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Panel Comment: The Attempt to Pass the Genetic Privacy Act in Maryland

Published online by Cambridge University Press:  01 January 2021

Extract

The Genetic Privacy Act (GPA) is a comprehensive effort to protect individuals from unauthorized analysis of their DNA and from unauthorized disclosure of information resulting from genetic analysis. Irrespective of merit, every bill must survive legislative scrutiny. This is a considerable challenge, particularly for a bill as complex and far-reaching as the GPA. To illustrate my point, I describe the fate of two bills introduced into the Maryland Senate in 1995 by Senator Jennie Forehand. The first, also entitled the Genetic Privacy Act (S. 645), was a slightly modified version of the model legislation prepared by Annas, Glantz, and Roche. After a hearing, the bill received a 9-2 unfavorable vote from the Economic and Environmental Affairs Committee. The second was a much shorter bill, DNA Testing – Informed Consent and Confidentiality (S. 707), which simply stated that “DNA analysis may only be performed with the informed consent of the person being analyzed” and that the results of such analysis “are the exclusive property of the person tested, are confidential, and may not be disclosed without the consent of the person being tested.” This bill had a hearing but was never put to a vote by the Judicial Proceedings Committee. My principal aim is to examine the testimony on these bills. I will conclude with some suggestions about accomplishing the goals of genetic privacy legislation.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1995

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References

Annas, G.J. Glantz, L.H. Roche, P.A., The Genetic Privacy Act and Commentary (Boston: Boston University School of Public Health, 1995).Google Scholar
S. 645, Md. 409 Leg. Sess. (1994).Google Scholar
Senate Bill 645 differed slightly from the GPA as follows. One, it defined genetic analysis as “an analysis of a DNA sample that results in private genetic information about an individual” (§ 4-501(H)). The GPA omits a definition. Two, it stated that authorization for collection or disclosure of an identifiable DNA sample “may not be coerced” (§§ 4-504(B), 4-505(a)(2)). Three, it included in the information to be verbally provided to a sample source the warning “that access to the results of genetic analysis by insurance companies, employers, or other third parties may occur if the sample source authorizes their disclosure and the disclosure may lead to discrimination against the source...” (§ 4-505(A)(8)). Fourth, unlike the GPA, Senate Bill 645 did not require the sample source's informed consent if the DNA sample was to be used anonymously for research. Fifth, it required the sample source's authorization before information obtained from an authorized use of a DNA sample could be included in the sample source's medical record (§ 4-509(G)). And sixth, it did not stipulate monetary fines for negligent or willful collection of disclosure of a DNA sample or genetic information in violation of the statute, although the other penalties were similar to those in the GPA (§ 4-528-531).Google Scholar
S. 707, Md. 409 Leg. Sess. (1994).Google Scholar
Hirtle, P.B. Chair, , Letter to Chairman Walter M. Baker, Senate Judicial Proceedings Committee Re: Senate Bill 707 (Baltimore Advisory Council on Hereditary and Congenital Disorders, Feb. 24, 1995).Google Scholar
Department of Health and Mental Hygiene, DNA Testing – Informed Consent and Confidentiality SB 707 (Baltimore: Office of Governmental Affairs, 1995): At 1–3.Google Scholar
Department of Health and Mental Hygiene, Genetic Privacy Act (Baltimore: Office of Governmental Affairs, 1995): At 1–6.Google Scholar
Department of Fiscal Services, Fiscal Note: SB 645 (Annapolis: Maryland General Assembly, 1995): At 1–2.Google Scholar
Everton, A.R., Letter to Walter M. Baker, Senate Judicial Proceedings Committee, Re: SB 707 DNA Testing – Informed Consent and Confidentiality OPPOSE (Medical and Chirurgical Faculty, Feb. 21, 1995).Google Scholar
Cole, W.M., Testimony on Senate Bill 645 Genetic Privacy Act (Maryland Chamber of Commerce, Mar. 9, 1995); and Cole, W.M., Letter to Walter Baker, Chairman Senate Judicial Proceedings Committee, Re: Senate Bill 707 – DNA Testing – Informed Consent and Confidentiality (Maryland Chamber of Commerce, Mar. 8, 1995).Google Scholar
Colwell, R.R., Letter to Senator Jennie Forehand (University of Maryland Biotechnology Institute, Feb. 21, 1995).Google Scholar
Annas, Glantz, Roche, , supra note 1, at ii.Google Scholar
Id. at vi.Google Scholar
In commenting on Senate Bill 645, the Child Support Enforcement Administration of the Maryland Department of Human Resources said that it did “not believe this legislation is intended to apply to paternity proceedings.” To remove any doubt, it asked for an explicit amendment to exclude them. Knight, J.M., Letter to Walter M. Baker, Senate Judicial Proceedings Committee, Re: Senate Bill 707 – DNA Testing – Informed Consent and Confidentiality (Maryland Dept. of Human Resources, Feb. 28, 1995).Google Scholar
The mutation, however, must be present in the proper gene dosage for the disease to appear—single dose for dominant diseases and X-linked recessive diseases in males, double dose for autosomal recessive diseases. Even in the proper dosage, the severity, and age of onset, of a disease will vary among people with the same mutation. In the case of Huntington's disease and other disorders in which the mutation consists of a change in the number of trinucleotide repeats, the precise cutoff in the number of repeats before the disease is manifest cannot always be established.Google Scholar
Annas, Glantz, Roche, , supra note 1, at i.Google Scholar
Similar language would also improve the chances that Senate Bill 707's successor will gain passage. Bill 707 is ambiguous on this point: “‘DNA analysis’ means a series of medical tests that detect changes in a person's genetic code which lead to disease.”Google Scholar
The Task Force was created by the NIH-DOE Working Group on Ethical, Legal, and Social Implications of Human Genome Research. It is expected to complete its work by December 1996. The Task Force will establish principles for safe and effective genetic testing, including informed consent. When needed, it will make recommendations for legislative, regulatory, and other means of implementing its principles. The adoption of these recommendations will reduce inappropriate uses of genetic tests. An ad hoc committee under Dr. Ellen Wright Clayton, has issued recommendations on informed consent for stored tissue samples from which DNA can be obtained. See Clayton, E.W. et al., “Informed Consent for Genetic Research on Stored Tissue Samples,” JAMA, 274 (1995): 1786–92.Google Scholar
Annas, Glantz, Roche, , supra note 1, at ii.Google Scholar
Medical Records Confidentiality Act of 1995 (S. 1360) was introduced by Bennett, Senators Dole, Leahy, Kassebaum, Kennedy, Frist, Simon, Hatch, Gregg, Stevens, Jeffords, Kohl, Daschle, Feingold, .Google Scholar
Holtzman, N.A., Testimony in Support of Senate Bill 645, The Genetic Privacy Act (Genetics and Public Policy Studies, Johns Hopkins Medical Institutions, Mar. 8, 1995).Google Scholar