherited mental retardation) Galactosemia (GALT; metabolic disorder affects ability to metabolize galactose) Hemophilia A and B (HEMA and HEMB; bleeding disorders) Huntington's disease (HD; usually midlife onset; progressive, lethal, degenerative neurological disease) Myotonic dystrophy (MD; progressive muscle weakness; most common form of adult muscular dystrophy) Neurofibromatosis type 1 (NF1; multiple benign nervous system tumors that can be disfiguring; cancers) Phenylketonuria (PKU; progressive mental retardation due to missing enzyme; correctable by diet) Polycystic Kidney Disease (PKD1, PKD2; cysts in the kidneys and other organs) Adult Polycystic Kidney Disease (APKD; kidney failure and liver disease) Prader Willi/Angelman syndromes (PW/A; decreased motor skills, cognitive impairment, early death) Sickle cell disease (SS; blood cell disorder; chronic pain and infections) Tay-Sachs Disease (TS; fatal neurological disease of early childhood; seizures, paralysis) Thalassemias (THAL; anemias - reduced red blood cell levels)