Risky Relations. Family, Kinship and the New Genetics by Featherstone, K., Atkinson, P., Bharadwaj, A. and Clarke, A.

Featherstone, K., Atkinson, P., Bharadwaj, A. and Clarke, A. Risky Relations. Family, Kinship and the New Genetics . Oxford : Berg , 2006 £16.50 (pbk) 176pp . ISBN 1-84520-179-5 . Despite a large number of projects which have looked at lay experiences of genetic medicine and countless published papers on individuals’ experiences of predictive and prenatal testing and the publics’ understanding of genetics, little has been written about individuals’ experiences of living with genetic disorders from a familial perspective. Risky Relations aims to fill this lacuna. This interesting book reports the findings of an ethnographic study of families with a range of genetic disorders who have attended genetic clinics in the UK. Following an elegant introduction to concepts such as family, kinship and risk in which the authors set out their case for the theoretical approach which drove the empirical investigation upon which the book is based, the authors provide a comprehensive account of the issues that may arise for families who have to deal with a genetic disorder. Unlike other work in this area (for example Finkler 2000) which seeks to simplify the issues faced by family members who are at-risk of a genetic disease, Risky Relations focuses upon the complexities of this situation in a series of chapters which look at: the ways in which ‘kinship/family’ is constructed by both the staff in the clinic and clinical procedures (e.g. drawing up pedigrees) and those who attend the clinic, individuals’ (and families’) beliefs about inheritance, the mutual surveillance of family members for signs of the disorder in self and others and finally a range of ‘practical’ ethical issues that arise for family members who are in receipt of genetic information and may need, or be instructed, to disclose it to their kin. While the structure of the book necessitates that these issues are addressed in self-contained chapters, the authors argue that, in reality, they are interconnected, and this is illustrated by the inclusion of a case study of an extended family affected by an inherited degenerative condition in the penultimate chapter. This case study forcefully reveals the complex nature of the issues faced by at-risk individuals who draw upon a range of skills designated by the authors as practical ethics, practical psychology and practical kinship, and involve them working out: who is at risk and why and then who to disclose genetic information to, what to tell them, when to tell them and how to tell them. The final chapter draws together some of the cross-cutting themes of the preceding chapters and reflects on the implications for clinical practice. However, in case you think that this book is merely a description of some of the ethical and practical issues family members face once they become involved in genetic medicine, then be warned; it is not. This book, or at least my reading of it, suggests that it is something much more subtle. It is an exploration of the concepts of family and kinship, of the ways in which relatedness in its many guises is negotiated by different actors for different purposes. It is the problematising of these concepts that makes this book a particularly interesting read. This aspect of the book, however, while not implicit, does require more work on the part of the reader and I hope is not missed by those of us who read in a more casual way. In its closing pages Risky Relations delivers a warning. The authors stress the need for restraint in the ways in which we, as social scientists, talk, and think, about genetic technologies and their effect on science, society, medicine and the ways in which social actors conceive of body and self. They stress the need to pay attention to the continuities between the past and the present, not only in clinical medicine, but also in the ways in which we social scientists engage with these new technologies. In the concluding paragraph of the preface the authors comment on the complexities of genetic medicine and the lifeworlds of the families who access this subspeciality, claiming that they ‘. . . have tried to remain faithful to that complexity’ within Risky Relations (p. xii), in this goal they have succeeded. However, this does not mean that the book itself is complex, for nothing could be further from the truth. This book makes for a stimulating read, it is elegantly written, refreshingly jargon free and manages to make its undoubtedly complex subject matter very accessible to the reader. They say that you cannot always tell a book by its cover and this is the case with Risky Relations. This is a good book with a horrible cover but, the artwork not withstanding, it does adorn my bookshelf and will be a welcome addition to my reading lists.