Hi,
The title of one of the sources on this topic sums up the answer...
A Complicated Question
http://intouchlive.com/genetics/introduction.htm
The positive benefits of genetic testing are easy.
Since the medical community has acquired the ability to discover many
genes that control complex functions in the human body, many disease
have been traced to genetic factors. Even severe generalized
periodontitis (http://www.ilgenetics.com/genetictesting/periodontitis-2.html)
is thought to have hereditary component.
The test depends on the disease. Some are caused by the absense of a
gene, some by the presence of a gene and others by the mutation or
malfunction of a gene.
Positively identifying these genetic traits can help plan treatments
and allow whatever preventive measures that exist to be employed.
Finding that the genetic trait is not present relieves worry that a
greater risk for the disease exists. Since many of the diseases are
cancer or other potentially life threatening illnesses, this is a very
large benefit.
There are many negatives.
In the psychological realm is the problem of dealing with having a
trait that probably increases your risk for develping a serious
disease. Notice I said "probably increases your risk." Having a
genetic trait does not guarantee that you will get the disease, only
that you have a higher risk of getting it. If the disease in question
is breast cancer, the risk may be as high as 85% or may be as low as
35% (http://cis.nci.nih.gov/fact/3_62.htm). You need to decide if you
will have surgery to remove your breasts to reduce that risk. It is a
very hard decision to make.
What if there is nothing that can reduce the risk? Is it better to
know that you are at risk of a terminal illness - that you may or may
not get - when there is nothing you can do about it?
What if you test negative and your sisters are all positive? Do you
feel relieved that you have a lower risk or distraught and guilty
because you have "survivor's guilt?"
If you are a young person and plan on having a family, should you
decide not to have children and possibly pass the bad gene to them?
What if you have children already... should you get them tested and
have them spend their lives worrying about dying from a disease that
they may never get?
The medical questions meet this same dilemma. Many of the drugs that
are administered to reduce the risk of disease carry a long list of
adverse side effects. Many of these side effects can be life
threatening. You'd hate to give a drug to someone who didn't need it,
but there is no way to tell which of the people with a genetic
tendency toward a disease will be spared. Once the test shows that a
patient has the traits associated with a specific disease, preventive
medication must be considered as an option, if it exists.
The testing also brings up legal and financial issues.
One fear is that insurance companies, who will under certain
circumstances pay for the testing, will use the results to deny
coverage to high risk people. They may be able to use the fact that it
is a "pre-existing condition" to avoid paying for expensive treatments
and hospitalizations.
What about employers who request medical information from newly hired
workers? Will having a genetic trait that puts you at risk of getting
cancer at a young age cause you not to be considered for promotions -
or laid off at the first opportunity?
Once the test is taken it exists in your medical records. Many
families who decide to have the testing done do so by paying for it
themselves and using a false name. This may complicate the
medicaltreatments, but it does assure that privacy will be maintained.
Then we have prenatal genetic testing. If a fetus is found to have a
defect that is correctable it is wonderful. But if the parents are
faced with the decision of having an abortion or a defective child the
situation can be horrendous.
http://www.bioethics.net/hsbioethics/webfair/spring2002/Prenatal_Genetic_Testing.shtml
is a high school project that addresses the issue of whether prenatal
genetic testing is ethical. The issues are presnted very clearly and
the question is very difficult to answer.
Some other web sites that discuss this are:
Huntington's Disease - http://www.wemove.org/hd_dia_gen_ipt.html
Simply Stated . . . Genetic Testing -
http://www.mdausa.org/publications/Quest/q76ss.html
No simple answer with cancer test -
http://www.madison.com/captimes/features/expert/26070.php
There are more, but these cover the issues well.
The bottom line is that, until the understanding of how genetics and
disease are linked is more fully understood and the treatment options
improved, this will remain an issue that has no clear answer.
search terms used:positive negative effects genetic testing
Good question!
bcguide-ga |
