What to do when medical genetic screening reveals unexpected parent

embryo
CREDIT: Flickr/wellcome images

One of the most provocative issues in the medical genetics is how to react to incidental findings. Sometimes when a patient is sequenced to explain one condition, another issue, perhaps a harmful mutation or risk factor for another disease, pops up.

In a particularly striking although not uncommon example, these kinds of analyses can inadvertently prove through genetic inheritance patterns that a person’s parents are not who he or she thought they were. Obviously, this can be devastating news for a family.

In a new paper published in Pediatrics, two bioethicists argue that parent-related incidental findings should never be disclosed to patients when a child is tested. But, they also argue, parents should know that genetic tests can reveal parenting information even though they will not be told of those findings. Parents who want to confirm their parentage should be referred to a companies that specifically test paternity.

Right now there is currently no standard policy about how genetic parenting information is presented to patients. Doctors and genetic counselors usually handle it on a case by case basis. As Emory ethicist Kathy Kinlaw told Al Jazeera America:

While the stated goal of the policy is to allow people more choice in what they learn, it removes other options. This can occur when gene testing reveals a switch in the nursery or IVF clinic and the baby is the biological child of other parents. “If there are other biological parents involved, why do we assume they don’t have any right to pursue custody?” said Kinlaw. “Maybe we don’t need to make that kind of paternalistic assumption.”

Others suggested that some DNA findings might point towards rape or incest and must be reported to the authorities, so some procedures for disclosure in the case of criminal activity must be in place. Still other critics of the paper said that patients have access to this information anyway, so they might as well be told directly by a healthcare professional who can properly explain the results.

The American College of Medical Genetics and Genomics hasn’t yet set an advisory position about incidental parental lineage findings, in part because the technology is new and the medical community hasn’t had a chance to weigh in on all the options. But, in a recent advisory piece the college said that patients who don’t want to receive incidental findings of any nature should be able to opt out. The policy group is not expected to create a policy guideline about paternity findings anytime soon.
Additional Resources:

{{ reviewsTotal }}{{ options.labels.singularReviewCountLabel }}
{{ reviewsTotal }}{{ options.labels.pluralReviewCountLabel }}
{{ options.labels.newReviewButton }}
{{ userData.canReview.message }}
screenshot at  pm

Are pesticide residues on food something to worry about?

In 1962, Rachel Carson’s Silent Spring drew attention to pesticides and their possible dangers to humans, birds, mammals and the ...
glp menu logo outlined

Newsletter Subscription

* indicates required
Email Lists
glp menu logo outlined

Get news on human & agricultural genetics and biotechnology delivered to your inbox.