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Routine DNA Tests For Newborns Mean Looming Privacy Problems

pogopop77 writes "CNN has an interesting story about how newborn babies in the United States are routinely screened for a panel of genetic diseases. Since the testing is mandated by the government, it's often done without the parents' consent. However, many states store that DNA information indefinitely, and even make it available to researchers with little or no privacy safeguards. Sometimes even the names are attached! Here is information on state-by-state policies (PDF) of the handling of the DNA information."

26 of 268 comments (clear)

  1. GATTACA by quantumphaze · · Score: 4, Interesting

    It will start with insurance companies discriminating against people who are more susceptible to diseases based on DNA.

    On the plus side we can all feel safe that the caring benevolent government can track down all those pesky criminals and terrorists and pirates.

    1. Re:GATTACA by MRe_nl · · Score: 4, Informative

      http://www.genome.gov/10002328

      What's the Genetic Information Nondiscrimination Act (GINA)?

      The Genetic Information Nondiscrimination Act of 2008, also referred to as GINA, is a new federal law that protects Americans from being treated unfairly because of differences in their DNA that may affect their health. The new law prevents discrimination from health insurers and employers. The President signed the act into federal law on May 21, 2008. The parts of the law relating to health insurers will take effect by May 2009, and those relating to employers will take effect by November 2009.

      Their logo even has "GATTACA" in it.

      --
      "Kill 'em all and let Root sort 'em out"
    2. Re:GATTACA by Anonymous Coward · · Score: 5, Insightful

      When did insurance companies start to care about laws? They'll just deny your application without any reasons or make one up. What makes you think their hordes of lawyers wouldn't find a way to weasel around such irrelevant laws?

    3. Re:GATTACA by BlueStrat · · Score: 3, Insightful

      Otherwise too many people fail to make provisions for the inevitable, and then fall back on the rest of us.

      See, that's where it gets dicey. Once you start down the path to limiting individual choices and freedoms for "the good of society", things just can't end well when you figure in every government's natural tendency to expand in size and scope while removing ever-more individual freedom.

      Just how much individual choice/freedom sacrificed for the "greater good" is too much? Since bad health costs more, and diet is so important, will the government mandate government-healthcare-prescribed daily diets? How about exercise? Mandatory exercise/gym membership? Traffic fines for going out in the cold without your scarf?

      Some lifestyles, sports, hobbies, etc could have a huge impact on an individuals' healthcare costs, so might they be regulated too?

      I just think America can reduce healthcare costs and take care of those without insurance without a 2,000-page purely one-party bill put together in secret backroom deals attempting to completely restructure ~20% of the US economy and having the government intruding even more on individual freedom and choice while likely actually increasing healthcare costs and the national debt with a new entitlement, reducing quality-of-care, still not insuring everybody, and not even addressing tort reform.

      Shouldn't reform actually...you know...*reform*?

      We can do much, much better.

      Strat

      --
      Progressivism (aka US 'Liberalism'): Ideas so good they need a police/surveillance-state to enforce.
    4. Re:GATTACA by Quikah · · Score: 3, Informative

      General Welfare clause is a perfectly reasonable justification to the constitutionality of federally run healthcare.

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      Q.
    5. Re:GATTACA by sjames · · Score: 4, Interesting

      It seems to me that rather than put the entire population through the intensive dane brammage of trying to figure out the deliberately incomprehensible insurance policies, not to mention the endless paperwork of showing that you either have insurance or can't afford it, it would make a LOT more sense to just cover everyone and be done with it.

      Truly massive amounts are wasted by forcing each and every healthcare provider to deal with each and every insurer's unique and convoluted claims process and by forcing each and every patient to show that they have insurance, determine that their particular insurance will work with that particular provider, and on and on and on.

      Then they get to deal with if you have procedure A as a result of B on a friday before the full moon at the low tide and the doctor has real plants in the waiting room, we cover 75.00030456762535646% of the bill (rounded down), except if you ever said booger before the age of 3 in which case we cover 32.7623235624784781% but only if you can hop on one foot. If you have the procedure on any other day, our percentage is based on a spin of the wheel-of-denial (better hope it doesn't land on bankrupt!)

