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27 Suffolk U. L. Rev. 1391 (1993)
Rethinking Medical Confidentiality: The Impact of Genetics

handle is hein.journals/sufflr27 and id is 1411 raw text is: RETHINKING MEDICAL CONFIDENTIALITY: THE IMPACT OF GENETICS* Robert Wachbroitt Advances in genetics have provoked many discussions concerning the justifications and limits of medical confidentiality.' Many of these discussions have focused on the interests that insurance companies and employers may have in obtaining access to information acquired through genetic testing of individuals. This issue arises chiefly be- cause genetic information has predictive value. Genetic testing not only attempts to determine an individual's current medical state, but also attempts to predict the likelihood that someone will develop vari- ous diseases and disabilities. For example, an individual with the ge- netic abnormality associated with alpha1-antitrypsin deficiency has a high probability of suffering early onset or severe emphysema, although the deficiency itself does not constitute a disease. Insurance companies and employers have an obvious interest in knowing the health risks of someone they are considering underwriting, hiring, or promoting since a health risk for that person is a financial risk for the insurance company or employer. Questions, therefore, have arisen over what genetic information third parties should have access to, and what actions they should be allowed to take on the basis of this information.2 The predictive value of genetic information and its possible useful- ness to people other than health professionals and their patients may be offered as reasons either for strengthening medical confidentiality, or for circumscribing it. Other features of genetic information, less often considered, might have an even more powerful impact on our view of medical confidentiality. For example, genetic information might include not only information about the person from whom it was obtained, known as the proband, but also information about the * Research for this paper was supported by Grant R01 HG00419 from the National Institutes of Health Center for Human Genome Research. I have also benefitted from comments from Arthur Evenchik, Alan Strudler, and David Wasserman on an earlier draft. t Research Scholar, Institute for Philosophy and Public Policy, University of Mary- land. B.S., Massachusetts Institute of Technology; Ph.D., University of California at Berkeley. 1. The best current bibliography of this material can be found in the ELSI Bibliogra- phy compiled by Michael Yesley at the Office of Energy Research at the Department of Energy. 2. See generally Robert Wachbroit, Making the Grade: Testing for Human Genetic Disorders, 16 HOFSTRA L. REV. 583, 589-93 (1988) (discussing competing interests impli- cated when third parties have interest in gaining access to genetic information).

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