SCI260 Introduction To Biochemistry

Question:

Discussion: Ethical Questions in Screening for Genetic Diseases

Genetic screening is still a new and exciting field.

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The integration of genetics in public healthcare offers many opportunities for health promotion and disease prevention.

There are three types of genetic screening that can be used for public health purposes: carrier, diagnostic, and predictive.

The most popular form of genetic screening is prenatal and neonatal screening. It helps to identify current diseases (e.g., Down syndrome, phenylketonuria).

Carrier screening determines if an individual is carrying a particular genetic trait (e.g. type 2 diabetes, breast cancer).

A predictive screening checks whether an otherwise healthy individual with positive family histories has a genetic mutation that could lead to late-onset disorders (e.g. Huntington’s Disease).

As the population genetic screening expands from the newborn to adult-onset arena, there are increasing concerns about whether such screening might have a negative psychological impact and discrimination by third parties including employers and insurers.

Ethical concerns are also raised about privacy, confidentiality, and individual autonomy.

Review the Learning Recourses to find a article in the Walden Library about a genetic disorder.

It can be a genetic condition or a disease with a genetic component.

You should consider the ethical implications of screening for genetic disease.

Keep these thoughts in your mind:

Give a brief overview of the article. Also describe the genetic epidemiology and cause of the disease.

One ethical question related to screening is this disease.

Your argument for or against mandatory screening for this condition is presented.

You can support your position with scholarly resources.

Answer:

Introduction

Genetic testing is a modern technology that helps to identify susceptibilities to any disease or defect.

Genetic testing is a useful diagnostic tool that can be used for both personal and healthcare purposes.

The genetic testing process can help detect complicated diseases like colon, breast, ovarian, or ovarian cancer at an early stage (Harper 2010).

This essay will discuss the most controversial ethical issue in genetic testing of breast cancer. The patient confidentiality of their breast cancer genetic testing information is discussed.

This essay discusses a similar issue, and provides rationale for mandatory breast cancer screening.

Genetic Epidemiology Of Breast Cancer

Breast cancer is second in most cases in females, after skin cancer.

Breast cancer was responsible for 13.7% of all female deaths worldwide in 2008.

Contemporary lifestyles have contributed to an increase in breast cancer deaths over the past 70 years (Davis 2010).

Butow and colleagues.

Butow et al. (2013) found that one in eight women has a lifetime risk of developing breast cancer. Additionally, one out of every 35 women who dies from cancer is at risk.

The United States has the highest annual breast cancer rate at 128.7 percent for 15,000 Whites and 111.6 percent for 15,000 African Americans.

Peterson et. al.

(2012) Breast cancer continues to be the most serious form of cancer in women in the United States.

The genetic testing for breast carcinoma is such a grave hazard, there are ethical concerns about its confidentiality and sharing.

Goldenberg & Sharp (2012) conducted a survey that asked 160 relatives of the victims to find out their family history of breast carcinoma.

Out of 376 participants 71% were first- or second-blood relatives while 82% were blood relations.

24% of participants didn’t know about or were not informed about their family history. The remaining 76% were blood relations.

This suggests that this is a sensitive topic.

Brierley and colleagues (2012) looked at the potential impact of confidentiality, cost, and discrimination on those who pursue genetic testing.

The study, which involved 184 participants, found that 106 of them underwent testing while 78 refused testing. This was due to cost, confidentiality and discrimination.

According to Butow and colleagues.

2013 survey of 238 relatives of breast cancer victims revealed that they were concerned about confidentiality and autonomy when it came to genetic testing.

The results showed that 86-87% of women disapproved of the disclosure of genetic results. 56-57% desired informed consent before sharing information with any family members. 98% preferred mandatory and voluntary genetic testing.

This suggests that genetic screening of breast cancer is important and necessary, but also poses ethical problems.

An Overview of the Article

This article will discuss the legal and ethical aspects of genetic testing for breast, ovarian and colon cancer.

These three types of cancer have almost the same privacy and confidentiality as a woman’s life.

This article describes the ethical conflict that patients must keep private information and the professional’s duty to share information for the benefit of others.

The articles provide information on disclosure obligations and the duties related to genetic susceptibility. Further, they discuss confidentiality and liabilities in genetic counselling, prenatal diagnosis and genetic screening.

