Bioethical Principle Paper: BRCA Genetic Testing
With so many advances in medical technology, ethical dilemmas often accompany the advances. Genetic testing continue to be one of the most heated ethical debate in today’s health care. In 1963, newborns began to be tested for phenylketonuria (PKU), an amino acid buildup in the blood that causes mental retardation. This is the earliest genetic testing documented in the health care of the United States. Today, more than 2,500 available genetic testing are available to the public where the lowest cost reported is a DNA home kit for one hundred dollars. In 2013, the famous actress, Angelina Jolie, undergone a preventive double mastectomy after the BRCA genetic tests that revealed she was at a high
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With this special bonding, if an individual was tested positive for BRCA1/2 mutation, it will be a great indicator that someone in the family also carries the mutated gene. There is a moral argument for whether it is obligated to share the genetic information with relatives who may potentially be at risk; however, this decision can violate patient autonomy and confidentiality. Studies have shown that most mutation carriers do not share this information with his/her family member, because it can cause tension in the relationship. In addition, if the mutation carrier decided to receive therapeutic treatment such as BRMx or BROx, the decision that the carrier made can further introduce suspicions and questions from the …show more content…
Therefore, in 2008, the Genetic Information Nondiscrimination Act prohibit discrimination on the basis of genetic information with respect to health insurance and employment. Employer cannot refuse to hire, or to discharge, any employee because of genetic information. In addition, it is unlawful to request, require or purchase genetic information of the employee (U.S. Equal Employment Opportunity Commission, 2008). However, even with genetic non-discrimination legislation, mutation carriers may find themselves ineligible for life insurance and other long-term
The Human Genome Project is the largest scientific endeavor undertaken since the Manhattan Project, and, as with the Manhattan Project, the completion of the Human Genome Project has brought to surface many moral and ethical issues concerning the use of the knowledge gained from the project. Although genetic tests for certain diseases have been available for 15 years (Ridley, 1999), the completion of the Human Genome Project will certainly lead to an exponential increase in the number of genetic tests available. Therefore, before genetic testing becomes a routine part of a visit to a doctor's office, the two main questions at the heart of the controversy surrounding genetic testing must be
It is patients’ right to opt for genetic testing on their own DNA, although they are accepting a great risk by doing so.
Genetic testing has brought about many changes in the way many couples look at conceiving and raising families. Through genetic testing you are able to screen for the increased chance that a fetus may have one of many congenital disorders, or even identify gene changes that are responsible for a disease that has already been diagnosed (Genetic Testing, March 2015). Unfortunately genetic testing is not always exact, in some cases giving parents false negatives or false positive results. Even if the results are accurate, there is the burden of knowledge once you know the results indicate a genetic abnormality such as Down’s syndrome. While caring for a 2 year old male patient with developmental delays and anotia, I learned that genetic testing had been started but never completed on the child. Genetic testing could help to identify genetic disorders that led to the child’s developmental delays and possible future disorders that may develop. The ethical dilemma I will be discussing to the ANA Ethical dilemma of the impact of informed consent of genetic testing on children for adult onset diseases and disorders.
There are two main ways genetic testing places a constraint on a child’s right to an open future. The first of these is that the revelation of a child’s disease status can change his life narrative and the way parents and others treat him, and substantially alter his or her life’s trajectory (Davis _____). Parents may feel guilty or shelter their not-yet-sick
Genetics has become a very important topic of discussion in the healthcare field. There are more and more diseases being linked to certain genes in the DNA. Carrier: Untangling the danger in my DNA, by Bonnie J. Rough, is one example of the modern problems people have to deal with in regards to genetics and genetic testing. The author writes about the problems she faced. She had some very difficult decisions about her possible offspring as well as herself. Rough writes about her struggle with deciding if she should get a genetic test for a gene that causes a disease that has been passed on through her families for generations. The reader also learns about her and her husband’s experience of getting pregnant and the steps they took to try
The inclusion of genetic testing into Electronic Health Records impacts the overall healthcare of patient’s because it informs the physicians and other medical professionals the selection of effective treatment or preventive action. A manager’s responsibilities are to implement policies to protect the confidentiality, privacy, and security of genetic tests results and information of patient’s. Policies contributing to potential discrimination acts are also advised because genetic/genomic testing reveals a patient’s physical characteristics.
