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Uncertainty prevails on sports DNA tests
Question of the Day
Eddy Curry, a 22-year-old player in the National Basketball Association who missed 19 games last season because of an irregular heartbeat, refused the Chicago Bulls' request that he take a DNA test to determine whether he is susceptible to a potentially fatal heart condition. He was traded last week to the New York Knicks, and he passed his physical on Friday.
These are the facts. A great deal of uncertainty remains, however. Not just about Curry's health but about the increasingly sophisticated and perhaps intimidating methods used to test and analyze the insides of athletes. What are the ethics of such testing? Does it work? Where might it lead? And how much information about a person is too much?
"I think there are valid points on both sides," said Peter Roby, director of Northeastern University's Center for the Study of Sport in Society. "A player must be careful about what source of information he allows people to get access to. Who the heck knows what's in your medical history or DNA?
"On the other hand, you have an organization that wants to make sure they can do all they can to protect their interests and investments before they commit upwards of $60 million to a player. So I can understand why they would want to use every possible means to investigate that."
Although some specialists in the field said it has happened before, this is the first reported instance of a professional athlete in the United States being asked to submit to genetic testing. Some doctors think such tests are accurate. Many inside and outside the medical community oppose it for privacy reasons.
Some members of the press reacted harshly, targeting Bulls general manager John Paxson, who asked Curry to be tested. "Butt out, Bulls," one Chicago columnist wrote. "Even if your heart is in the right place. ... you have dangerously stepped past a health issue and into a privacy issue."
In the column, an unnamed cardiologist was quoted as saying, "With something like this, you can never tell the motives. But it looks like someone buying an expensive racehorse."
NBA Commissioner David Stern has taken the middle ground, expressing both the need for comprehensive testing and the right to privacy. The NBA Players Association was opposed to Curry being tested (union chief Billy Hunter was not available for comment) and Alan Milstein, Curry's attorney, urged him not to take the test. Henry Thomas, a player agent, was quoted as saying, "The ramifications could go beyond this particular case."
Even those who do not have a stake in the matter have some concerns.
"What I'm nervous about is, I don't want to set a precedent where a boss or any third party -- military or the police -- can force you to take a genetic test," said Art Caplan, director of the Center for Bioethics at the University of Pennsylvania. "It should be voluntary, and it should be between you and your doctor. The principle I'm trying to defend is, for that kind of test, a prediction about the future, you should be able to choose."
Curry, a 6-foot-11-inch, 285-pound center who was diagnosed with an irregular heartbeat, or arrhythmia, that caused him to miss the final month of this past regular season and the first round of the playoff series against the Washington Wizards, made his choice. He refused to submit to a test that might determine whether he is at risk for hypertrophic cardiomyopathy (HCM), a disease that killed basketball players Reggie Lewis and Hank Gathers, among other athletes. Citing his right to privacy, he acted on advice from his agent and attorneys, including Mr. Milstein.
Mr. Milstein, who did not return several messages, told the Chicago Tribune, "If employers could give employees DNA tests, then they could find out if there's a propensity for illnesses like cancer, heart disease or alcoholism. They will make personnel decisions based on DNA testing."
But those who favor genetic testing for Curry refer to legislation before Congress that would prohibit discrimination in the workplace based on genetic testing. Barry Maron, a Minneapolis cardiologist who suggested the procedure to Mr. Paxson, said the test would be limited to HCM.
Dr. Maron did not return messages. Lisa Salberg, who has written a book with Dr. Maron and actively supports DNA testing for this form of heart disease, said she understands the issues involved and the dilemma that Curry faced.
"I can argue both sides of the case very strongly," said Mrs. Salberg, founder and president of the Hypertrophic Cardiomyopathy Association. "In this particular situation, I don't think [testing] was an unreasonable request, just like I don't think it was unreasonable for Mr. Curry to deny it. He has his rights, and the team has their rights."
But Mrs. Salberg said she thinks Mr. Milstein and others who oppose the test have "mischaracterized" its nature. It is not a catch-all that would reveal other abnormalities, she said. Nor should Curry be mistaken for someone randomly selected to see what might come up, because his is a very specific case.
"You have somebody who had an episode of an irregular heartbeat, who has test findings not in the normal range, something that is not 100 percent right," she said. "The way you can rule this out from being a disease as opposed to an anomaly is to take the test. You're not looking for a needle in a haystack. You're looking for a very specific and precise mutation, not a propensity for baldness or alcoholism or obesity.
"They're making it look like a witch hunt," said Mrs. Salberg, who has HCM and suffered a stroke because of it and lost several family members, including a sister, to the disease. "They're talking about a test that does not exist. I think it's damaging to give misinformation. We are not the enemy."
She added that the notion of looking for "everything under the sun" is false. "We are looking for specific diseases that could be catastrophically detrimental to an athlete if they compete," she said.
As for the possibility of the NBA and other leagues one day screening all their athletes through genetic testing, Mrs. Salberg said, "If you were to tell me that the NBA was going to start drawing blood to screen athletes to see if they have the gene for HCM, I would be completely outraged. I don't think this is the right role for genetic testing. But if someone has the symptoms, I think it's completely reasonable."
The Knicks did not demand a DNA test, but several doctors, including a cardiologist who works for the NBA, examined Curry and pronounced him fit to play. Dr. Lisa Callahan, the Knicks director of player care, told reporters that there were several proven ways to diagnose HCM but that genetic testing was not among them.
"DNA evaluation is a newer, less proven, more controversial technique," she said.
Curry told reporters that he looked forward to putting his health issues aside and that "people can start looking at me as a basketball player and not a patient."
But that is unlikely. Curry will be watched closely, and the issue of genetic testing might only be warming up. Some even think it might be part of future collective bargaining negotiations.
"I think it's a slippery slope," Mr. Roby said. "With advances in technology and science, there are going to be situations where you will know just about anything and everything about someone in terms of what they put in their bodies and their history and what their future medical life will be. ... It's important for people on both sides of the argument to work together."
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