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TWENTY. Women's Legal Defense 25 Chris November 14, 1997 Ihd Bruce Reed, Assistant to the President for Domestic Policy Executive Office of the President 2nd Floor, West Wing 1600 Pennsylvania Ave., NW Washington, DC 20500 Dear Mr. Reed: The job of deciphering every gene found in the human body, more than 80,000 in all, is proceeding at record speed. Today, genetic tests are available for over 400 disorders. Millions of women and their families stand to benefit from improved prevention, detection and treatment of diseases like breast and ovarian cancer alone. But without adequate protection against discrimination and misuse, the potential for real medical benefits from genetic advances may be outweighed by harmful consequences, such as the loss of health insurance or employment. For your information, the Women's Legal Defense Fund (WLDF) has enclosed a chart comparing pending legislation that would prohibit discrimination by employers and health insurers on the basis of genetic information. The medical community and women's health advocates are working toward the same goal of improving women's health, and genetics research can bring us closer to this goal. However, there is growing concern that genetic information may be used in ways that hurt patients and research participants. Several researchers, in fact, are finding a shortage of volunteers willing to participate in studies, citing fear of discrimination as a significant deterrent. Let us imagine a very plausible situation. Theresa is a 46-year old woman whose mother and sister both died in their mid-40s from breast cancer. She has heard of a research study being conducted by the National Institutes of Health on prevention of breast cancer. By participating in this study, she will learn whether she has inherited a gene that predisposes her to breast cancer and be closely monitored for any signs of the disease. While she would like to participate, she knows there are risks. Even though she does not have breast cancer, an insurance company may deny her coverage simply for having taken the test, assuming that by asking she has indicated her greater risk. In addition, she is worried that she may jeopardize her children's health insurance, since her genetic makeup influences her children's as well. If her employer or future employer learns about the genetic test, her ability to keep or get a job could be severely undermined by assumptions that she would be too costly to insure. Despite her desire to participate, she decides not to volunteer in the study, foregoing both the benefits to her own health and to the advancement of scientific knowledge. 1875 Connecticut Ave., NW Suite 710 Washington, DC 20009 Telephone (202) 986-2600 Fax (202) 986-2539