While I agree in principle with Dr. Slaughter's thesis that new government regulations are necessary to protect citizens from inappropriate discrimination based on their genetic information, I suspect that the tone of this Editorial (11 May, p. 797) could inadvertently increase rather than allay public unease with respect to the use of genetic testing.
First, the proposition that "discrimination based on one's genetic makeup alone could logically be extended into a form of discrimination against everyone" is a logical fallacy. Indiscriminate discrimination? Surely such an oxymoron does not constitute our prime concern.
More importantly, the statement that "[g]enetic discrimination is, of course, inherently unjustifiable and illogical" is not only false, but circumvents rational discussion of the possible utility of genetic testing. The employers and insurance brokers who chose not to take a risk with carriers of sickle cell anemia made a logical (if inappropriate) decision and were able to justify (to themselves, if not to the victims) their actions. Whether or not we agree with an action has no bearing on its inherent logic.
The cases of genetic discrimination described here were clearly detrimental to public health, yet I can imagine a scenario in which genetic information could be used in a very positive sense, and I think it is important when drafting government regulations to take such considerations into account. Just as we hope that genetic testing will help doctors to select the most appropriate individualized medical treatment, genetic testing could also help us to make important personal and professional decisions. For example, although existing regulations already aim to reduce occupational exposure to toxins or carcinogens, if people with genotypes making them especially susceptible to certain chemicals had access to their genetic information, they could use it to take additional precautions at work, or to choose a more appropriate working environment. Assuming that testing is carried out with free and full consent, wouldn't this serve to increase, rather than decrease, public health and well-being? Positive genetic discrimination therefore has the potential to be used as a valuable tool for protecting the health and promoting the well-being of vulnerable members of society.
Taking a purely defensive stance on the use of genetic information by discussing only negative outcomes will surely exacerbate the public’s fear of genetic technologies. Only by rational discussion of the full spectrum of possible applications of genetic testing, or of any new technology, can the general public or government regulators be expected to make sensible decisions which will benefit the health of us all.
Joanne Whitehead
Institut Curie, Paris, France.
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