Ethical and legal issues in genetic epidemiology.

Since the discovery of recombinant DNA techniques in the 1970s, the identification of diseaserelated genes has rested on epidemiologic data (1, 2). The implications of gene identification for research subjects, for the transition to clinical practice, for clinical practice itself, and, finally, for society at large form the basis of this review. The ethical issues inherent in genetic testing have been widely discussed (3-6), as have the ethical issues in epidemiology (7), but little attention has been focussed on the specific ethical issues that arise in genetic epidemiology. In addressing genetic epidemiology, the emphasis of this review will be on topics of current interest, and often controversy, regarding the development and implementation of genetic testing and intervention technologies. We hope it will become clear that people considering genetic tests or treatments need reliable information—much of it based on epidemiologic studies—on which to make decisions, and society needs to develop measures to prevent the misuse of genetic testing and genetic information.