Despite all of the progress that has made towards equal opportunity, discrimination is still a major problem in the United States of America. A relatively new phenomenon, titled genetic discrimination, occurs when individuals are discriminated against on account of their genetic information. On May 21st, 2008, the GINA Act was passed, making it illegal to refuse to provide employment or health insurance to individuals based on their genetic information in all U.S. states and territories. Title I prevents genetic discrimination in health coverage, while Title II prevents genetic discrimination in employment. Title I took effect on May 21st, 2009, and Title II took effect eighteen months later on November 21st, 2009. With the GINA Act, it is
However, confidentiality rights also protect the patient's health information and right to privacy. Another issue that arises concerns the confidentiality of HD diagnoses with relation to insurance companies. Many patients fear that they will be denied or will no longer be able to afford insurance coverage if the insurance company learns that they will one day have HD (Ethical issues of genetic diagnosis, 2007). Insurance companies may also begin to mandate that genetically-related individuals undergo predictive genetic testing for HD if one family member develops the disease (Ethical issues of genetic diagnosis, 2007).
In the following, I will attempt to map out the current debate as it applies to genetic screening and testing, with special attention paid to the criticism offered by disability studies theory and disability rights advocates. I will begin with a brief overview of the traditional arguments in favor of reproductive liberty and a more permissive stance toward the use of genetic technology. This will include a discussion of autonomy as the underlying ethical principle at work, and the related focus on informed consent as both a guiding axiom and common target of criticism. The principle of beneficence is a crucial underlying
<br>4. The rights of knowing someone's own health status and keeping that information private to oneself should be provided to all members of a society. Only the individual should have full access to information about his own genetic constitution and others should be prevented by legal regulations. As we have said above, the results of genetic tests can sometimes be detrimental to the individual. If a person does not want to know the information, its nobody's business nor right to declare it. This includes even not explaining favorable test results without the individual's request.
If the genetic information is only accessible to the individual then there is a decreased chance of such discrimination occurring because the information is disclosed to who the individual wishes to. Genetic information can raise questions about personal responsibility, personal choice versus genetic determinism, and concepts of health and disease. Personal factors, family values, and community and cultural beliefs can mould the reactions to these issues. For example the response to the genetic information and suggestion from physicians after the test will be drastically different in a society where traditions and religion determine life choices, such as India, than to a more individually liberal society like the USA. Even in a progressive society that has had specific ethnic groups for multiple generations disparities with medical technology are common. A study conducted, using the national representative data, in the USA with the sample that consisted of 1724 men and women of non-Hispanic whites, Latinos, and African American background. Results exposed significant differences by racial/ethnic groups in knowledge and concerns about the potential misuse of genetic testing. Significantly higher levels of mistrust in a physician and the medical system was a common thread within minorities. The genetic tests can be a way of ridding anxiety attached to the assumed inheritance of genetic disease due to family background whilst for others the genetic test reveals their reality. The results can have a great deal of a psychological impact upon the individual. The possibility of developing a genetic disease alone can create anxiety within some. The psychological impact from the results revealed is another issue that society is concerned about. A
I think in an advancing society it is necessary but, with limitations. A person has a right to know about their future children and is entitled to avoid anything they may consider to be too troubling to handle; however, patients should be made aware that the results may be negative or defamatory. But, access to this kind of information requires a serious amount of sensitivity and the person handling it should be aware of this and understand that the only ethics that have entitlement in this situation are the subjects’ . I think it’s all very delicate and subjective. There should be many considerations when having a child or dealing with one’s genetics but, the most important one is quality of life. As long as the ethics support that they are not only beneficial but,
The distress and the health risk to the mother are concerns when viewed through the lens of the principle of nonmaleficence or of “do no harm”. The accessibility and cost of the prenatal genetic testing are contentious. Although prenatal genetic testing is considered to be a useful tool, some believe it leads us down a “slippery slope”. Controversy exists surrounding prenatal genetic testing for reasons of social, psychological, moral, and religious rationales.
Although the gene chip will enable an individual to know whether he/she has a genetic disease, that person may not want to know the information. Many people are frightened that a positive finding on a genetic test will result in discrimination and ostracism because the society will consider them abnormal (Easthope 2005). The other concern is that with genetic test information one might lose or might be unable to get a job or insurance. There have been concerns that with the knowledge of one’s medical information after a gene test, he/she might suffer a psychological problem especially when the results reveal that one suffers from a terminal disease or has high possibility of suffering from one (Willis 2009).
Genetic information can be identified at any point throughout a person’s lifespan from pre-conception until after death. In addition to heritable, biological information, family history, genetic test results, and medical records are also sources of genetic information” (Jenkins & Lea, 2005). We are put in a position to gather and retain information that could be utilized for a better future, but is confidentiality involved for the sake of profiting? Ask yourself, who should have access to genetic information? Who owns and controls it? How can families resolve conflicts when some members want to be tested for a genetic disorder and others do not?