Polygenic Risk Scores Raise Legal Questions About Workplace Accommodations

A medical visit may now include a polygenic risk score that predicts a person’s likelihood of a serious disease, such as a heart attack. In the scenario, a patient learns of a “hugely elevated risk” and requests workplace adjustments—e.g., a less physically demanding role or reduced stress—to mitigate the health threat. Under U.S. law, an employer can refuse such accommodations, because statutes governing genetic discrimination and disability do not obligate employers to act on future health risk predictions.

New York Times

Genetic testing focuses on single-gene mutations that cause conditions like Huntington’s disease or cystic fibrosis. Polygenic risk scores, by contrast, scan dozens of variants across the genome and combine them into a cumulative risk estimate for complex diseases such as diabetes, cancer, or cardiovascular events. The technology is described as moving from “finding one severed wire” to operating a “soundboard” of many switches that together shape disease probability.

New York Times

The Genetic Information Nondiscrimination Act of 2008 (GINA) bars employers from firing workers based on genetic test results, while the Americans With Disabilities Act (ADA) protects individuals with “active disabilities.” Neither law requires an employer to provide accommodations aimed at preventing a projected future condition. Consequently, employees who seek preventive adjustments based on polygenic risk scores may face denial of those accommodations without legal recourse.

New York Times

Harvard Law School professor I. Glenn Cohen, who specializes in bioethics and law, notes that polygenic risk scores will become a routine part of personal health management. He frames the situation as an opportunity to revisit policy: “These polygenic risk scores are going to become an increasing part of your life,” Cohen said, emphasizing the need to address “questions that, from a policy perspective, are legitimately hard.”

New York Times

Legal and public-health scholars warn that the rapid advancement of genomic tools outpaces current regulatory structures, leaving individuals vulnerable to “outright firings” and other adverse employment actions. The lack of statutory accommodation requirements is identified as a gap that could exacerbate health inequities if employers are not compelled to consider preventive genetic information.

New York Times

The article does not provide data on how many workers have faced accommodation requests based on polygenic risk scores, nor does it quantify the prevalence of such scores in clinical practice. This absence of empirical evidence limits assessment of the scale of the legal challenge.

New York Times

• “These polygenic risk scores are going to become an increasing part of your life,” — I. Glenn Cohen, Harvard Law School professor

New York Times

Scholars suggest lawmakers revisit the scope of GINA and the ADA to determine whether future-risk accommodations should be mandated. The call for “reopening questions about what the rules should be” signals a policy debate that will likely shape employer-employee relations as polygenic risk scoring becomes more widespread.

New York Times