The genetics revolution. Ethical, legal, and insurance concerns

Genetic researchers will soon complete a structural description of the human genome. Understanding of the detailed function and interactions of the genes will soon follow, as will the ability to manipulate genes and use them for our own purposes. This knowledge will force us to rethink our basic philosophy of life and fundamental ethics. The accumulating body of knowledge will have profound effects on the view of human beings in the cosmos and on human interactions and institutions. Although change will be gradual, primary care physicians should be prepared to deal with this process, even in today's practice. The crucial concerns are proper patient education and consent for genetic testing, maintenance of confidentiality, and awareness of a patient's right to access health insurance and specialty care. The unprecedented control of the genetic makeup of human beings will affect society's concepts of race, equality, disability, and social responsibility.