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Genetic Screening in Adults: Ethical and Legal Issues - Coggle Diagram
Genetic Screening in Adults: Ethical and Legal Issues
Genetic Information Nondisclosure Act (GINA)
Federal statute that prohibits discrimination on basis of genetic information; by health insurers and employers only
Analysis of human stuffs that detect genotypes, mutations or chromosomal changes
No longer protected once the disease manifests because a physician could tell they have the disease
Issues: people may not get tested for these reasons
Some states do offer protections beyond GINA
Direct-To-Consumer (DTC) genetic testing
Informed consent
Basic elements of informed consent
Recommened diagnostic test, exam or treatment, including risks and benefits
Reasonable alternative tests, exams or treatments, including risks and benefits
Option of no diagnostic test, exam, or treatment, including risks and benefits
Disclosure of relevant medical information
Informed consent for genetic testing
Probabilistic risk information
Can medical intervention prevent the condition or reduce risk?
Multiplex genetic testing
Testing for diff conditions at the same time
Incidental secondary findings
ACMG recommendations for reporting secondary findings in sequence
They now believe that patients should be able to opt out of learning about secondary findings, though this needs to be something that the patient purposefully opts out of with proper consent.
AMA suggests that physicians should be able to discuss every aspect of genetic testing with patients (this also affects families because genetic info is important)
Genetic counseling
They are trained to help with genetic informed consent
They should be involved in counseling
before
testing to know if patients even want to know results and
after
testing to help interpret the significance and provide support for decision making or coping with the result
Affordable Care Act (ACA)
Health insurance can't deny coverage or increase premiums because of pre-existing conditions
Americans with Disabilities Act (ADA)
Protects after GINA (after a condition manifests)