Analysis of GINA
The GINA legislation swept through Congress with near unanimous support and was then signed into law by President Bush. This unusual consensus is an indicator that the legislation was necessary and critical.
Because of GINA, individuals may be more comfortable getting genetic diagnostic tests that can be beneficial for medical reasons. Also, biomedical research, via an increase in participation in studies, will continue to advance. Individuals don’t have to fear that employers and health insurers can use genomic analysis to discriminate against those with genetic mutations that could predispose them to disease.
With more people receiving genetic tests, a more individualized approach to healing and treatment of both rare and common diseases could be established. Genetic tests are being used to determine whether patients are responding to certain medications and what dosage is ideal for each patient to avoid side effects (Lea, 2009).
Still, some say that GINA is a step in the right direction, but that more legislation in this area of genetic and health privacy and nondiscrimination is necessary (Allison, 2008). Others believe that GINA is another example of the U.S.’s inconsistent approach to health care policy.
Consider three Americans. One has an increased genetic risk for colon cancer. One has a family history of colon cancer. One has a finding that is consistent with a predisposition to colon cancer after a colonoscopy. Under GINA, the first two are protected but the third person is not.
In another sense, GINA is limited by our current knowledge of the genetic basis of disease. In the future, it may be known that almost all diseases have a genetic component. This would cause the distinction between genetic information and other health information to be inconsequential (Korobkin and Rajkumar 2008). Will the protection afforded by GINA eventually cover most health conditions?
Allison, M. Industry welcomes Genetic Information Nondiscrimination Act. Nat Biotech. 2008 June; 26-6: 596-597.
Korobkin R. and Rajkumar R. The Genetic Information Nondiscrimination Act – A Half-Step toward Risk Sharing. New England Journal of Medicine. 2008 July 24; 359-4: 335-337.
Lea, D. The Genetic Information Nondiscrimination Act (GINA): What it Means for Your Patients and Families. Online Journal of Issues in Nursing. 2009 May; 14-2.