ABSTRACT
Genetics is by no means a new field of medicine, but it is certainly a rapidly evolving one. This chapter explores the ethical and legal duties of physicians in the context of genetic testing. We begin this introduction by comparing genetic information with other types of health information. This comparison will clarify how the traditional ethical and legal duties of physicians apply in the genetic context. First, our genetic make-up is largely inherited. Clinically significant genetic information concerns not just patients, but also their families. Second, genetic information is a powerful predictor of disease in individuals and across generations. Third, our genetic make-up is uniquely identifying: our genes can reveal information about where we come from and to whom we are related. Accordingly, professional norms must reflect these characteristics of genetic information, while being mindful that other non-genetic forms of health information can also exhibit these ‘exceptional’ qualities. It must also be remembered that both genetic and environmental (e.g. lifestyle, socio-economic) factors play a role in all common diseases. The predictive strength of genetic testing is ‘probabilistic,’ meaning a positive result does not reveal a condition, but rather a predisposition: an increased likelihood that a condition may arise in the future. It is imperative that medical decision-making reflect the inherent uncertainty of genetic testing as well as its broad social implications.
