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OrphanWilde comments on Two-boxing, smoking and chewing gum in Medical Newcomb problems - Less Wrong Discussion
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Anybody who one-boxes in the genetic-determinant of Omega are reversing causal flow.
Why? They one-box because they have the gene. So no reversal. Just as in the original Newcomb problem they choose to one-box because they were the sort of person who would do that.
From the original post:
If you one-box, you may or may not have the gene, but whether or not you have the gene is entirely irrelevant to what decision you should make. If, confronted with this problem, you say "I'll one-box", you're attempting to reverse causal flow - to determine your genetic makeup via the decisions you make, as opposed to the decision you make being determined by your genetic makeup. There is zero advantage conferred to declaring yourself a one-boxer in this arrangement.