A great deal of activity, ranging from public policies to address poverty or climate change, to individual choices about whether to change a job or marry one’s partner, depends on how risk averse or risk acceptant one is or the policy should be. This is a psychological, moral, political, and practical conundrum, with all aspects tightly entwined. Should a state’s government shut schools during a pandemic in order to do everything possible to prevent serious illness and death, or should the government keep schools open (with appropriate cautions) in order to promote student learning as much as possible? Should the FBI help states to develop a DNA database of criminal suspects with the goal of identifying and convicting as many criminals as possible, or is a criminal justice DNA database a new form of Jim Crow surveillance that threatens everyone’s privacy and tightens the state’s grip on disadvantaged and powerless people of color? Should I undergo genetic testing and gene therapy of my fetus in the hopes of curing a genetic disease before the baby is born, or is prenatal genetics a recipe for parental anxiety, an unintended encouragement to abortion, or an insult to people with inherited disabilities?These and similar questions are accompanied by an equally vexing set: who should decide? Should individual parents, the local community, or the state decide about schooling in a pandemic? Should parents, their doctor, or the society as a whole decide on the acceptable extent of prenatal genetic testing? Decisions about a forensic DNA database are different, since the policy is all or nothing; it makes no sense to say that some suspects’ DNA should be sampled but not that of others. So should this stark choice be made by judges, a popular referendum, or expert criminologists?

Genomic Politics explores these vexed issues through its three cases of ancestry testing, forensic DNA databases, and medical science’s exploration of genetic disease. The issues are intrinsically important, and their development will affect everything from identity to crime to health. They are also great vehicles for investigating details of policy, and personal risk acceptance or aversion.A few findings to whet readers’ appetite: No genomics policy or practice that I have examined has a partisan or ideological valence, even in this era where everything seems to be politicized. Majorities of even Democrats and self-defined liberals, and a plurality of African Americans, endorse use of forensic DNA databases; every public official who has spoken on the subject enthuses about them. But the lack of politicization does not imply universal acceptance. In my surveys, fewer than 20 percent of the American public trust democratic processes (e.g. community forums or elected officials) to set policy on gene therapy; only a third trust religious or economic leaders. Survey respondents look askance even at doctors and families; the most popular response was “a little trust” or “no trust” to all proffered decision-makers.

Perhaps most important, splits between precautionary and pro-active people and policies are much greater and less amenable to compromise than are splits between people and policies that disagree about the amount of genetic impact. I learned that in a tense conference about a drug for congestive heart failure that had recently been approved by the FDA for prescription to only self-defined African Americans. Scholars, disproportionately white, were horrified by the implication that “race” has a medically relevant genetic component. Practitioners, disproportionately Black, knew all about race-based eugenics but wanted an effective drug for their patients. The two sides of the room, who mostly shared strong liberal and egalitarian values, stared at each other in consternation. What was going on? I wanted to know.In sum, genomics innovations are fast-moving, controversial, and significant on their own terms. They are also an excellent vehicle for pondering personal, institutional, and moral dilemmas of how to balance protection against and acceptance of risk in innovations. Finally, new genomic technologies present a stark case for exploring who should make risky decisions.