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Understanding the human genome and its interaction with the environment has the potential to change medical care by tailoring interventions to the precise needs of the individual patient. Little of this knowledge is currently being used in care. There are well recognized barriers to its use including lack of sufficient evidence of benefit, inadequate education of the provider workforce, concerns about privacy and reimbursement. However, there are also gaps in the current healthcare delivery system, particularly between traditional public health departments and clinical care that impede the translation of knowledge into practice. While this problem is not limited to genomics, the purpose of this article is to identify these gaps and propose potential solutions using examples from genomic medicine from the perspective of the United States healthcare system.

THE RECENT LITERATURE ON EQUALITY AND DIFFERENCE EVINCES TWO DIFFERENT APPROACHES TO THE TASK OF DEFINING JUSTICE IN A MANNER THAT IS RESPONSIVE TO SOCIAL DIFFERENCE. THE FIRST, THE JURIDICAL MODEL OF JUSTICE TOWARD GROUPS, ACCEPTS THE IDEA OF LIBERAL IMPARTIALITY. ON THE BASIS OF THAT IDEAL, THE JURIDICAL MODEL BEGINS WITH THE PREMISE THAT JUSTICE SHOULD BE DEFINED THROUGH A PROCESS OF REASONING THAT IS SHIELDED FROM THE TUG AND PULL OF PARTICULARIST POLITICAL INTERESTS. IN CONTRAST, THE POLITICAL SOLUTION TO THE PROBLEM OF DIFFERENCE REJECTS THE NOTION THAT JUSTICE CAN BE DEFINED PRIOR TO POLITICS. INSTEAD, ITS ADVOCATES MAINTAIN THAT STANDARDS OFJUSTICE CAN ONLY AVOID REPRODUCING INEQUALITY IF THEY ARE DEFINED WITHIN A POLITICAL PROCESS THAT PROVIDES THE OPPORTUNITY FOR MARGINALIZED GROUPS' PERSPECTIVES TO BE EXPRESSED AND HEEDED. IN THIS ESSAY, THE AUTHOR ARGUES THAT THE POLITICAL APPROACH TO DEFINING JUSTICE TOWARD GROUPS NOT ONLY HAS IMPORTANT ADVANTAGES OVER, BUT IS ACTUALLY IMPLICIT (ALTHOUGH UNDEVELOPED), IN THE JURIDICAL APPROACH. THE CLASH BETWEEN THE TWO APPROACHES TO RECONCILING EQUALITY AND DIFFERENCE BRINGS TO LIGHT A PROFOUND NEED TO RECONCEIVE THE ASPIRATION TO IMPARTIAL JUSTICE AND, IN THE PROCESS, TO RECONSIDER THE RELATIONSHIP BETWEEN THE POLITICAL AND JUDICIAL SPHERES WITHIN CONSTITUTIONAL DEMOCRACIES.

Islam generally, & Muslim immigrant communities in particular, have recently been targeted for criticism by Western academics & in popular Western media. Here, the substance of these criticisms is explored, weighing them against the beliefs & practices of Muslim immigrants in Western liberal democracies. Three distinct questions are addressed: (1) What sort of cultural adaptations is it reasonable for liberal democratic states & societies to expect immigrants to make, & what kinds of adaptation is it unreasonable to demand from them? (2) How vulnerable are Islamic beliefs & practices to the criticisms commonly leveled against them in the name of liberal democracy & gender equality? (3) How strong are the parallels between the claims for political recognition & accommodation that issue from immigrant cultural communities & the claims for recognition & inclusion that issue from groups that have historically been marginalized in liberal democratic societies? Although tensions may exist between the core commitments of liberal democratic societies & some Islamic practices, it is concluded that Western writers exaggerate these tensions. Muslim communities generally pose no greater challenge to liberal societies than do other religious & immigrant communities. Western writers should be chary of rejecting their claims to toleration & accommodation too swiftly. 65 References. Adapted from the source document.