While scientific advances raised new hopes for people suffering from a host of diseases in 1993, the year's events prompted some heavy debates over how medical technology should be applied.
A report of the first cloning of a human embryo and the continued efforts of a retired Michigan pathologist to help terminally ill patients commit suicide also focused ethical debates.And, when a National Cancer Institute researcher announced he found evidence of a gene at least partly responsible for male homosexuality, activists on both sides of the gay rights debate raised concerns that such information could be misinterpreted.
"Nothing will be more troublesome to deal with than the development of genetic tests that arguably predict behavior," said Dr. Philip Reilly, former chairman of the social issues committee of the American Society of Human Genetics. But he added that a number of state legislatures already are considering the implications of genetic testing and what legislation is needed to protect individual information.
Progress in identifying the underlying genetic causes of colon cancer, diabetes, muscular dystrophy and Huntington's disease were among the recent achievements, as thousands of scientists worldwide continued work on the Human Genome Project, a multibillion international dollar effort to map and identify the 100,000 building blocks of human life.
Harvard's Jeffrey Sklar said doctors now have genetic tests that can help patients with 24 different cancers.
"They will give you information about the disease that will allow (doctors) to save lives," Sklar said.
Close to year's end, Dr. Daniel Cohen of the Centre d'Etude du Polymorphisme Humain in Paris announced the most complete map of the human genome yet developed - a "guidebook" for researchers trying to locate genes responsible for diseases such as epilepsy, muscular dystrophies, diabetes and cancers, said Francois Gros, secretary of the French Academy of Sciences.
"Before today, a physical map existed for only 2 percent of the human genome. Our map covers about 90 percent of the genome," said Cohen.
Pinpointing a genetic defect that makes a person susceptible to a disease means a simple blood test can identify those at greatest risk. But some fear this information could be used by insurance companies and employers to deny benefits or employment to a person who might develop a disease later on.
But these and other advances - which make simple blood tests available to identify people at greatest risk of developing certain diseases - also raised concerns that genetic information might be misused for employment or insurance discrimination.
"It can be thought of as your `future diary'," said Boston University's George Annas, a medical ethicist. "It's written in code that we are breaking every day, and . . . it tells you what probably will happen in terms of your health in the future."
The discoveries also have a real impact on families afflicted by a genetic disease. Researchers from the University of California, San Diego, said the incidence of Tay-Sachs disease dropped by more than 90 percent from 1970 to 1985 as a direct result of genetic screening. In addition to identifying fetuses with genetic defects, simple blood tests help identify couples at greatest risk of having children with genetic defects.
Ethicists also were challenged when fertility doctors at George Washington University in Washington, D.C., created 48 human embryos from 17 original ones in an experiment they hoped would lead to techniques to help infertile couples have children.
Reports of the experiment, revealed at a scientific meeting in October, led to protests by people opposed to genetic manipulation. A poll showed a majority of Americans were uncomfortable with the prospect of human cloning.