When genetic researchers successfully cloned the gene in which mutations cause cystic fibrosis, they also triggered a growing debate about under what circumstances and in what setting CF testing should be offered.

To understand this debate, one needs some background on the history of carrier testing in the United States, a history with two strikingly different testing experiences, both of which are influencing plans for CF testing.

The first experience dates to the early 1970s, when about a dozen states enacted poorly conceived laws that mandated testing blacks for sickle cell trait. The testing programs usually targeted black school children or black couples seeking marriage licenses.

These laws paid little, if any, attention to the importance of providing genetic counseling services, to protecting the privacy of the test results, to the problem of the inadvertent discovery of nonpaternity, and to other sensitive issues. As a result, they drew sharp criticism,...

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