Life is unfair, and while others have suspected as much before, biochemists can now prove it. You have colon cancer—possibly because a flawed APC gene failed to produce the protein that helps prevent the disease. When the cancer spreads to your liver, you need Pfizer’s Camptosar. But if you’re the one-in-ten patient with a flawed UGT1A1 gene—find out with a Food and Drug Administration–approved test kit—you lack an enzyme to purge the drug from your body before it accumulates to toxic levels. Your oncologist may be able to adjust the dose so you can take Camptosar anyway. Or maybe not.
Washington can’t help. The Fourteenth Amendment doesn’t guarantee equal protection at the pharmacy. No privacy-protecting, discrimination-banning law, no promise that someone else will pay, will ensure that a drug that suits others will suit your genetic profile too. If Pfizer can’t make a gentler Camptosar, it will only do business with tougher patients. Meet “pharmacogenomics”—eugenics for drugs.
This is where diversity blather gives way to the rigorous diversity science that’s taking over the medical show. Drugs supply almost all the real health care these days, because human hands are too big to grapple with the microscopic things that cause most of our problems. Eugenic drugs reflect how biochemically separate and unequal people are. Some, indeed, target genes that track sex, race, or ethnicity; their FDA licenses affirm truths unmentionable in polite society and approve conduct illegal in every other sphere of commerce and public life. All are terrible news for anyone determined to pull people together, pool medicine’s costs, equalize its benefits, and lose diversity in the crowd. The doctors of equity promise universal access to the Mayo Clinic, where the real doctors now brew discriminatory cures and card your genes at the door.
