Question:
Discussion: Ethical issues in screening for genetic diseases
Genetic screening is an emerging and relatively new field.
Integrating genetics into public health opens up a number of opportunities for disease prevention and promotionaEUR”the basic principles of public health.
Three types of genetic screening are available from a public health perspective: predictive, carrier, and diagnostic (Fluda & Lykens 2006).
Prenatal and newborn screening are the most common forms of diagnostic screening. This is used to determine current disease status (e.g., Down syndrome, phenylketonuria).
Carrier screening is used to determine if an individual has a particular genetic trait (e.g. breast cancer, type 2 diabetic).
Predictive screening is used to determine if a seemingly healthy individual with positive family history has a gene mutation that could lead to Huntington’s disease.
There are growing concerns that population genetic screening could have a negative impact on the psychological health of people, as well as discrimination from employers and insurers.
There are also ethical concerns regarding individual autonomy, privacy and confidentiality.
This Discussion will review the Learning Recourses. Next, select an article from Walden Library that is related to a specific genetic disease.
You can choose a genetic or an inherited disease.
Be aware of the ethical concerns associated with screening for genetic diseases.
These are my thoughts:
Briefly summarize the article. Also, describe the genetic epidemiology for the disease.
Discuss one ethical concern related to screening for this condition.
Give a reason why screening for this disease should be mandatory.
Use scholarly sources to support your position.
Answer:
Introduction
Genetic testing, a new technology that is applied to biological processes, can be used to help vulnerable people detect their susceptibility to any type of disease or defect.
Genetic testing can be used in both the medical and personal worlds to diagnose diseases.
Genetic testing can detect complex diseases such as breast cancer, ovarian, and colon cancer early (Harper 2010, 2010).
This essay discusses the most important ethical issue in genetic screening for breast cancer. It is confidential information about breast cancer genetic testing that patients should keep private.
This essay provides a brief overview of a similar issue and explains why mandatory breast cancer genetic screening should be supported.
Genetic Epidemiology of Breast Cancer
Breast cancer is the second most common cancer in women after skin cancer. It is also the first most serious cancer cause death in women.
Worldwide, breast cancer claimed 13.7% of female deaths in 2008.
The impact of modern lifestyles has led to a rapid increase in breast cancer deaths since the 1970s (Davis 2010, 2010).
Butow et. al.
2013 study found that 1 in 8 American women are at risk for breast cancer, and 1 in 35 of those women will die from the disease.
The United States has the highest breast cancer risk, with 128.7 for 1 lakh Whites and 111.6 for 1 lakh African Americans.
Peterson and colleagues.
(2012) Breast cancer is still one of the most fearful diseases for women in the United States. It is a very complicated form of the disease.
Genetic testing for breast cancer is a serious health risk. There are ethical issues, especially in regards to confidentiality and sharing of information.
Goldenberg & Sharp (2012) carried out a survey in which 160 family members of breast cancer survivors were surveyed to determine their family history.
The survey included 376 participants, 71% of whom were blood relatives, and 82% who were first or second-degree blood relatives.
24% of the participants did not know or were not notified about their family history with breast cancer. 76% of those remaining unaware were blood relatives.
This shows that the issue of confidentiality and patient informed decisions to share information is very sensitive.
Brierley et al. (2012) examined the effects of cost, confidentiality and discrimination on people who are interested in genetic testing.
This study involved 184 participants. 106 were tested and 78 were denied testing.
The study by Butow et. al.
According to the study by Butow et al. (2013), 238 first-degree relatives of breast cancer patients were asked about their attitudes toward confidentiality and autonomy in genetic testing for breast cancer.
According to the results, 87% of women were against the disclosure of their genetic results. 56-57% preferred the process of informed consent before they shared information with others in their family. 98% supported mandatory and voluntary genetic testing for breast carcinoma.
This shows that genetic screening for breast carcinoma is a public issue and requires ethical consideration.
A Brief Summary of the Article
This article focuses on the ethical and legal issues involved in genetic testing for colon, breast and ovarian cancer.
These cancers all share a similar level of privacy and confidentiality in the lives of women.
This article discusses the ethical conflict between confidentiality for patients and disclosures by professionals to protect the welfare of others.
