Podcast
Questions and Answers
Incidental findings in clinical exome and genome sequencing should never be reported to patients.
Incidental findings in clinical exome and genome sequencing should never be reported to patients.
False (B)
The ethical issues related to genetic testing are solely the responsibility of the individual patient.
The ethical issues related to genetic testing are solely the responsibility of the individual patient.
False (B)
The legal landscape surrounding prenatal genetic testing is static and unchanging.
The legal landscape surrounding prenatal genetic testing is static and unchanging.
False (B)
A European consensus on reporting incidental findings in clinical NGS testing has been reached.
A European consensus on reporting incidental findings in clinical NGS testing has been reached.
Genetic counseling should primarily focus on the technical aspects of genetic testing, rather than the emotional and psychosocial implications.
Genetic counseling should primarily focus on the technical aspects of genetic testing, rather than the emotional and psychosocial implications.
The potential conflicts of interest of authors should not be disclosed in scientific publications.
The potential conflicts of interest of authors should not be disclosed in scientific publications.
Genetic diversity should be imposed through legal means, rather than promoted through education and awareness.
Genetic diversity should be imposed through legal means, rather than promoted through education and awareness.
Practical genetic counseling should only be offered by highly specialized professionals.
Practical genetic counseling should only be offered by highly specialized professionals.
Individuals with mental disabilities cannot make autonomous medical decisions.
Individuals with mental disabilities cannot make autonomous medical decisions.
The concept of the "right not to know" in genetic counseling has been unanimously accepted.
The concept of the "right not to know" in genetic counseling has been unanimously accepted.
The text suggests that the right to know one's genetic test result is an absolute, unyielding right.
The text suggests that the right to know one's genetic test result is an absolute, unyielding right.
It is always ethically permissible for a genetic counselor to share a patient's genetic test results with their family members.
It is always ethically permissible for a genetic counselor to share a patient's genetic test results with their family members.
The text argues that all individuals, regardless of age, are capable of making autonomous medical decisions.
The text argues that all individuals, regardless of age, are capable of making autonomous medical decisions.
The text implies that the concept of autonomy is a universal, culturally independent principle.
The text implies that the concept of autonomy is a universal, culturally independent principle.
The text emphasizes the importance of economic and social factors in shaping patients' access to medical choices, potentially limiting their autonomy.
The text emphasizes the importance of economic and social factors in shaping patients' access to medical choices, potentially limiting their autonomy.
Individuals who choose not to know their genetic risk status must necessarily be considered lacking in autonomy.
Individuals who choose not to know their genetic risk status must necessarily be considered lacking in autonomy.
In genetic counseling, the concept of autonomy should dominate over all other values in all situations.
In genetic counseling, the concept of autonomy should dominate over all other values in all situations.
A genetic counselor's role is to pressure the patient to make a particular decision.
A genetic counselor's role is to pressure the patient to make a particular decision.
A genetic counselor can reveal a patient's genetic test results to their relatives without the patient's consent.
A genetic counselor can reveal a patient's genetic test results to their relatives without the patient's consent.
A patient's autonomy is more important than the autonomy of the family in all situations.
A patient's autonomy is more important than the autonomy of the family in all situations.
The concept of non-directiveness emphasizes that a genetic counselor should avoid discussing the implications of different genetic test results.
The concept of non-directiveness emphasizes that a genetic counselor should avoid discussing the implications of different genetic test results.
The traditional and theoretical response to a patient asking "What would you do if you were in my place?" is to answer the question directly.
The traditional and theoretical response to a patient asking "What would you do if you were in my place?" is to answer the question directly.
A genetic counselor's role is to ensure the patient makes the decision they are most comfortable with.
A genetic counselor's role is to ensure the patient makes the decision they are most comfortable with.
The genetic counselor's obligation to maintain confidentiality is absolute and never questioned.
The genetic counselor's obligation to maintain confidentiality is absolute and never questioned.
Flashcards
P/C Autonomy
P/C Autonomy
The right of patients/clients to make their own medical decisions.
Non-autonomous individuals
Non-autonomous individuals
People incapable of making independent medical decisions, such as minors or disabled individuals.
Right to know
Right to know
The ethical principle that individuals can access information about their genetic status.
Right not to know
Right not to know
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Limitations of autonomy
Limitations of autonomy
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Ethical construct
Ethical construct
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Genetic counseling
Genetic counseling
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Huntington’s disease awareness
Huntington’s disease awareness
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Prenatal Genetic Testing
Prenatal Genetic Testing
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Professional Liability
Professional Liability
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Ethical Issues in Genetics
Ethical Issues in Genetics
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Incidental Findings
Incidental Findings
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ACMG Recommendations
ACMG Recommendations
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Whole-Genome Sequencing
Whole-Genome Sequencing
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Secondary Findings
Secondary Findings
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Patient/Client Autonomy
Patient/Client Autonomy
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Familial Autonomy
Familial Autonomy
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Non-Directiveness
Non-Directiveness
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Coercion
Coercion
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Client Confidentiality
Client Confidentiality
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Ethical Dilemmas
Ethical Dilemmas
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Counselor's Role
Counselor's Role
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Cultural Norms
Cultural Norms
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Study Notes
Principles of Genetic Counseling in the Era of Next-Generation Sequencing
- Genetic counseling involves advising patients or relatives at risk of a hereditary disorder about its consequences, probability of development/transmission, and prevention/amelioration strategies
- Traditional counseling focused on single-gene, Mendelian disorders
- Next-generation sequencing (NGS) can analyze multiple genes simultaneously, increasing the complexity of counseling due to multiple variant possibilities
- The internet and ubiquitous networks allow for greater sharing of genetic data, changing the way genetic counseling is conducted
Aspects of Genetic Counseling
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Diagnosis:
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Comprehensive medical and family history collection for a clear pedigree is crucial
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Objective evidence and confirmation of information during history taking are important
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Gathering paternal and maternal information is essential
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Consideration of additional tests such as biochemical tests is often necessary
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Prioritize legal permissibility of tests for the specific disorder before proceeding
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Estimation of Risks:
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Accurately determining the risks becomes more complex in NGS data due to the presence of multiple variants or variants of unknown significance (VUS)
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Counselors must classify risks associated with observed variants
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Communication and Support:
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Clearly presenting test findings in a supportive way to patients and their families is critical
Ethical Issues
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Right to Know/Right Not to Know:
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The concept of not knowing genetic information is relevant to various cases and societies
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Important to have a balanced approach and consider the patient's viewpoint of knowing and not knowing
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Coercion:
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Subtle pressure tactics such as persuasion from relatives can present ethical challenges to the counselor's responsibility
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Offering alternative solutions such as testing other family members can be a helpful approach
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Confidentiality:
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Protecting patient data from unauthorized release is paramount
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Counselors must ethically navigate the possible conflict of not sharing with some relatives, while sharing with others
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Reproductive Decision Making:
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Different legal standards exist across areas regarding prenatal testing or pre-implantation genetic diagnosis (PGD)
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These standards also vary with cultural and societal norms
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Autonomy:
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Patient control over their medical decisions is crucial.
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Privacy:
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Privacy concerns are subjective and dependent on cultural values, and should be considered carefully
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Balancing patient autonomy with societal needs is critical.
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