1 Department of Pediatrics, Johns Hopkins Hospital Baltimore, Maryland
2 Department of Pediatrics and Division of Medical Genetics, Harbor General Hospital, Torrance, California
An approximate desire to "do something" about sickle cell disease has produced a plethora of sickle screening programs. While the advantages of early identification of individuals with sickle cell disease is apparent, the purpose of identifying children with sickle trait is less clear. There is uncertainty about the clinical significance of sickle trait, and there are ethical and legal hazards in being so identified. The demonstrated failure of genetic counseling to successfully transmit information in other population groups also dictates a reexamination of the presumed benefits of sickle screening programs.
Screening programs should be initiated after pilot studies have resolved these issues, not before.