Would You Take the DNA Test?
EDITORIAL
Chicago Tribune, 10/05/2005
Before he was traded, Eddy Curry faced a demand from the Chicago Bulls that he submit to a DNA test. The team wanted to know if his enlarged heart was a result of athletic training or a sign of something more ominous--a genetic disease.
Curry refused, arguing that the Bulls were invading his privacy. He said his doctor told him he was fit to play and that was good enough for him. Now he's gone to the New York Knicks, where presumably he won't be required to take such a test.
The Curry case was fought on some rarefied high-stakes terrain. He's a pro athlete and, chances are, you are not. But there are some issues here that could someday confront you, whether you're a factory worker, an office manager or a basketball player.
What would you do if your employer demanded that you take a DNA test that could predict whether you face a serious health risk--one that could make you less employable?
Would you take the test to learn your own health risk? Would you reject the test to protect your employability? Should your employer or your insurer be prohibited from even making such a demand?
Who should have access to this information and under what circumstances? How can we ensure that the powerful information unlocked from human DNA is not used to betray the same patients it is meant to help?
In the coming years, many Americans may find themselves faced with similar questions, and fears, when deciding whether to take genetic tests.
First, it's important to remember that DNA is not destiny. In the vast majority of cases, genetic tests suggest a propensity toward developing a disease, not a certainty that someone will suffer from that illness. Such tests also don't predict when you might get the disease.
There are hundreds of genetic tests on the market, and more coming all the time. Some are even designed for home use, although most require sophisticated interpretation.
Like almost all medical tests, they aren't perfect. They can say yes when the answer really is no. Or vice versa.
When the tests are ordered by a doctor they are rightly a private matter between doctor and patient, and should be handled the same as other medical records. In general, what these tests impart--the knowledge of what someone might, or might not, develop in future decades--should be protected against unwarranted use as other medical information is protected.
But there will be circumstances, such as the Curry case, where the tests are likely to be far more diagnostic than predictive. That is, they may be able to warn someone of a life-threatening illness or condition that exists right now.
The idea of employers requiring predictive genetic testing and using them to make hiring, firing or promotion decisions is troubling. Under some limited circumstances--such as physically demanding jobs--employers may have good reason to require an employee to take such a test. An employer has a responsibility to ensure that an employee is reasonably fit for the task. In today's litigious climate, a company that fails to do so could be accused of neglecting the employee's well-being.
At the same time, these tests will become more valuable to doctors and patients. If you know you have a genetic predisposition to colon cancer, for instance, there are ways you can cut the risk. People should be encouraged to make decisions about taking such tests based on what's best for their long-term health, not on fears of how the information could be misused.
That's why many states, including Illinois, have passed laws that prohibit insurers from establishing rules for eligibility based on genetic information.
There's a wide-ranging bill in Congress aimed at prohibiting employers from using predictive genetic tests in hiring, firing or promotions. It would largely curtail an employer's ability to "request, require, or purchase" such genetic information about employees. The proposed law leaves room for limited exceptions, including tests used for wellness programs or to monitor employees' health under hazardous conditions.
The bill passed the Senate 98-0 earlier this year, but has stalled in the House over fears of creating a new area for employment litigation.
Decoding the secrets of human DNA was a remarkable feat. Using that information wisely may prove to be almost as challenging.
EDITORIAL
Chicago Tribune, 10/05/2005
Before he was traded, Eddy Curry faced a demand from the Chicago Bulls that he submit to a DNA test. The team wanted to know if his enlarged heart was a result of athletic training or a sign of something more ominous--a genetic disease.
Curry refused, arguing that the Bulls were invading his privacy. He said his doctor told him he was fit to play and that was good enough for him. Now he's gone to the New York Knicks, where presumably he won't be required to take such a test.
The Curry case was fought on some rarefied high-stakes terrain. He's a pro athlete and, chances are, you are not. But there are some issues here that could someday confront you, whether you're a factory worker, an office manager or a basketball player.
What would you do if your employer demanded that you take a DNA test that could predict whether you face a serious health risk--one that could make you less employable?
Would you take the test to learn your own health risk? Would you reject the test to protect your employability? Should your employer or your insurer be prohibited from even making such a demand?
Who should have access to this information and under what circumstances? How can we ensure that the powerful information unlocked from human DNA is not used to betray the same patients it is meant to help?
In the coming years, many Americans may find themselves faced with similar questions, and fears, when deciding whether to take genetic tests.
First, it's important to remember that DNA is not destiny. In the vast majority of cases, genetic tests suggest a propensity toward developing a disease, not a certainty that someone will suffer from that illness. Such tests also don't predict when you might get the disease.
There are hundreds of genetic tests on the market, and more coming all the time. Some are even designed for home use, although most require sophisticated interpretation.
Like almost all medical tests, they aren't perfect. They can say yes when the answer really is no. Or vice versa.