      But if you have chronic pain, we will provide you the new FDA approved baby aspirin with cyanide!

      Honestly, it's to the point that people might seriously consider the value of "insurance insurance" to cover those times when your insurance finds a new way to let you down when you need it most.

      Howsabout instead of all of that, we just cover everyone out of the general funds and be done with it.

  2. Re:CSI by Sockatume · · Score: 5, Funny

    Not right now. They're still taking...

    *sunglasses*

    Baby steps.

    --
    No kidding!!! What do you say at this point?
  3. Uninsurable by eldavojohn · · Score: 5, Interesting
    The article touches on insurance but I fear this particular part more than the privacy concerns:

    Since health insurance paid for Isabel's genetic screening, her positive test for a cystic fibrosis gene is now on the record with her insurance company, and the Browns are concerned this could hurt her in the future.

    And if the disease is considered genetic by the medical community like Alzheimer's or even high cholesterol, is it going to affect her descendants through the ages forthcoming when they try to get insurance? Already you have people with pre-existing conditions finding it hard to get insurance but I fear of a future where health care crises are addressed by increasing fees passed on to people with genetic disorders and diseases that they not only have no control over but also don't even suffer from yet.

    --
    My work here is dung.
    1. Re:Uninsurable by SBrach · · Score: 3, Interesting

      Have you ever heard of Insurance or, gasp!, Taxes ?

      It must be awful to not understand what insurance is. All insurance (Auto, Life, Fire, Health, etc) works by the majority subsidizing the minority. The majority pays much more in premiums than they receive in benefits due to the fear of the small chance they will require care that is very expensive. The chances of you using as much coverage as you pay in premiums has to be small or insurance would not work. It is not a charity.

      It's to get a pool of money so that you can provide services to all without having every single person to pay in full. If you have to pay in full for service then insurance is useless.

      First: That pool of money has to equal the total premiums or taxes paid, right? The pool doesn't receive charitable donations and money doesn't just magically appear.
      Second: The total benefits paid out can't be larger than the pool or else insurance would operate at a loss, which other than the government apparently, is unsustainable.
      Third: The math doesn't lie. Some people will pay much more in premiums than they receive in benefits and some people will pay much less in premiums than they receive in benefits. Insurance operates on the fear that you will be unlucky and be one of the people who requires expensive treatment. The majority would be better off putting their money in a savings account. I am 25 years old and have paid for my own insurance for 7 years. It cost me (including what my employer contributes) about 5 grand a year. With no interest I would have $35,000 right now minus 7 routine check ups @ a couple hundred dollars each cash. If I invested that $5000 a year in a savings account that earns 2% interest starting now, when I am 50 I will have $172,009. I am basically gambling that I will require over $172,000 worth of medical care by the time I am 50. Even though the chances of that being the case are very small.

    2. Re:Uninsurable by El+Gigante+de+Justic · · Score: 3, Insightful

      With no interest I would have $35,000 right now minus 7 routine check ups @ a couple hundred dollars each cash. If I invested that $5000 a year in a savings account that earns 2% interest starting now, when I am 50 I will have $172,009. I am basically gambling that I will require over $172,000 worth of medical care by the time I am 50. Even though the chances of that being the case are very small.

      1)Good luck finding a savings account that actually pays out 2% interest (yes I know there are a few, but they keep dropping rates as long as the fed stays at 0-0.25%. Mine has dropped from 3% to 1.2% in the last 18 months). CDs aren't much better unless you're willing to lock it up for a long time. 401k is the best, but the money is not then available if you do need it for medical expenses.

      2)You'd be amazed at how quickly you can rack up $172,000 in medical expenses and the chances are probably higher than you think. Cost per day in a hospital is anywhere from $1000-$3500, depending on level of care. If you get in an auto-accident or have some other condition requiring emergency surgery, that's very expensive. Plus, if you're uninsured, you get charged more or you may be denied non-emergent care unless you can prove the ability to self-pay. Chemo treatments can easily be $5000 per treatment or more, and a typical course would be 6 weeks of treatment 3 times a week.
            Also take into account any lost wages due to a serious injury or medical condition leading to hospitalization and possibly long recovery.

