Book Review: Destiny's Child No Longer – Rewriting genetic fate

Destiny's Child No Longer: Rewriting Genetic Fate
By Dr William Haseltine and Dr Kim Hazel
Published by ACCESS Health Press
ISBN-13: ‎979-8992158366
Buy this book from Amazon UK

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We stand at an exciting and uncertain time in the field of developing new therapies for genetic diseases. Headlines about new treatments and clinical trials for previously untreatable conditions are becoming more common, with the first treatment for Huntington's disease being a recent and unprecedented example (see BioNews 1308).

This reflects developments in medical research over the last few decades, where we have been able to understand the causes of genetic conditions better and use more advanced technologies, such as gene therapies, to address them. However, because the field is nascent and fast-moving, with a mixture of successes and failures, it's hard to keep track of it if you aren't a scientist.

Destiny's Child No Longer: Rewriting Genetic Fate, a new book by medic and biotech entrepreneur Dr William Haseltine and science writer Dr Kim Hazel, is a much-welcomed attempt to summarise the state of the gene therapy landscape for a lay audience.

I was extremely happy to see the attention and level of detail that went into explaining the underlying science, which was a perfect introduction to the content for anyone without a science background. The most important examples of gene therapy breakthroughs are discussed, alongside some of the more salutary examples of mistakes. I particularly liked that these case studies were centred around the experience of patients and their families.

It also covers broader topics such as the uncertainty around how access to gene therapies will work and how they will be paid for. Topics directly related to gene therapy are also discussed in a good level of detail, such as genome sequencing and genome editing. I do not think there is another book like this available that aims to give a working fluency in these specific areas at once.

On the other hand, I have to say there were many points where I did not love the writing itself. Too often, I felt the authors veer towards melodramatic language that could have come from a bad advert (one that ends up in your junk folder and you roll your eyes at).

In one scenario, highlighting the dangerous possibility of a world where 'designer babies' with edited genes are the norm (a serious concern), a couple have a meeting with a doctor who conjures a 'holographic DNA strand' from his tablet. After asking the expectant parents 'would you like to enhance or design your baby's genes', the father pleads back 'What about the risk? The ethics? The... humanity of it all?'

Some people will disagree with me and may appreciate the more dramatic tone. However, I do think it's an example of how theatrics are sometimes chosen over providing an accurate and clear message. For example, later in the same chapter, Drs Haseltine and Hazel thoughtfully and correctly discuss how editing a gene would likely have unintended consequences that we cannot know, and that the way genes contribute to characteristics is often excruciatingly complicated. This would be a more cohesive and meaningful message if they hadn't begun the discussion with the above A-level drama piece.

While this example is a particularly cartoonish one, it is not unrepresentative of the tone, and often serious discussion is devalued or muddied in a way that is more subtle. For example, one of the biggest gripes I had with the book was the way it invokes 'genetic fate' or 'genetic destiny' from the title (there is an irritating repetition problem in general, where the lines that felt hammiest to me crop up again and again). Drs Haseltine and Hazel discuss the fact that environment (and often also chance) are major determinants in our biology as much as genetics. It's just in conflict with how many times we hear something like 'What if we could decode the mysteries hidden in our genes and use that knowledge to reshape our destinies?'

If I did not have a background in science, I would probably not understand just how much this starts to bleed into a biological essentialism at times. Previously, I reviewed How Life Works by Dr Phillip Ball, an overlapping primer for the state of biological research that is excellent but covers much wider aspects of research and is far more demanding (see BioNews 1254). Dr Ball places great consideration on avoiding biological essentialist thinking when talking about DNA and genetic diseases. It is hard to ignore the fact that Destiny's Child No Longer is more slapdash in this regard and is written by someone who has founded companies that are trying to commercialise gene therapies.

While I do think Destiny's Child No Longer pushes it close in terms of tone, I still think it is very informative and considerate in terms of the material that it covers. For someone specifically interested in gene therapy, it is a great starting point, although I would encourage people to take in some of their rhetoric with a pinch of salt. Regardless of how I personally feel about the way it is written, for now, it is certainly the best way to get to know more about the topic and should be a fascinating read.

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Buy Destiny's Child No Longer: Rewriting Genetic Fate from Amazon UK.