Genetic screening: ethical issues - Nuffield Council on Bioethics

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62 6.22 There is clearly a need to strike a balance which takes into account the competing interests in this area. We are concerned to ensure that nothing should be done to undermine the employer’s ultimate responsibility to provide a safe working environment. <strong>Genetic</strong> <strong>screening</strong> should not be an excuse for cutting costs on health and safety standards, nor should it become a justification for excluding people from the labour market. Indeed in view of the sensitive <strong>issues</strong> raised, it is open to question whether the decision to introduce a <strong>screening</strong> programme ought properly to be that of the employer alone. It may be appropriate that such a programme should be implemented only in consultation with workplace representatives, with the coordinating body proposed in paragraph 9.7 and possibly also only with the approval of the Health and Safety Commission. 6 6.23 Subject to this prior consultation and authorisation, genetic <strong>screening</strong> of a workforce for increased occupational risks ought to be contemplated in our view only where:- (i) (ii) (iii) there is strong evidence of a clear connection between the working environment and the development of the condition for which the <strong>screening</strong> is conducted; the condition in question is one which seriously endangers the health of the employee or is one in which an affected employee is likely to present a serious danger to third parties; the condition is one for which the dangers cannot be eliminated or significantly reduced by reasonable measures taken by the employer to modify or respond to the environmental risks. But although it may be appropriate to introduce a <strong>screening</strong> programme on these limited grounds, it should only be done if accompanied by safeguards for the employee, as indicated in paragraph 6.20. A need for further legal provision? 6.24 Under the law as it presently stands, employers may introduce genetic <strong>screening</strong>, and may require potential employees to be screened as a condition of employment. There are no preconditions to be satisfied before a <strong>screening</strong> programme is introduced, and there are no safeguards against misuse or abuse where such a programme is introduced. The absence of specific
63 legal regulation does not appear to be peculiar to this country, though there are a number of jurisdictions where there is more direct legal intervention. Legal regulation elsewhere 6.25 In Europe draft legislation has been introduced in Denmark which would prohibit an employer from demanding or making use of a genetic test at the time of appointment or at a subsequent stage. 7 This would be subject to a proviso to permit the Minister of Labour to authorise genetic tests for “any disorders which might jeopardise other people in the relevant function or job.” Rather different forms of regulation in a number of jurisdictions in the United States prohibit discrimination in employment on the basis of one or more genetic traits. Florida, Louisiana, and North Carolina prohibit discrimination based on sickle cell trait, the prohibition in the last case extending also to haemoglobin C. New Jersey goes further in prohibiting discrimination on the additional grounds of carrier states for thalassaemia, Tay-Sachs disease and cystic fibrosis. 8 Legal Intervention in Britain? 6.26 In the light of our comments about the circumstances in which genetic <strong>screening</strong> ought properly to be conducted in this country, and in the light also of the lack of any regulation of the practice, the question arises as to whether it would be appropriate to introduce legislation such as that now in draft in Denmark or provided in some of the states of the USA. We are reluctant to recommend any initiative at this stage because of the lack of evidence which we have been able to uncover about the systematic use of genetic <strong>screening</strong> programmes by employers in this country. Still less is there evidence of any systematic abuse by employers.
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NUFFIELD COUNCIL ON BIOETHICS GENET
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ii The broad framework provided as
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vi Page Chapter 7 : INSURANCE 65 Li
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2 the ways in which groups have bee
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8 In addition to the genetic contri
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10 Chromosomal disorders 2.6 Chromo
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