powerful tools for analyzing genetic information. Once the relevant genes are identified, biomedical researchers will have a better understanding of how and why the diseases occur, be able to develop more sensitive and accurate diagnoses, and eventually offer more effective treatments. In the future, researchers hope to use gene therapy to treat and even cure some diseases.

In short, genetic research promises to deliver the most revolutionary improvement of medicine since the discovery of antibiotics, and perhaps the most revolutionary ever. But this advance comes at a price with which many people are uncomfortable: the power of prophecy. Reading a person's DNA has the potential to peek at that person's future. In some cases the prophecy is dead certain. If, for instance, you have the genetic alteration associated with Huntington's disease, then you know that once you reach your 30s or 40s or 50s, your brain will start to deteriorate, you will lose control over your movements, and within another ten to twenty years you will die. In other cases, the predictions are not sure things but instead are statistical statements indicating a predisposition. If, for instance, you are a woman and have an altered version of the BRCA1 gene, your chances of getting breast cancer increase four to seven times more than average. Theoretically, once the relevant genes have been tracked down, genetic analysis should offer probabilistic information about a wide range of afflictions, from how likely you are to suffer from depression or develop cancer to what your risks are for having a heart attack. The predictions, being statistical in nature, would not foretell the fate of any given individual but would be reasonably accurate in estimating, say, how many people out of a thousand with a particular gene would develop diabetes.

That sort of power has tremendous potential for abuse. If an insurance company learned that a woman has the mutated BRCA1 gene, it might refuse to offer her insurance even if she has no prior history of breast cancer. If an employer learned that an applicant was at risk for serious depression, it might look for someone else for the job.

And unfortunately, this is not just a potential problem, Paul Billings of the Department of Veterans Affairs in Grand Prairie, Texas, told the workshop. "Genetic discrimination arising from genetic information available from medical records exists in the United States, and there are real losses and vulnerabilities associated with the participation in genetic research and genetic testing." In the early 1990s Billings published the first evidence of genetic discrimination in insurance and employment matters, and he has now reviewed more than five hundred cases of people reporting discrimination based on genetic information. The degree of this discrimination has not yet been quantified.

"The primary type of genetic discrimination arises from insurance contract issues," Billings said. "The second most common comes when employment benefits are considered . . . The results for some individuals of participation in genetic testing have been uninsurability, unemployability, the lessening of certain other life prospects, and financial instability."



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