Possible instance of genetic discrimination

By Razib Khan | April 29, 2010 3:36 am

Dr. Daniel MacArthur pointed me to this story, Conn. woman alleges genetic discrimination at work:

A Connecticut woman who had a voluntary double mastectomy after genetic testing is alleging her employer eliminated her job after learning she carried a gene implicated in breast cancer.

Pamela Fink, 39, of Fairfield said in discrimination complaints that her bosses at natural gas and electric supplier MXenergy gave her glowing evaluations for years, but targeted, demoted and eventually dismissed her when she told them of the genetic test results.

Her complaints, filed Tuesday with the U.S. Equal Opportunity Commission and Connecticut Commission on Human Rights and Opportunities, are among the first known to be filed nationwide based on the federal Genetic Information Nondiscrimination Act.

What probability do readers put in regards to this being a legitimate complaint? This seems a large firm, so I doubt that group insurance rates would change because of one person (I have heard of this occurring in small businesses where an expensive employee or employee’s family member can effect the rate for everyone else). So if it is legitimate the main issue would have been their fear of future illness, but the woman in question went through a double mastectomy, which I assume would obviate that concern. What am I missing? Are there expectations that she’d be taking medical leave in the future due to follow up operations or treatment?

Update: Brendan Maher has some follow up from Fink’s lawyer.

CATEGORIZED UNDER: Genetics, Medicine
  • Ray

    I’m more concerned with this part: “. . . voluntary double mastectomy after genetic testing . . .”

    It sounds like she had elective surgery to remove both breasts because of a DNA test and not because she had breast cancer. Huh?

    I think there’s another side to this story that we haven’t heard yet, and it involves her mental state.

    ETA: A reading of the linked news article looks to me like she got fired because the person the company brought in to do her job while she was absent did it better (or at least was there to work).

  • Robert E

    A family history of breast cancer (both sisters have already had it) and a genetic predisposition to cancer are two of the points listed by the Mayo Clinic for considering a “prophylactic mastectomy.”

    So her “mental state” has nothing to do with it.

  • http://www.cancerandyourgenes.com Matt Mealiffe, MD

    Ray (from post above) – It’s important for you to know that: (1) women found to have mutations in the BRCA2 gene have very substantial lifetime risks of developing breast cancer (about 50 to 80 percent as compared to a typical lifetime risk of about 12 percent); (2) they are also at markedly elevated risk for ovarian cancer; (3) facts 1 and 2 have led clinical researchers to test strategies to decrease these risks – for example, prophylactic removal of the ovaries and fallopian tubes of a woman with a BRCA1/2 mutation, in addition to substantially decreasing the risk of ovarian cancer, can decrease future breast cancer risk by about half; (4) many woman with these mutations pursue prophylactic removal of the ovaries and fallopian tubes for this reason; (5) a substantial fraction of women with BRCA1 and BRCA2 mutations pursue prophylactic removal of both breasts because it decreases the risk of future breast cancer by about 90 – 95 percent (see: http://www.ncbi.nlm.nih.gov//pubmed/14981104 ). Although the decision to pursue prophylactic mastectomy for women with BRCA1/2 mutations is an intensely personal issue, some women decide to pursue it, and this is quite reasonable (as is the decision not to pursue it). Your assertion that this woman is crazy is not backed up by the facts.
    Sincerely, Matt Mealiffe, M.D. (http://www.cancerandyourgenes.com)

  • http://www.cancerandyourgenes.com Matt Mealiffe, MD

    Razib – In response to your question about future operations or treatment, one thing that she presumably would be considering in the future would be prophylactic salpingo-oophorectomy (removal of the ovaries and fallopian tubes).
    Matt Mealiffe, M.D.

  • Angela

    There are a number of women who choose to have a double mastectomy because of the BRCA gene, which is implicated in early onset breast cancer, or due to family history. One of my close friends is considering it because of a very strong family history of metastatic breast cancer. Her mother is in the final stages of her third fight with it, and several other close female relatives on both sides of her family tree have had breast cancer. It’s a preventative measure, somewhat similar to taking asprin to prevent a heart attack in that it doesn’t completely eliminate the risk by may reduce it.

    It would be a very difficult choice to make, but it shouldn’t cause someone to lose their job!

  • bc

    yes, there are lots of women who have a family history of breast cancer, who will get double masectomies after finding benign tumors over and over. After your mother dies young, and you keep finding growths, even if they aren’t malignant, it’s enough to drive you crazy. Removing the breasts altogether means you finally have peace of mind and can live your life. I know someone that did this. It sounds like a slightly different scenario but I imagine she went through a similar thought process.

    There is almost no chance of cancer after removal. Insurance companies should know this and I don’t see why they’d raise rates.

    So it makes no sense whatsoever.

  • Bellhalla

    By the way… it should be “where an expensive employee or employee’s family member can affect the rate for everyone else” (not effect as originally written).


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About Razib Khan

I have degrees in biology and biochemistry, a passion for genetics, history, and philosophy, and shrimp is my favorite food. In relation to nationality I'm a American Northwesterner, in politics I'm a reactionary, and as for religion I have none (I'm an atheist). If you want to know more, see the links at http://www.razib.com


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