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13 J.L. & Biosciences 1 (2026)

handle is hein.journals/jlbsc13 and id is 1 raw text is: Journal of Law and the Biosciences, lsaf016 https: //doi.org/ 10.1093/jlb/lsaf016 Original Article Polygenic disease risk scoring and genetic non-discrimination Jin K. Park', Susannah Baruch2 and I. Glenn Cohen i;3* 1Yale Law School, 127 Wall Street, New Haven, CT 06511, United States 2Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, 23 Everett St, Cambridge, MA 02138, United States 3Harvard Law School, 1525 Massachusetts Ave, Cambridge MA 02138, United States *Corresponding author. E-mail: igcohen@law.harvard.edu ABSTRACT The Genetic Information Nondiscrimination Act (GINA) became law almost two decades ago, when genomic medicine was stillin its infancy. One reason for its passage was to ensure that individuals and society would reap the benefits of emerging advances in genetic medicine, and would be able to benefit from genetic testing and research without fear of employment or health insurance discrimination. Since then, genomics has matured into a complex probabilistic science that increasingly allows for individualized estimates of genetic risk derived from large-scale population studies. Polygenic risk scores (PGSs), which provide genome-wide estimates of disease liability and may help indicate effective preventive care for an individual, raise new benefits but also concerns. PGS testing may become common in clinical practice, particularly to mitigate common complex diseases such as cardiac conditions and cancer. But are existing antidiscrimination protections adequate for a world where polygenic risk scoring is the norm? In this paper, we consider how existing laws apply and whether newlegal and policy approaches are needed to support widespread, beneficial clinical use of PGSs. We also propose avenues for potential action by policymakers. KEYWORDS: genetic discrimination, polygenic risk scores, GINA, ADA I. INTRODUCTION We are now witnessing a proliferation of scientific efforts that take full advantage of human genetic variation to elucidate the genetic architecture of complex diseases and phenotypes, the most prominent of which is the practice of polygenic disease risk scor- ing, which provides genome-wide estimates of disease liability. The development and © The Author(s) 2026. Published by Oxford University Press on behalf of the Duke University School of Law, Harvard Law School, Oxford University Press, and Stanford Law School. This is an OpenAccess article distributed under the terms ofthe Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.