Letter: Sickle cell screening.

The analysis of burgeoning statesupported sickle cell anemia screening programs ("Some Negative Aspects of State Health Departments' Policies Related to Screening for Sickle Cell Anemia") that was published last month [AJPH, 64:217-221] points out the dangers of hasty applications of biomedical technology. While I am in agreement with the thrust of the article, I wish to clarify the problem of mandatory legislation that the authors raised. Mly own research into this subject suggests that most of the original sickle cell screening laws (passed in 1971 and 1972) were sponsored by black legislators and applauded as a benefit to their constituents. When it became apparent that serious potential discrimination lay in compulsory screening, few if any states acted to enforce these laws.' Mlore important to clarify is the failure of the article to point out that the National Sickle Cell Anemia Control Act premises all funding of screening programs by either state or local groups on "wholly voluntary" participation by the persons to be tested. Failure to so comply precludes sharing in a piece of the federal screening budget. In effect, the federal law has stimulated the repeal of compulsorn state legislation. It is important that the sickle cell laws, until now little discussed in detail, be reviewed to prevent further ill considered legislation in the future.