There are currently about 900 genetic tests available. They can be helpful to understand, plan for, prevent, or treat genetically related conditions. With the approaching introduction of "gene chip" technology (which enables biologists to scour huge chunks of genomes in search of the genes that promote disease), large numbers of genetic tests are likely to become quick, relatively inexpensive, and routine.
Such accessible genetic information has many implications. One crucial area is that of employment.
Popular fears have been expressed in novels and movies that employers will use these genetic tests to choose employees not for their ability but for their genetic potential. If the employers did so, they would be misunderstanding human genetics. Human beings are so complex that a rich genetic endowment can be unfulfilled and a relatively poor one can be substantially transcended. Companies seeking to predict future performance would do far better to look at past performance and current-ability-based tests than to look at genetic heritage.
Employers are likely to try to use genetic tests to limit what they spend on medical care. To survive long term, businesses depend on producing more revenue than they consume, either by raising income or reducing expenses. Medical care is often a major factor in company costs.
Most employees in the United States are covered by company self insurance. Many of the others are under experience-based policies where a companys premium changes with how much medical care employees need. In either case, medical care for employees and their dependents is a significant part of the employers outlays. Awareness of this impact is heightened for management by the concentration of medical care expenses in one subset of employees. In any given year, 5 percent of employees incur about 50 percent of health care expenditures, and 10 percent need about 70 percent of these resources.
THE LINK BETWEEN medical care costs and employment gives a powerful incentive to companies to find ways to keep the presently or potentially disabled or ill out of their work force. Genetic testing offers a way for the company to foresee likely costs and avoid them by releasing such workers, or not hiring them in the first place. That course is devastating to the employee who is laid off or cannot find work and harmful to society that will probably still pay for at least some medical care, but loses the workers contribution.
Genetic discrimination is further expanded by misunderstanding the difference between being a genetic carrier for a disease and actually having a disease. Being a carrier means that one has a disease gene, but its effects are covered by a healthy gene that is paired with it. A carrier does have a heightened possibility of having children with the disease, with all the attendant expenses, but is not directly at-risk him- or herself. Confusion was widespread when the genetic basis of sickle cell disease was first recognized decades ago. People who carried the sickle cell trait were turned down for jobs, ostensibly because they had a genetic disease, when actually they were quite healthy and would remain so.
As genetic testing becomes quick and inexpensive, it will become increasingly attractive as a tool to winnow potentially expensive employees out of the workforce. New federal and state legislation has been enacted to try to limit such discrimination, but it is difficult to enforce. With increasingly easy access to extensive genetic information about likely future health, the only antidote is a system of medical care that provides a decent minimum regardless of where one works.
JAMES C. PETERSON is the C. C. Dickson Associate Professor of Theology and Ethics at Wingate University in Monroe, North Carolina. His book on the ethics of human genetic intervention is scheduled for publication by Eerdmans next January. Glen Stassen, the Lewis B. Smedes Professor of Christian Ethics at Fuller Theological Seminary in Pasadena, California, serves as consultant and adviser for this Ethics page.