      3)You also need to take into account costs of what would happen if you had a large medical expense now, not covered by insurance. The interest rate on any debts accrued because of it would most certainly be greater than the 2% you would gain in a savings account.

  4. The important part of the article by thomasdz · · Score: 4, Insightful

    Lots of people probably don't mind "the government" keeping their DNA on file, but lots of people probably DO mind private insurance companies having the DNA data:

    "Since health insurance paid for Isabel's genetic screening, her positive test for a cystic fibrosis gene is now on the record with her insurance company, and the Browns are concerned this could hurt her in the future.
    "It's really a black mark against her, and there's nothing we can do to get it off there," Brown says. "And let's say in the future they can test for a gene for schizophrenia or manic-depression and your baby tests positive -- that would be on there, too."
    Brown says if the hospital had first asked her permission to test Isabel, now 10 months old, she might have chosen to pay for it out of pocket so the results wouldn't be known to the insurance company."

    --
    Karma: Excellent. 15 moderator points expire sometime.
    1. Re:The important part of the article by Anonymous Coward · · Score: 4, Insightful

      Brown says if the hospital had first asked her permission to test Isabel, now 10 months old, she might have chosen to pay for it out of pocket so the results wouldn't be known to the insurance company."

      ...which is just as bad, of course.

      The insurance business model relies upon insuring measurable, but fundamentally unknown risks.

      If you know you're going to get a condition that costs $1M to treat, you're going to want insurance against that condition. Conversely, if you know that you're not going to get any of these improbable-but-expensive conditions, (but will instead die of a nice cheap heart attack), you're better off not buying insurance in the first place.

      In the end, it will be this phenomenon - that consumers, en masse, can invest a small amount of money into a DNA test, and gain an informational advantage over the insurance company that's, actuarially speaking, worth more than the cost of the test - that kills the insurance industry as a business.

      In a world of cheap and widely-available DNA testing, it doesn't matter whether you keep the current system, or if you make coverage mandatory and have the government (the taxpayer) as the carrier of last resort. The end result is indistinguishable from single-payer.

      Unfortunately, Congress isn't interested in talking about health care reform, they're still talking about health insurance reform. The only difference is that the middleman, who can afford the lobbyists, gets a cut of the pie.

    2. Re:The important part of the article by sjs132 · · Score: 3, Interesting

      "Lots of people probably don't mind "the government" keeping their DNA on file....

      I mind... The last grovernment that tried to use genetics to modify it's society of illness didn't have the technology,
      so they just resorted to gassing millions of the "unfit" to protect the chosen.

      If you kill the baby before birth because of a genetic code defect, it is the same result. Just less gas and mass of bodies,
      but the results are the same. Case in point, both my children had Downs Syndrome like symptoms. If the "lives" program were
      implemented as suggested by Rahm Emanuel then I would not have two wonderful children. Did they have downs? Nope, just similar
      gene issues, but mentally they are higher than their peers.

      Now granted, the PDF references the DBS (Dried Blood Spot) test, but the in womb testing was also pushed by the gyny before the
      children were born along with "Counseling"... Pretty "standard" test from talking to other parents. You have the option to
      opt-out, but one could easily see that option being eliminated if the "cost" could be justified by the long term health care savings
      of the terminated "unfit" pregnancies.

      Even our current president stated:

      I've got two daughters. 9 years old and 6 years old. I am going to teach them first of all about values and morals.
      But if they make a mistake, I don't want them punished with a baby.

      But I guess he wouldn't want to teach them to take responsiblities for their actions... no reason to teach that anymore.

      I guess I'll get off my soapbox now...

      --
      --- Relax, that mass muderer is just trying to reduce our carbon footprint, one fetus at a time...
    3. Re:The important part of the article by Mr.+Slippery · · Score: 4, Insightful

      The last grovernment that tried to use genetics to modify it's society of illness didn't have the technology, so they just resorted to gassing millions of the "unfit" to protect the chosen.

      The Nazis were just more vigorously implementing a eugenics concept that originated in the U.S., where compulary sterilization was carried out on over 60,000 people. (The SCOTUS okayed this in Buck v. Bell, which has not been overturned.)

