Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
Copyright 1999 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
To the Editor: In attempting to define who
should be protected by the Americans With Disabilities Act (ADA), Mr Gostin
and colleagues1 failed to mention the critical
distinction between risk factors (eg, carriage of a BRCA1 mutation for breast cancer) and presymptomatic disease (eg, human
immunodeficiency virus carriage or cervical dysplasia). The former is not
a disease and may never manifest with illness and disability. To paraphrase
Judge Ginsberg, no rational legislature would require nondiscrimination because
of risk for a disease that may never become manifest. If we wish to allow
"disability" to continue to have real meaning, we must be careful to distinguish
between disability that is inevitable, as in the case of presymptomatic disease,
and disability that is potential, as in the presence of risk factors.
Wendel TD. Protection Under the Americans With Disabilities Act. JAMA. 1999;282(12):1131-1132. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-12-jbk0922