In addition to the exciting promise that genome sequencing holds, concerns are also often described. These concerns relate to: privacy/confidentiality of findings; impact of findings on insurability and discrimination; autonomy and the impact of one's findings on others; questions of clinical utility; the potential for psychological distress; and equity of access. While each of these concerns may constitute a reason for some not to pursue sequencing technology at this time, others remain ready and willing to move forward immediately. Clearly the weighing of risks and benefits are different for different people. Delineating these differences will take time and require empirical exploration. One seemingly obvious bot often neglected differentiation is the starting point for individuals (or family members) - whether they are sick or healthy. Decision making in the context of illness likely (and understandably) influences the weightings given to risks and benefits - perhaps even reframing the balance of promise and concern entirely (a "game changer"). This talk will present the various concerns put forward regarding genome sequencing and discuss the ways in which these are more and/or less relevant depending upon one's relative health situation.