      If you kill the baby before birth because of a genetic code defect, it is the same result. Just less gas and mass of bodies, but the results are the same.

      You can't kill a "baby" before it's born., because it's not a "baby" yet. It's a fetus, embryo, blastocyst, or zygote. The distinction is very important: selecting which of several embryos to implant in order to avoid creating a person with a genetic disorder, is not the same as killing a three month old infant.

      If the "lives" program were implemented as suggested by Rahm Emanuel then I would not have two wonderful children.

      Sorry, you lost me here. Are you suggesting that Rahm Emanuel has been advocating some sort of forced eugenics program? Link, please?

      Did they have downs? Nope, just similar gene issues, but mentally they are higher than their peers.

      What the heck is "similar" to trisomy 21? Down's syndrome is not a subtle genetic alteration, it's a whole extra copy of a chromosome.

      But I guess he wouldn't want to teach them to take responsiblities for their actions... no reason to teach that anymore.

      Aborting a fetus rather than having a baby you can't properly care for, is responsible behavior. (Of course using contraception and not getting pregnant in the first place is even more responsible.)

      --
      Tom Swiss | the infamous tms | my blog
      You cannot wash away blood with blood
  5. names egregious, but not relevant by neurogeneticist · · Score: 5, Insightful

    Sadly, a genotype fingerprint of just 24 well-selected markers is enough to differentiate an individual, with an error rate far lower than 1/ # of people on the planet. So while having names attached to samples is ethically deplorable, in practice it doesn't really even matter. I do genetic research, and the first thing we do is de-identify samples in the database. When we get samples from other sites with names still on them, we get pissed at the site. It's just sloppy, and certainly doesn't help the research.

    1. Re:names egregious, but not relevant by tOaOMiB · · Score: 3, Informative

      To clarify, you want each of your markers to carry maximum information. SNPs are the easiest/cheapest markers to genotype, and represent positions in the genome where some chromosomes in the population have one nucleotide (e.g. G, one of the alleles) and others have a different nucleotide (e.g. T, the other allele). (I say chromosomes instead of people, since people are diploid and will have 2 copies of each chromosome. Diploid genotypes are then GG, GT, or TT for a G/T SNP). To maximize information, you want to choose a SNP where the probability of these genotypes is relatively even--maximized if the proportion of G's and T's in the population are equal, leading to 25% GG, 50% GT, and 25% TT.

      While the parent is correct that 24 SNPs is sufficient in a given population, in practice it's probably hard to choose 24 SNPs that cover ALL populations in the world well (since a SNP with a high minor allele frequency in, say, Europeans, may not have a high minor allele frequency in Asians, or Indians, or Australians...

  6. Re:CSI by bsDaemon · · Score: 4, Funny

    YEEEEEEEEEAAAAAAAAAAAAAAAAAHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!

    ('cause you forgot the real punchline. This public service announcement added to sneak past the lameness filter.).

  7. HIPAA by Anonymous Coward · · Score: 5, Interesting

    At a minimum, HIPAA should apply http://www.hhs.gov/ocr/privacy/

  8. From someone who does Genetic Testing by dafz1 · · Score: 5, Interesting

    My wife does molecular and cytogenetic testing. This was her reaction:

    "Over reaction. Yes the state labs keep blood spots...I don't know when anyone would ever want to go back and get a sample with someone's name on it unless they were working on a gene that is on the newborn screening panel. They legally can not use genetic testing to prevent you from getting a job or insurance..and who would. It would take more time and money than it's worth to get that information from a newborn screening card. Everyone is told about newborn screening and everyone has the opportunity to decline. It's a matter of whether you are actually paying attention to what is happening with your child. If you don't understand you have a responsibility to speak up. Newborn screening is important...research on deidentified samples is important. No one is out to get you. No one has the time or energy to get you. Life is not CSI."

    1. Re:From someone who does Genetic Testing by Rogerborg · · Score: 4, Insightful

      They legally can not currently use genetic testing to prevent you from getting a job or insurance

      Fixed that for you. It's really just a question of how much lobbyists will have to pay to be allowed to do end runs around GINA. For a baby born now, they've got 70+ years to manage it.

