Genetic discrimination and the Americans with Disabilities Act.

摘要

Genetic discrimination is the denial of insurance, employment, or other societal benefits to an individual or members of the individual's family on the basis of real or perceived differences in that person's genetic constitution from what is considered "normal." Complex interaction between technology, law, and society has made such discrimination more and more common. Technological advances in prenatal diagnosis and genetic testing, and particularly the advent of the Human Genome Project, have resulted in a reemergence of reductionist and determinist attitudes with regard to genetic information. Such information is also perceived to be different from other medical information in that it is more personal and has greater potential for abuse. This discussion explores who is at risk of genetic discrimination and some of its potential consequences, such as the creation of a "biological underclass" of the "asymptomatic ill.".;Aspects of genetic discrimination are discussed: its sources, such as genetic testing, medical histories, and information databanks; the societal forces behind such discrimination, such as insurers, employers, and the cost of health care; and examples of these forces at work. The responses to the rise of genetic technology and genetic discrimination from groups such as professional societies, consumer advocacy groups, and legislators are also discussed. There follows a review of major federal antidiscrimination legislation including the Civil Rights Act of 1964, the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990 (ADA).;There are several groups whose conditions are analogous to those with atypical genotypes, and which are explicitly protected by the ADA, such as cancer survivors and individuals infected with HIV. There is also evidence that the Act would protect those at risk of future illness who are currently asymptomatic. The conclusion is that, while ultimately the courts will decide, the ADA almost certainly will provide legal protection for those at risk of genetic discrimination, particularly when coupled with the emerging body of state and federal law which protects the privacy and confidentiality of genetic information.