When the tests are ordered by a doctor they are rightly a private matter between doctor and patient, and should be handled the same as other medical records. In general, what these tests impart--the knowledge of what someone might, or might not, develop in future decades--should be protected against unwarranted use as other medical information is protected.
But there will be circumstances, such as the Curry case, where the tests are likely to be far more diagnostic than predictive. That is, they may be able to warn someone of a life-threatening illness or condition that exists right now.
The idea of employers requiring predictive genetic testing and using them to make hiring, firing or promotion decisions is troubling. Under some limited circumstances--such as physically demanding jobs--employers may have good reason to require an employee to take such a test. An employer has a responsibility to ensure that an employee is reasonably fit for the task. In today's litigious climate, a company that fails to do so could be accused of neglecting the employee's well-being.
At the same time, these tests will become more valuable to doctors and patients. If you know you have a genetic predisposition to colon cancer, for instance, there are ways you can cut the risk. People should be encouraged to make decisions about taking such tests based on what's best for their long-term health, not on fears of how the information could be misused.
That's why many states, including Illinois, have passed laws that prohibit insurers from establishing rules for eligibility based on genetic information.
There's a wide-ranging bill in Congress aimed at prohibiting employers from using predictive genetic tests in hiring, firing or promotions. It would largely curtail an employer's ability to "request, require, or purchase" such genetic information about employees. The proposed law leaves room for limited exceptions, including tests used for wellness programs or to monitor employees' health under hazardous conditions.
The bill passed the Senate 98-0 earlier this year, but has stalled in the House over fears of creating a new area for employment litigation.
Decoding the secrets of human DNA was a remarkable feat. Using that information wisely may prove to be almost as challenging.
EDITORIAL
Chicago Tribune, 10/05/2005
Before he was traded, Eddy Curry faced a demand from the Chicago Bulls that he submit to a DNA test. The team wanted to know if his enlarged heart was a result of athletic training or a sign of something more ominous--a genetic disease.
Curry refused, arguing that the Bulls were invading his privacy. He said his doctor told him he was fit to play and that was good enough for him. Now he's gone to the New York Knicks, where presumably he won't be required to take such a test.
The Curry case was fought on some rarefied high-stakes terrain. He's a pro athlete and, chances are, you are not. But there are some issues here that could someday confront you, whether you're a factory worker, an office manager or a basketball player.
What would you do if your employer demanded that you take a DNA test that could predict whether you face a serious health risk--one that could make you less employable?
Would you take the test to learn your own health risk? Would you reject the test to protect your employability? Should your employer or your insurer be prohibited from even making such a demand?
Who should have access to this information and under what circumstances? How can we ensure that the powerful information unlocked from human DNA is not used to betray the same patients it is meant to help?
In the coming years, many Americans may find themselves faced with similar questions, and fears, when deciding whether to take genetic tests.
First, it's important to remember that DNA is not destiny. In the vast majority of cases, genetic tests suggest a propensity toward developing a disease, not a certainty that someone will suffer from that illness. Such tests also don't predict when you might get the disease.
There are hundreds of genetic tests on the market, and more coming all the time. Some are even designed for home use, although most require sophisticated interpretation.
Like almost all medical tests, they aren't perfect. They can say yes when the answer really is no. Or vice versa.
When the tests are ordered by a doctor they are rightly a private matter between doctor and patient, and should be handled the same as other medical records. In general, what these tests impart--the knowledge of what someone might, or might not, develop in future decades--should be protected against unwarranted use as other medical information is protected.
But there will be circumstances, such as the Curry case, where the tests are likely to be far more diagnostic than predictive. That is, they may be able to warn someone of a life-threatening illness or condition that exists right now.
The idea of employers requiring predictive genetic testing and using them to make hiring, firing or promotion decisions is troubling. Under some limited circumstances--such as physically demanding jobs--employers may have good reason to require an employee to take such a test. An employer has a responsibility to ensure that an employee is reasonably fit for the task. In today's litigious climate, a company that fails to do so could be accused of neglecting the employee's well-being.
At the same time, these tests will become more valuable to doctors and patients. If you know you have a genetic predisposition to colon cancer, for instance, there are ways you can cut the risk. People should be encouraged to make decisions about taking such tests based on what's best for their long-term health, not on fears of how the information could be misused.
That's why many states, including Illinois, have passed laws that prohibit insurers from establishing rules for eligibility based on genetic information.
There's a wide-ranging bill in Congress aimed at prohibiting employers from using predictive genetic tests in hiring, firing or promotions. It would largely curtail an employer's ability to "request, require, or purchase" such genetic information about employees. The proposed law leaves room for limited exceptions, including tests used for wellness programs or to monitor employees' health under hazardous conditions.
The bill passed the Senate 98-0 earlier this year, but has stalled in the House over fears of creating a new area for employment litigation.
Decoding the secrets of human DNA was a remarkable feat. Using that information wisely may prove to be almost as challenging.