      --
      If you were blocking sigs, you wouldn't have to read this.
    2. Re:From someone who does Genetic Testing by SecurityGuy · · Score: 5, Insightful

      Oh, thank $DIETY, as long as it's not legal, we're fine. Can we talk about illegal wiretaps by the government en masse in recent years with the cooperation of major telecoms, where nobody will ever be prosecuted?

      Your wife's right, nobody's going to go back to a paper card for information. They're going to go to a database where getting this information is easy and inexpensive. Just look to jurisdictions that do or want to take DNA if you're convicted or accused of a crime, or in some cases arrested. If this information isn't in a database now, it will be when someone comes up with a perfectly reasonable and innocuous reason to do it. The abuse of the data comes later. The medical field is great at this, sadly. It makes me angry when I get forms, like I did for umbilical cord blood donation, that talk about how it can save lives of my child or others if they have some condition or other.. ...oh, and we can use it for research if we want. ...oh, and we can also use it for anything else we want, without limitation.

      What? No. Stop being ridiculously unreasonable and overreaching. Ok, testing for certain genetic diseases is a good idea. You may proceed. You may not keep the samples. You may not do anything with the information that doesn't directly benefit my child's health without my consent.

    3. Re:From someone who does Genetic Testing by Rich0 · · Score: 4, Insightful

      Plus, this ignores the other side of the case - if you KNOW your kid will never get cystic fibrosis, why pay for insurance that covers that disease? If you KNOW your kid will be diabetic (most likely), why not go ahead and buy the super-deluxe no-copay/no-limit health plan?

      Insurance only works in the absence of knowledge by BOTH parties. Genetic testing makes true insurance impossible.

      Now you can still have socialized medicine, and many people call it "insurance" but that really isn't what it is. A kid born with a bad heart valve or whatever doesn't need insurance - they need health care. In the US, for a number of reasons, the one has become synonymous with the other. What most people think of as "insurance" is just a discount buying plan so that you're not taken advantage of by price-gouging hospitals and doctors/etc.

      Note, this isn't intended as a criticism of either private insurance or socialized medicine. The problem we as a society has it that most people don't really appreciate what both of these things really are, and what their inherent pros/cons are. The fact that people with a profit motive (from insurers to vendors to doctors to everybody else) bribe politicians left and right doesn't help to clarify things either.

  9. No worries. by Thanshin · · Score: 4, Funny

    The solution is obvious; we just need ways of permanently change our DNA.

    If irradiated spiders aren't enough, we can bring back the nuclear testing.

    This has the added positive effect of fighting crime.

  10. We've been doing this for years! by mediis · · Score: 3, Interesting

    Don't you remember the 80's and 90's when there was the big push to get your children's registered -- just in case they were abducted. What do you think happened to THOSE databases.

  11. Insurance by Orgasmatron · · Score: 3, Insightful

    You also can't get fire insurance after your house burns down.

    If you already have an expensive condition, the concept of insurance no longer applies to you. It is no longer possible to pool your risk. At that point, you are looking for a SUBSIDY.

    Insurance is only possible when you have a large pool of people looking to mitigate the risk of a low probability but high downside event. Mathematically, fire insurance is a terrible purchase. The cost of premiums times the chance of having a claim is WAY higher than the expected payout. But you buy it because the downside is huge and you don't know if you are going to be on the unlucky side or not.

    --
    See that "Preview" button?
  12. The day will come when this is used maliciously by mbone · · Score: 4, Insightful

    We used Census records (supposedly secret for a century) to help find Japanese to intern in World War II.

    In the same war the Germans, of course, respected no privacy constraints at all, and used any information they could get for all sorts of much more nefarious projects.

    I am old enough to remember that, not only were blacks segregated in the South, but that blood tests would be run to determine just who was and wasn't black, in borderline cases. If DNA testing had been available, I have no doubt it would have been used.

    So it seems pretty clear that DNA information, if kept indefinitely in an identifiable fashion, will eventually be used maliciously. A long and lamentable history shows that we can count on that. The question is, are we going to act on this knowledge, or do nothing about it, and continue to let things slide into what could be a very nasty future.