Review for test 2 -Ethics of gene testing

Question 1

Biotheical principles

Answer 1

1. Autonomy
2. Nonmaleficence
3. Beneficence
4. Justice
5. Veracity
6. Fidelity

Question 2

Steps in ethical reasoning (3)

Answer 2

1. Define the problem
2. State the alternatives/ options
3. Evaluate choices

“Define state, evaluate-ATE”

Question 3

Rationale for treating genetic test results differently

Answer 3

1. Predictive diary
2. Gives info about family members
3. Psychological harm
4. Has been used to discriminate and stigmatize

Question 4

GINA prohibits

Answer 4

Discrimination in health coverage and employment

Question 5

Gene info can include

Answer 5

1. My indiviual test
2. My family members genetic test
3. Test of embryo
4. Manifestation of a disease
5. Participation (receipt of being in a study that involves genetic info)

Question 6

What GINA will NOT do

Answer 6

1. Does not allow the overall premium of group rate to increase based on a persons genetic profile.
2. Does not stop health insurance companies from using your genetic info to determine payment decisions.

Question 7

Steps in bioethics

Answer 7

Define the conflict

Get the facts

Identify

• Ethical principles
• Options with logical conclusions

Make decisions INDEPENDENT of legal and financial concerns.

Question 8

When to break confidentiality

Answer 8

ID
Abuse
Court order
Threat
GSW

Question 9

Duty to warn was first established in the context of

Answer 9

contagious disease

Question 10

Pate v Threkel 1995

Answer 10

Pate discovered that she had medullary thyroid carcinoma 3 years after her mother was treated for the disease.

She sued physician arguing he had a duty to warn her mothers’s children of the risk.

Court found no duty to warn children directly . . adequate to just warn patient of their relatives risk

Question 11

Safer v. Estate of Pack, 1996

Answer 11

Safer’s father treated for cancer associated with multiple colon polyps in 1956.

Safer was then diagnosed with colon cancer 26 years later and sued father’s physician’s estate for failure to warn.

Court rule: upheld a duty to warn those at risk of avoidable harm from genetic disease; may not be satisfied by merely warning patient.

In 2001 , New Jersey legislature overturned decision by passing genetic privacy statue

• Law prohibits disclosure of genetic information without consent
• A physicians non consensual disclosure of a patients genetic info, does violate statute.

Question 12

Molloy v Meier 2001

Answer 12

Failure to diagnose Fagile X syndrome lead to birth of second child defect.

Court found a physician “ may owe a duty to a 3rd party who is not a patient and there is liability in failing to warn mother of risks to a future child