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75 U. Det. Mercy L. Rev. 547 (1997-1998)
What Kind of Public Policy Do We Need

handle is hein.journals/udetmr75 and id is 557 raw text is: What Kind of Public Policy Do We Need? TOBY CITRIN* Having heard from David Doukas about the challenges that ge- netic testing poses for physicians, from Len Fleck about the way that the values framework and community dialogues can assist in respond- ing to these challenges, having heard from Jim Haveman about the response of our Governor and our Department of Community Health to some of these challenges, I would like to move us further now into the realm of policy. I would like to suggest initially a definition of policy which I have found fairly handy. It came out of a policy task force on which I am currently engaged. That group defined policy as decisions made by public, private, professional and community groups, and organiza- tions to affect behavior and direct resources. That definition is broad enough to embrace laws, regulations, professional standards of practice, and the rules and guidelines that determine the conduct of health care providers and insurers.- The key element of policy is a decision made in advance which will affect the conduct of people and organizations in the future, and when that decision is reflected in a law or a regulation or a govern- ment budget decision or an administrative guideline of an agency of government, then we usually term it public policy. I think it has become obvious that genetics research and the technology which it spawns has enormous potential to do good and to cause harm. Analogies have been made between genetics research and atomic research as presenting a two-edged sword to society. Proponents of the research claim it will revolutionize medicine and public health, enabling us to learn the genetic causes of a grow- ing number of diseases, to prevent their onset, and to treat their oc- currence. Those more skeptical of this path of research point out the historical evidence of harms done by the eugenics movement, espe- cially when that movement provided the rationale for the unspeak- able horrors of the Nazi program. They also point to instances when. genetic relationships to disease have exacerbated prejudices; dis- crimination, and stigmatization of minority groups. Still others call * The author holds a law degree from Harvard University and is at the School of Public Health at the University of Michigan. He is a Professor of Health Man- agement and Policy, and Principal Investigator of the Genome Policy Dialogue proj- ect, and the former chair of the Council on Genetics and Society. 1. Report of National Policy Task Force, Community-Based Public Health In- stitute, June 1996 (unpublished).