Table 1

 Barriers to acceptance of genetic risk factors for sudden infant death syndrome (SIDS) and invalid assumptions that serve as additional barriers

Barriers
• There are well established environmental risk factors that may overwhelm any potential theoretical role for as yet ill defined genetic risk factors
• Delineating causal genetic factors is not a meaningful exercise as it does not enhance potential for effective prevention or intervention
• SIDS is not a distinct entity but rather appears to have multiple causal pathways
Invalid assumptions
• Diseases are genetic or environmental in origin, but not both; the existence of established environmental risk factors precludes the concurrent existence of causal genetic risk factors
• SIDS does not follow the same “rules” as other human disorders with known causal genetic risk factors
• There is a 1:1 relation between genotype and disease: knowing genotype defines or predicts destiny
• If SIDS is a genetic disorder, then there must be a SIDS genotype
• If SIDS is a genetic disorder, then there will be a substantial recurrence risk
• If SIDS is a genetic disorder, there is a parental source and therefore some potential to infer blame or responsibility