ETHICS, EPIDEMIOLOGY AND THE THRIFTY GENE - BIOLOGICAL DETERMINISM ASA HEALTH-HAZARD

This paper briefly describes the rise of the thrifty genotype hypothes is as an explanation for the late twentieth century epidemic of diabet es, particularly in post-colonial indigenous societies. It looks at so me of the ethical consequences of the biological deterministic paradig m, particularly the popular confusion of ''genes'' with ''race'' and h ow this paradigm served to exclude consideration of social determinant s of disease in epidemiological thinking. Some alternative hypotheses to the thrifty gene theory are explored, together with the consequence s of acceptance of these other theories in terms of public health acti on. Finally, there is a need for epidemiology to be continually consci ous, critical and transparent with respect to the general disease (and wellness) theory under which it operates if it is to be truly a scien ce rather than a collection of methodologies. (C) 1998 Elsevier Scienc e Ltd. All rights reserved.