Public Health Context

Genetic testing and screening programs have long been part of public health programs in the United States. For decades public health authorities have recommended the screening of newborns for specific genetic (and nongenetic) conditions through genetic tests that use blood samples from infants. Neonatal genetic testing and screening increasingly are becoming part of public health practice in the modern genetic revolution. Genetic testing and screening in the delivery of health services and for occupational purposes (Shulte and DeBord) are becoming more common despite legal impediments.

The proliferation of genetic testing and screening in the interests of protecting public health may help improve health outcomes on a population basis, but it simultaneously raises significant legal, social, and ethical concerns. When should genetic tests be allowed without informed consent? Should genetic screening be allowed for every condition for which a reliable and accurate test is available? When should genetic screening programs be mandatory (required) or voluntary (optional)? How can public health authorities or others acquire, use, or disclose sensitive genetic test results? These and other ethical issues are discussed in this entry in the context of the classic debate between individual rights and the goal of protecting the public's health.

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