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French DNA
Trouble in Purgatory
by Raul Rabinow

Reviewed by
James J. Ferguson Jr., M.D.

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To a reader committed to avoiding the label of 'francophile' or 'francophobe,' this small book emerges as a fascinating trip through the interstices of 'French mentality', if there exists such an entity. The term 'French DNA' does indeed exist, introduced with local horror at the prospect of France sharing its DNA with an American biotechnology company (Millennium), with all the mercenary implications that sharing suggests, especially since Millennium was started with venture capital. The author, a philosopher, sociologist, anthropologist, ethicist, reporter (take your pick, they all seem to apply), in an extended series of interviews, readings, conferences, lunches, etc., pieces together a fascinating description of the turmoil that has faced France as it grapples with the fate of its CEPH (Centre d'Etude du Polymorphisme Humain). CEPH started out roughly as the French equivalent of the US Human Genome Project, but quickly became bogged down in an odd mixture of politics and socio-mysticism. Generally avoiding ponderous judgments, Rabinow provides a fairly detached view of machinations concerning CEPH and its multiple intramural intrigues. He further documents CEPH's interactions with French industry, other national research organizations, and the French National Ethics Committee, as well as several French presidents.

The most shocking example of paralysis of French national policy relates to the blood transfusion problem that France endured in the early 1980s. Blood was accepted as a somewhat mystical gift from one person to another (as occurred during the French Resistance and after World War II). France could not expeditiously mobilize the wherewithal to halt the transmission of HIV and other viruses to hemophiliacs who required transfusions and derived blood products, even to the point of not permitting viral blood-testing procedures devised by US companies. The latter action resulted from lobbying by the Institut Pasteur, which was then developing such a diagnostic test.

CEPH, despite its original shortcomings, managed to weave a number of (locally) controversial people within its fiber. Daniel Cohen stands out as a prime example. Brilliant, talkative, itinerant, he seems to have had the knack of provoking the CEPH intramural establishment and its governmental supervisors beyond rationality. He was accused of selling 'French DNA' to an American firm (Millennium), which he had helped start (with MIT and Harvard faculty members). Another example is Philippe Froguel, a constant critic of Conen, but one encumbered with small attachments to industry (Glaxo and Hoffmann-La Roche).

Numbers of worthy projects developed within CEPH had immense merit, notably those seeking a genetic basis for muscular dystrophy, non-insulin dependent diabetes—a disease known to have a very considerable genetic component, as well as Project Chronos, which sought a genetic basis for achieving survival beyond the century mark. But all seem to have collapsed under the weight of national and local policy regarding reasonable access to 'French DNA' and the potential financial implication of such access.

It is unfortunate that the French scientific/political 'mandarinate' could not unravel the ethical complexities of a coordinated analysis of the human genome. A country with such a richness of scientific minds should not stumble on the issues of paternalism and usury. The greater good of its populace and that of the remainder of society should have prevailed.

Rabinow, Paul. French DNA: Trouble in Purgatory. The University of Chicago Press, Chicago, Illinois, 1999.

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