Congress passed the Genetic Information Nondiscrimination Act of 2008 (GINA) in order to remove a perceived barrier to clinical genetic testing. By banning health insurance companies and employers from discriminating against an individual based on his or her genetic information, legislators hoped that patients would be encouraged to seek genetic testing that could improve health outcomes and provide opportunities for preventive measures. Their explicit legislative goal was to fully protect the public from discrimination and allay their concerns about the potential for discrimination, thereby allowing individuals to take advantage of genetic testing, technologies, research, and new therapies.

However, GINA left a number of issues unresolved, most notably failing to define the concept of disease manifestation. GINA was structured such that it only provides protection against misuse of genetic information up until the point when an individual's disease has manifested. It protects an individual with a genetic predisposition for a disease, but not an individual actively suffering from that disease.

Pediatric participation in non-therapeutic research that poses greater than minimal risk has been the subject of considerable thought-provoking debate in the research ethics literature. While the need for more pediatric research has been called morally imperative, and concerted efforts have been made to increase pediatric medical research, the importance of protecting children from undue research risks remains paramount.

United States research regulations are derived largely from the deliberations and report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The authors of this report specifically designated children as a vulnerable population and suggested additional protections, most of which became U.S. law. One of the more contested sets of regulations surrounds non-therapeutic research, e.g., research that does not offer the potential for direct benefit to participants. Federal regulations allow local Institutional Review Boards (IRBs) to approve non-therapeutic research posing a minor increase above minimal risk when it involves children who have the disease or medical condition that the research addresses (Table 1).

There are not many public health issues where views are as extremely polarized as those concerning vaccination policies. Ever since its Fast Track approval by the U.S. Food and Drug Administration (FDA) in 2006, Merck's human papilloma virus (HPV) vaccine Gardasil has been sparking controversy. Initially, the criticism has been focused at Merck, due to their overly aggressive marketing strategies and lobbying campaigns. According to a 2007 editorial in Nature Biotechnology, Surrounded by a chorus of disapproval, Merck cracked. As Nature Biotechnology went to press, the company announced a cessation of all efforts to lobby for US state laws requiring compulsory vaccination. Subsequently, questions have been raised whether it was appropriate for vaccine manufacturers to partake in public health policies when their conflicts of interests were so obvious. Some of their advertising campaign slogans, such as cervical cancer kills x women per year and your daughter could become one less life affected by cervical cancer, seemed more designed to promote fear rather than evidence-based decision making about the potential benefits of the vaccine versus any risks.

From the earliest days of the Human Genome Project, the holy grail of genomics was the ability to perform whole-genome sequencing quickly, accurately, and relatively inexpensively so that the benefits of genomics would be widely available in clinical settings. Although the mythical $1,000 genome sequence seemed elusive for many years, next-generation sequencing technologies and other recent advances clearly indicate that inexpensive whole-genome sequencing is at hand.

Whole-genome sequencing has demonstrable value in elucidating the genetic etiology of rare disorders, in identifying atypical variants in common diseases, in determining pharmacogenomically appropriate drugs and dosages, in performing tumor genome sequencing, and in aiding other clinical applications for the diagnosis and treatment of individuals who are symptomatic or whose family health history places them at substantial risk. Undoubtedly, the clinical applications of wholegenome sequencing will increase in the future.

Promoting and protecting the public's health in the United States and abroad are intricately tied to laws and policies. Laws provide support for public health measures, authorize specific actions among public and private actors, and empower public health officials. Laws can also inhibit or restrict efforts designed to improve communal health through protections for individual rights or structural principles of government. Advancing the health of populations through law is complex and subject to constant tradeoffs. This column seeks to explore the role of law in the interests of public health through scholarly and applied assessments across a spectrum of key issues. The first of these assessments focuses on a critical topic in emergency legal preparedness.

In the last several years, Brazil has gained international attention as an emerging BRIC economy, was awarded the 2014 World Cup and 2016 Olympics, and elected its first female president. This has led many to declare that Brazil is emerging as a potential world power for the 21st century. In addition to improving its international stature, in the last several decades Brazil has also significantly improved the availability and quality of health care within the country. Despite these gains, however, Brazil still suffers from poor maternal health. In fact, Brazil's Maternal Mortality Ratio is five to ten times higher than the rates in high-income countries. Last year, these conditions lead the United Nations Committee on the Elimination of Discrimination against Women to issue a decision declaring that Brazil was violating its international obligations to provide pregnant women with adequate health care, and to call for a reduction in preventable maternal deaths. It is against this backdrop that Brazil enacted a new law last December, Provisional Measure 557 (MP 557), to require pregnant women to register with the state.