Genetic+Bias

US to outlaw corporate prejudice based on genes
06 May 2007 New Scientist Print Edition

Soon it will be illegal to deny US citizens jobs or insurance simply because they have an inherited illness, or a genetic predisposition to a particular disease. On 25 April, the House of Representatives voted 420 to 3 to pass the Genetic Information Nondiscrimination Act (GINA). The Senate is expected to endorse the act within a few weeks, which is also supported by President Bush. "I am so stunned by the majority," says Sharon Terry, president of the Genetic Alliance, a charity lobbying for the rights of people with inherited illnesses. "Clearly the House finally understood the incredible significance this has. The American public can now access genetic tests, feel safe about their genetic information not being misused and participate in research that involves genetic information." WIRED MAGAZINE =Genetic Discrimination Ban Clears House; Senate OK Expected= Brandon Keim 04.26.07 | 12:00 AM If legislation passed Wednesday by the House of Representatives becomes law, it will be illegal to deny a job or health insurance on the basis of a person's genetic makeup. With more links drawn between genetic profiles and disease predispositions every day, supporters of the [|Genetic Information Nondiscrimination Act] say the bill will ease patients' worries of being singled out for faulty genes. “GINA will do more than stamp out a new form of discrimination,” said [|Louise Slaughter] (D-New York) who introduced the bill. “It will allow us to realize the tremendous potential of genetic research without jeopardizing one of the most fundamental privacies that can be imagined.” Such discrimination is rare, but supporters of the bill worry that as genetic testing becomes common and scientists chart the complex links between genes and health, profiling might also increase. Scientists say that public fear of discrimination is already widespread, causing a shortage of participants in genetic research and clinical trials of gene-based medicines. After Wednesday's 420-3 vote, it is almost certain that the bill will become law. The Senate unanimously approved similar legislation in two previous sessions only to have it stall in House committees. Another Senate vote is expected in the next month, and President Bush has already given his support. The act finally made it to a House vote thanks to renewed Democratic influence, but the bill enjoyed broad bipartisan support. Of 224 co-sponsors, 95 were Republicans. Public opposition came primarily from the Chamber of Commerce. In a March [|letter] to the House, senior Chamber official R. Bruce Josten said the bill's provisions conflict with existing medical privacy laws and "invite frivolous litigation and abuse." The Chamber of Commerce did not return phone calls requesting comment for this article. Currently, a patchwork of state and federal laws prohibit genetic discrimination, but policy analysts say the regulations are untested and incomplete. For example, the Health Insurance Portability and Accountability Act, prohibits group insurance plans from discriminating on the basis of genetic information, but individual insurance plans are exempted. The Americans With Disabilities Act also might prohibit gene-based job discrimination, but that interpretation hasn't been tested in court. As for state laws, some apply only to employment and others to insurance. "A lot of people would say you want protections not to be dependent on the state you live in," says Susannah Baruch, senior policy analyst at the [|Genetics and Public Policy Center] at Johns Hopkins University. Few cases of genetic discrimination have been documented, though some have been [|settled] out of court. However, Baruch says the legislation is not merely preventive. “One thing it’s meant to address now is the fear people have of genetic discrimination,” she says. “Researchers report that people are afraid to take part in clinical trials for fear of results being used against them.” That fear also discourages people from taking genetic tests that could inform treatment and lifestyle choices, says Kathy Wicklund, president of the [|National Society of Genetic Counselors]. "For a lot of people who've considered having genetic tests and haven't," she says, "this will open up a lot of options for them."

=Suicide-Gene Test Could Spawn Customized Drugs= By Alexis Madrigal 10.01.07 | 12:00 AM After years of unfulfilled promises, genomics finally seems poised to impact health care. Research from the National Institute of Mental Health has associated two genetic markers with suicidal thoughts in patients who take the antidepressant drug Celexa. And an enterprising company called [|NeuroMark] is piggybacking on the discovery, already offering a test for those gene markers. "We think this test represents the leading edge of personalized medicine," said Kim Bechthold, CEO of NeuroMark, which produced the Mark-C test. "And (it's) a first in neuropsychiatry." Genetic testing has been done for years, but most research has focused on rare diseases like cancer or Huntington's disease, so the impact on public health has been limited. And the [|Human Genome Project], launched more than a decade ago and completed in 2003, promised to revolutionize health care but has led to few breakthroughs so far. The latest genetic tests, however, could put a dent in the large number of serious health problems and deaths caused by adverse drug reactions in the United States. Problems such as a disability or life-threatening hospitalization caused by prescription drugs [|more than doubled] between 1998 and 2005 to 468,000, as did the number of deaths, to nearly 90,000. In September, the FDA approved the first personlized genetic test for people who take a specific drug. The test, developed by [|Nanosphere], helps identify patients who might be at risk for complications when taking a frequently prescribed blood-thinning drug called [|warfarin]. Celexa has been prescribed to 8 million people in the United States and 30 million worldwide, according to the drug's manufacturer [|Forest Labs]. NeuroMark's test, which [|doesn't require FDA approval] but has passed the Clinical Laboratory Improvement Amendments regulatory standards, will be available Monday for $500. The NeuroMark test includes the two suicidal-ideation genes identified in the new trial, plus two more that NIMH researchers will discuss in an upcoming paper, Bechtold said. The test, however, is not yet covered by insurance, which has [|limited the use] of previous tests. The study appears in the October issue of the [|American Journal of Psychiatry]. Scientists screened genetic material from 1,915 adult patients with major depression who were being treated with [|citalopram], Celexa's generic name. Variants of two genes, GRIK2 and GRIA3, increased the odds that patients would think about suicide. Both genes regulate how the brain processes glutamate, an amino acid that helps mediate communication between neurons in the brain. "There is more and more information pointing to glutamate as having a significant role in antidepressant-treatment outcomes," said Dr. Gonzalo Laje, one of the study's authors. "We're going to hear a lot more about it in upcoming years." The researchers looked at more than 700 gene sites, looking for differences between the 6 percent of patients who reported suicidal ideation and the rest of the trial population. Laje cautioned that this study and one that will be published in early October must be replicated, but said the work was an important step toward personalizing treatment for people suffering from depression. Over the last several years, studies have shown an increase in suicidal thinking among young people who take antidepressants. In 2004, the FDA required that antidepressants be labeled with a black-box warning about such risks. Data later showed a jump in suicides among teenagers that year. It's too early know for sure what created the spike, although some researchers have suggested that a drop in teen antidepressant use contributed to the problem