These articles discuss the general duties of disclosure as well as duties regarding disclosure of genetic susceptibility. They also discuss confidentiality, liability of genetic counselling, prenatal diagnosis, and genetic screening for new-borns.
The article also discusses public perceptions about genetic discrimination, public testing, and ethical issues associated with breast cancer.
According to the author’s research, genetic testing for breast-cancer is an ethical concern for feminists.
Women’s attitudes towards new technology and social trends will be determined by their traditional beliefs, professional and political authorities and their gender.
Traditional feminist beliefs still affect women. They are unable to see the entire healthcare system and decide to not disclose personal information.
There are however efforts to change traditional beliefs and provide awareness and alertness for the female population.
Lastly, article states that the ethical dilemmas and conflicts surrounding the genetic susceptibility to cancer remain and will continue to be a feminist discussion. Therefore, it is necessary to promote healthcare ethics using feminist methods to allow women their right of autonomy and confidentiality (Dickens Pei & Taylor 2012).
Genetic Screening for Breast Cancer: Ethical Issue
Patient confidentiality has been an ethical concern in genetic screening for breast carcinoma. This is due to security, privacy and feminism.
Studies have shown that breast cancer screening requires disclosure of certain information (Harper, 2010).
Butow et. al.
According to a 2013 study by Butow et al.
Modern genetic screening has been affected by this lack of communication.
A survey of 1,251 doctors who were involved in genetic screening for breast cancer found that 53% of them felt the need to protect confidentiality rather than explaining to patients the need to share information.
Peterson et al. (2012) found that healthcare providers in the United States are required to protect patient data and not divulge it without consent.
Genetic screening is a case in point. Confidentiality breaches are a legal offense.
This means that a physician cannot disclose information to a patient whose relative is at high risk for a similar disease.
(2014) stated that breast, colon, and ovary cancers were the most dangerous for patients’ children, siblings, and their families.
The confidentiality law states that the physician is not legally required to warn patients about the risk. This is because patient confidentiality is the primary priority.
However, if a physician becomes aware that a patient may infect another spouse, then they have a legal obligation to notify the spouse. This could lead to the disclosure of information.
Because of this unclear vision, confidentiality is an ethical issue in genetic screening for breast cancer.
Justification for the Mandatory Breast Cancer Genetic Screening
Because of the potential for human mortality, genetic screening should be mandatory in public health.
Genetic screening is a modern method of ensuring safety or existence risk in the foetus. Prenatal screening provides a promising control over future risks (Davis 2010, 2010).
Dancey et.al.
Mandatory genetic screening (2012a) will allow for timely counselling and reduce the risk of dying vulnerable.
Clayton et al. (2014) argue that mandatory genetic screening for breast carcinoma would revolutionize women’s healthcare and create political stability in their place in society.
These reasons are sufficient to justify mandatory genetic screening for women’s health.
Conclusion
According to this study, confidentiality is still a significant ethical concern in genetic screening for breast cancer.
It is ethical because of traditional beliefs, privacy, and protection for the vulnerable.
This genetic screening for breast cancer diagnosis holds promise for women’s health and prevents them from dying.
Refer to
Genetic dilemmas: parental choices and genetic technology.
Oxford University Press.
Practical Genetic Counselling 7th edition.
CRC Press.
Negative events in genetic testing for cancer: legal, financial, and ethical implications.
The Cancer Journal, 18(4): 303-309.
A systematic review of psychological outcomes and risk perceptions after genetic counselling and testing for breast cancer.
Medical Journal of Australia, 172(2), 77-81.
Clayton, E. W. McCullough L. B., Biesecker L. G. Joffe, S. Ross L. F. Wolf S. M. & For Clinical Sequencing Exploratory research (CSER), Consortium Pediatrics Working Group.
The ethical issues in genetic testing and the sequencing of children.
The American Journal of Bioethics 14(3): 3-9.
Genetic basis of cancer treatment decisions.
Genetic counseling and testing for susceptibility to colon, breast and ovarian cancer are subject to legal and ethical questions.
Canadian Medical Association Journal, 154.6, 813.
The programmatic and ethical challenges of genetic newborn screening.
Discrimination and health insurance in a clinic population.
Cancer Epidemiology and Prevention, 11(1), (79-87).