In an era of personalized medicine rife with population databases and international consortia, genetic discrimination is once again moving to the forefront of the genetics policy debate. In North America and Europe, many countries have taken a political stance on the use of predictive genetic information by insurers. Asia is also becoming more conscious of the challenge raised by genetic discrimination. In this paper, we present data on the different policy options adopted to resolve the genetic and insurance dilemma in 47 different countries located in four world regions. Approaches varied according to legal traditions, the role insurance plays in each state, and the interplay between private and public health care systems. We conclude that a truly informed international debate on genetic discrimination in insurance should properly account for the limits of genetic predictive information and the social value of health and life insurance as perceived by the public.

Few areas of recent research have received as much focus or generated as much excitement and debate as stem cell research. Hope for the therapeutic promise of this field has been matched by social concern associated largely with the sources of stem cells and their uses. This interplay between promise and controversy has contributed to the enormous variation that exists among the environments in which stem cell research is conducted throughout the world. This variation is layered upon intra-jurisdictional policies that are also often complex and in flux, resulting in what we term a 'patchwork of patchworks'. This patchwork of patchworks and its implications will become increasingly important as we enter this new era of stem cell research. The current progression towards translational and clinical research among international collaborators serves as a catalyst for identifying potential policy conflict and makes it imperative to address jurisdictional variability in stem cell research environments. The existing patchworks seen in contemporary stem cell research environments provide a valuable opportunity to consider how variations in regulations and policies across and within jurisdictions influence research efficiencies and directions. In one sense, the stem cell research context can be viewed as a living experiment occurring across the globe. The lessons to be gleaned from examining this field have great potential for broad-ranging general science policy application.

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