On the edge of tomorrow: fitting genomics into public health policy

The project to map the human genome and the field of genetics in general offer unique opportunities for not only clinical medicine, but also for public health to address and prevent disease. At the same time, genomics is fraught with ethical challenges, not the least of which is how to prevent misuse and abuse of genetic information by virtue of the legal powers conferred on public health organizations. This article examines the role that public health can perform in the 21st Century in using the knowledge gained from the human genome project, including how to address the barriers to widespread application. The article also examines the challenges facing public health in dealing with the legal and ethical issues arising from genomics and in avoiding misapplication. While the opportunities that genomics offers public health agencies are unprecedented, so too are the challenges, which include the fact that genomics exists within a legal and policy paradigm that is the opposite of the one in which public health has traditionally existed. The danger of abuse and misuse, therefore, is very real.