About the Discussion

@NEJM Ask the Authors & Experts: GINA, Genetic Discrimination, and Genomic Medicine

In their recent publication, "GINA, Genetic Discrimination, and Genomic Medicine," that was published on January 29, 2015 in The New England Journal of Medicine, the authors reflect on GINA, the Genetic Information Nondiscrimination Act that was signed into law in 2008.

The authors tell us that GINA was designed “to fully protect the public from discrimination” and also to “allay their concerns about the potential for discrimination, thereby allowing individuals to take advantage of genetic testing, technologies, research and new therapies.”

Why was this law passed to prevent discrimination in a group that had no well-documented history of widespread discrimination? Where are the potentials for genetic discrimination? Did the law work in calming fears of discrimination? Does the American public even know about GINA to have any affect on fears? Since GINA doesn't cover life, disability, or long-term care insurance discrimination, are we currently, or will we, see discrimination in these areas? What type of employment discrimination might some people face?

But the biggest question lies in understanding what is genetic risk? How much does it truly predict the future? How much will this be ameliorated by diet, exercise, pharmaceuticals, and gene therapy? What does genetic risk mean if all of medicine is moving toward genomic, personalized medicine?