HEALTH CARE POLICY ISSUES AS A RESULT OF THE GENETIC REVOLUTION: IMPLICATIONS FOR PUBLIC HEALTH.
Abstract
The genetic revolution has spawned 4 distinct issues of universal importance to health care policy and society: genetic privacy, regulation and standardization of genetic tests, gene patenting, and education.
Adequate policy advancements for these 4 areas are lacking. Stringent controls must be placed on individual health records to prevent their misuse. Genetic testing within the clinical setting should undergo thorough evaluation before it is implemented. Regulations are needed to prevent the monopolization of DNA sequences.
Society and health care professionals must be educated about the scope of genetic testing because current trends indicate that genetic and molecular assessments are destined to become a routine component of health care.
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Acknowledgments
We thank Ruth L. Eudy and Amy O. Longnecker for technical advice regarding this article.
Human Participant Protection
No protocol approval was needed for this study.
Footnotes
Peer Reviewed
Note. Portions of this article were originally submitted to fulfill partial requirements for a course at the University of Arkansas for Medical Sciences, College of Public Health.
Contributors
R.P. Ojha developed the ideas for this article. The ideas were reviewed and further refined by R. Thertulien. Both authors performed the research required and contributed to writing the article. Accepted for publication February 17, 2004.
Raymond Thertulien, M.D., Ph.D., will be a featured speaker at the upcoming Batey Relief Alliance’s international conference, “HIV/AIDS in the Dominican Republic and Haiti: a bilateral challenge.” For more information about BRA’s humanitarian health care intervention and conference, please visit www.bateyrelief.org.
References
1. AustinMJ, Kreiner T. Integrating genomic technologies in health care: practice and policy challenges and opportunities. Physiol Genomics. 2002;8: 33?40.[Abstract/Free Full Text]
2. CollinsF, McKusick V. Implications of the Human Genome Project for medical science. JAMA. 2001;285: 540?544.[Abstract/Free Full Text]
3. AustinMA, Peyser P, Khoury M. The interface of genetics and public health: research and educational challenges. Annu Rev Public Health. 2000; 21:81?99.[CrossRef][ISI][Medline]
4. Omenn G. Public health genetics: an emerging interdisciplinary field for the post-genomic era. Ann Rev Public Health. 2001;21:1?13.[ISI]
5. LittleJ, Bradley L, Bray M, et al. Reporting, appraising, and integrating data on genotype prevalence and gene-disease associations. Am J Epidemiol.2002;156:300?310.[Abstract/Free Full Text]
6. Collins F. Shattuck lecture-medical and societal consequences of the human genome project. N Engl J Med. 1999; 341:28?37.[Free Full Text]
7. Pang T. The impact of genomics on global health. Am J Pub Health. 2002; 92:1077?1079.[Abstract/Free Full Text]
8. Perera F. Molecular epidemiology: on the path to prevention? J Natl Cancer Inst. 2000;92:602?612.[Abstract/Free Full Text]
9. KhouryMJ, Beskow L, Gwinn ML. Translation of genomic research into health care. JAMA. 2001;285: 2447?2448.[Free Full Text]
10. BurnsJ, Cook-Degan R, Alberts B. The Human Genome Project after a decade: policy issues. Nat Genet. 1998; 20:333?335.[CrossRef][ISI][Medline]
11. ShinamanA, Bain LI, Shoulson I. Preempting genetic discrimination and assaults on privacy: report of a symposium. Am J Med Genet. 2003;4: 589?593.[CrossRef]
12. US Department of Energy. Human Genome Project Progress. 2004. Available at: http://www.ornl.gov/sci/techresources/Human_Genome/project/progress.shtml. Accessed January 4, 2004.
13. FullerBP, Kahn MJ, Ellis MJ, et al. Privacy in genetics research. Science. 1999;285:1359?1361.[Free Full Text]
14. Private matters, public affairs. Nat Genet. 2000;26:1?2.[CrossRef][ISI][Medline]
15. BurkeW, Atkins D, Gwinn M, et al. Genetic test evaluation: information needs of clinicians, policy makers, and the public. Am J Epidemiol. 2002;156: 311?318.[Abstract/Free Full Text]
16. CaulfieldTA, Gold ER. Genetic testing, ethical concerns, and the role of patent law. Clin Genet. 2000;57: 370?375.[CrossRef][ISI][Medline]
17. ThomasSM, Hopkins MM, Brady M. Shares in the human genome-the future of patenting DNA. Nat Biotechnol.2002;12:1185?1188.[CrossRef]
18. CaulfieldTA, Knoppers BM, Gold ER, Sheremeta LE, Bridge PJ. Genetic technologies, health care policy, and the patent bargain. Clin Genet. 2003;63: 15?18.[CrossRef][ISI][Medline]
19. BobrowM, Thomas S. Patents in a genetic age. Nature. 2000;409: 763?764.[CrossRef][ISI][Medline]
20. Centers for Medicare and Medicaid Services. The Health Insurance Portability and Accountability Act of 1996 (HIPAA). 2002. Available at http://cms.hhs.ov/hipaa. Accessed January 3, 2004.
21. PiperM, Lindenmayer JM, Lengerich EJ, et al. The role of state public health agencies in genetics and disease prevention: results of a national survey. Public Health Rep. 2001;116: 22?31.[CrossRef][ISI][Medline]
22. GoldT, Caulfield TA, Ray P. Gene patents and the standard of care. CMAJ. 2002;167:256?257.[Free Full Text]
23. IlagLL, Ilag LM, Ilag LL. From patenting genes to proteins: the search for utility via function. Trends Biotechnol. 2002;5:197?199.[CrossRef]
24. WillisonD, MacLeod S. Patenting of genetic material: are the benefits to society being realized? CMAJ. 2002; 167:259?262.[Free Full Text]
25. GostinL. Public health law in a new century: part I: law as a tool to advance the community?s health. JAMA. 2000;283:2837?2841.[Abstract/Free Full Text]
26. GuttmacherAE, Collins, PS. Welcome to the genomic era. N Engl J Med. 2003;349:996?998.[Free Full Text]
27. GiardelloF, Brensinger JD, Petersen GM, et al. The use and interpretation of commercial apc gene testing for familial adenomatous polyposis. N Engl J Med. 1997;336:823?827.[Abstract/Free Full Text]
POLICY, BIOLOGY, AND HEALTH
Rohit P. Ojha, BA and Raymond Thertulien, MD, PhD
Rohit P. Ojha is with the University of Arkansas for Medical Sciences, College of Public Health and the University of Arkansas for Medical Sciences, Myeloma Institute for Research and Therapy, Little Rock. Raymond Thertulien is with the University of Arkansas for Medical Sciences, Myeloma Institute for Research and Therapy, Little Rock and the Batey Relief Alliance, Inc, New York, NY, a not-for-profit organization dedicated to providing health care in the Dominican Republic and Haiti.
Correspondence: Requests for reprints should be sent to Rohit P. Ojha, 4301 W. Markham, #776, Little Rock, AR 72205 (e-mail: ojharohitp@uams.edu).
March 2005, Vol 95, No. 3 | American Journal of Public Health 385-388
? 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.026708