 Hi, my name is Shobita Parthasarathy. I am an assistant professor of public policy and the co-director of the Science, Technology, and Public Policy program at the Ford School. Today I'm gonna talk to you a little bit about my book that is gonna come out in the next few weeks, sometime in April of 2007. The title is Building Genetic Medicine, Breast Cancer, Technology, and the Comparative Politics of Healthcare. The book compares the development of genetic testing for breast and ovarian cancer in the United States and Britain, and I chose those two countries because they have very similar incidences of breast cancer, similar interest in genetics and biotechnology, and of course they're pretty similar countries in a lot of ways. And I was interested in this particular topic because I wanted to think about how national context matters in the development of science and technology in particular. When we talk about how national context matters in the case of healthcare, we often focus on funding differences or often when we talk about national healthcare systems, we talk about waiting lists for example. But I was interested in what it actually meant for the development of scientific practice and technological development. And what I found through my research is that in fact this technology, BRCA testing as it's called, is incredibly different in the US and Britain. So in the US it's really defined as a consumer product, DNA analysis that can be provided to anybody for a specific fee. And it's available out there and what the results of that DNA analysis say really matter. In Britain on the other hand, there is a focus on what happens in the clinic. So there what's important is thinking about both the clinical dimensions of finding out what a person's family history is as well as the DNA analysis are important as part of an overall risk assessment scheme. So it's thought of really as a public health effort, as a preventive effort and it's not really focused on as just the DNA analysis and it's certainly not a consumer product because it's embedded in a British approach to healthcare. And I think that's one of the really interesting things about the study is that what you find is that in the US and Britain, it's not just funding that matters, it's in fact the way that these people in these two different countries think about science, it's about how they define and develop technology in very different ways. And the second thing that I found to be very important about the observations is that the implications of this new technology are often embedded in the design of the technology themselves. So when we talk about genetics and biotech, we're often talking about how they have all kinds of social and ethical implications, whether it's who should have access to this kind of information, insurers, employers, other third parties, or whether it's ethical to offer results if there are no clinical interventions available. But here what you see is that these technologies in the US and Britain are built very differently, but in fact sort of ideas about what healthcare should be and how it should be provided are embedded in the technologies themselves. So what does that tell us about how we should build these technologies in the future? Well, I think for me, one of the things that I hope that people and policy makers in particular take away from the research is the idea that we should be engaging much more systematically in upstream technology assessment early on in the development process when we're still thinking about how to build the technology because often some of the social and ethical concerns and the questionable implications are actually already dealt with through the developmental process itself. And if you wait until the development is over, then the horse has already left the barn as it were. So what I hope is that it might lead to a new way of thinking, particularly about controversial technologies like those in the area of genetics and biotechnology, and that we can use the methods that I've developed in the book to do this study to engage in this kind of technology assessment in the future.