ABSTRACT
This paper presents the existing legal frameworks, professional guidelines and other documents related to the conditions and extent of the disclosure of genetic information by physicians to at-risk family members. Although the duty of a physician regarding disclosure of genetic information to a patient's relatives has only been addressed by few legal cases, courts have found such a duty under some circumstances. Generally, disclosure should not be permitted without the patient's consent. Yet, due to the nature of genetic information, exceptions are foreseen, where treatment and prevention are available. This duty to warn a patient's relative is also supported by some professional and policy organizations that have addressed the issue. Practice guidelines with a communication and intervention plan are emerging, providing physicians with tools that allow them to assist patients in their communication with relatives without jeopardizing their professional liability. Since guidelines aim to improve the appropriateness of medical practice and consequently to better serve the interests of patients, it is important to determine to what degree they document the 'best practice' standards. Such an analysis is an essential step to evaluate the different approaches permitting the disclosure of genetic information to family members.
Subject(s)
Genetic Predisposition to Disease/epidemiology , Neoplastic Syndromes, Hereditary/genetics , Practice Guidelines as Topic , Truth Disclosure , Canada , Female , Genetic Privacy , Genetic Testing/standards , Humans , Male , Neoplastic Syndromes, Hereditary/diagnosis , Patient Rights , PedigreeABSTRACT
This article addresses the ethical and legal issues surrounding the possibility of a "duty to recontact" patients concerning new genetic developments. The text examines the rationale of this concept, the conditions required for the creation of such a duty and who should be bound by it. While this "duty to recontact" has yet to be developed, the predictive familial dimensions of genetic information, however, may lead policy makers to favour such a duty. Professional organizations should begin to assess the implications of the genetic revolution on patient management and physicians' continuing education.