This article discusses the public’s perceptions of genetic discrimination and public health testing. It also addresses ethical concerns related to breast carcinoma.

This article’s author has found that genetic testing for breast carcinoma is an ethical concern for feminists.

Their attitudes to new technologies and society’s trends are determined by the traditional views, political and professional authority of women.

Women are still being victim to traditional feminist perceptions.

However, attempts are being made to alter traditional views and increase awareness and alertness of the female sector of society.

Lastly, however, the article mentions that ethical issues and conflicts concerning genetic testing susceptibility to breast cancer will still remain a feminist topic. It is therefore necessary to promote healthcare ethics and feminist methods to ensure women have their autonomy as well confidentiality.

Genetic Screening for Breast Cancer: A Moral Issue

Due to privacy, security and feminism, the confidentiality of patients has always been a significant ethical issue in genetic screening.

According to Harper (2010), disclosure of breast cancer screening information is an overrated ethical issue and requires specific legal obligations.

Butow and colleagues.

The 2013 study found that even family members with a history or breast cancer were not informed about the situation.

Contemporary genetic screening practices have been affected by this.

53% of the 1,251 physicians who handled genetic screening of breast carcinoma said that they need to keep their patients’ confidential information.

(2012) showed that any American healthcare provider is required by law to protect patient information.

For genetic screening, confidentiality breaches can be considered a criminal offense.

This prevents physicians from disclosing information, even if a relative is at risk for similar diseases.

Clayton et al. (2014) found that breast, colon, ovary, and lung cancers are the most serious cancers for children, siblings, or other family members.

According to confidentiality law, the physician does not have a legal obligation to warn the patient about this risk.

If a physician is aware that a patient could infect a spouse, it is their legal responsibility to inform the spouse.

In order to ensure that genetic screening of breast carcinoma is done ethically, this vision is unclear.

Reasons for Mandatory Breast Cancer Genetic Screening

Genetic screening for breast cancer should be an integral part of public health. This is regardless of conflict or ethical concerns. Increased risk of such deadly diseases can threaten the equilibrium of human survival.

Modern methods like genetic screening provide a safe diagnosis that ensures the existence or safety of the risk to the foetus even through prenatal screening. This provides a promising control for future risk (Davis 2010).

Dancey and colleagues.

Mandatory genetic screening, (2012) will aid in timely counselling and lower the risk for vulnerable deaths.

(2014) state that mandatory genetic testing for breast cancer could revolutionize healthcare worldwide and help women to feel more secure about their status in society.

These are all reasons that genetic screening should be mandatory for women’s health.

Conclusion

This study shows that confidentiality remains an ethical issue when genetic screening is done for breast cancer.

Because of traditional beliefs, privacy, protection of vulnerable and other reasons, it is an ethical issue.

However, genetic screening for the diagnosis of breast cancer is a promising option for improving women’s health by avoiding deadly consequences and reducing their risk.

References

Genetic dilemmas: Reproductive technology, parental choices, children’s futures.

Oxford University Press.

Practical Genetic Counselling 7th Ed.

CRC Press.

Negative events in cancer genetic testing: financial, medical, ethical and legal implications.

The Cancer Journal 18(4), 309-309.

Psychological outcomes and risk perceptions following genetic counselling in breast cancer: A systematic review.

Medical Journal of Australia 178(2): 77-81.

Clayton, E. W.; McCullough L. B.; Biesecker L. G. Joffe S., Ross L. F. Wolf S. M. For the Clinical Sequencing Exploratory Researchers (CSER), Consortium Pediatrics Working Group.

Genetic testing and genetic sequencing of children: ethical dilemmas.

The American Journal of Bioethics. 14(3), 3-9.

The genetic basis for cancer treatment decisions.

Legal and ethical issues regarding genetic counseling and testing for susceptibility breast, ovarian, and colon cancer.

Canadian Medical Association Journal, 54(6), 813.

The ethical risks and programmatic challenges associated with genomic newborn screening.

Health insurance and discrimination concerns, and BRCA1/2 testing in clinic populations.

Cancer Epidemiology and Prevention Biomarkers 11(1), 79–87.

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