Genetic screening: ethical issues - Nuffield Council on Bioethics
Genetic screening: ethical issues - Nuffield Council on Bioethics
Genetic screening: ethical issues - Nuffield Council on Bioethics
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counsellors) in particular am<strong>on</strong>g those engaged in primary health<br />
care. The resource implicati<strong>on</strong>s, including the need to train large<br />
numbers of practice nurses and health visitors in the subject<br />
matter and the basic principles of counselling, need to be<br />
assessed within the broader c<strong>on</strong>text of the expansi<strong>on</strong> and<br />
extensi<strong>on</strong> of primary care. (Paragraph 4.30 summarising<br />
paragraphs 4.17 - 4.22)<br />
10.6 Screening of individuals who are unable to give properly informed<br />
c<strong>on</strong>sent (minors, the mentally ill and those with severe learning<br />
difficulties) require special safeguards (paragraphs 4.24 - 4.26).<br />
89<br />
II :<br />
The results of genetic <str<strong>on</strong>g>screening</str<strong>on</strong>g> and c<strong>on</strong>fidentiality<br />
10.7 The family implicati<strong>on</strong>s of genetic <str<strong>on</strong>g>screening</str<strong>on</strong>g> and genetic testing<br />
will sometimes require health professi<strong>on</strong>als to review the<br />
applicati<strong>on</strong> of the current principles governing the c<strong>on</strong>fidentiality of<br />
medical informati<strong>on</strong>. We have in Chapter 5 made a start at<br />
examining the implicati<strong>on</strong>s. This work will need to be carried<br />
further by the health professi<strong>on</strong>al bodies resp<strong>on</strong>sible for producing<br />
guidelines that govern the c<strong>on</strong>duct of their members as experience<br />
is gained from the <str<strong>on</strong>g>screening</str<strong>on</strong>g> programmes now being introduced.<br />
10.8 We regard it as axiomatic that:-<br />
(i)<br />
(ii)<br />
individuals should normally be fully informed of the results<br />
of genetic <str<strong>on</strong>g>screening</str<strong>on</strong>g>, and in particular of the implicati<strong>on</strong>s of<br />
those results for the family; and<br />
the accepted standards of the c<strong>on</strong>fidentiality of medical<br />
informati<strong>on</strong> should be followed as far as possible.<br />
10.9 When genetic <str<strong>on</strong>g>screening</str<strong>on</strong>g> reveals informati<strong>on</strong> that may have serious<br />
implicati<strong>on</strong>s for relatives of those who have been screened, health<br />
professi<strong>on</strong>als should explain why the informati<strong>on</strong> should be<br />
communicated to other family members. We recommend that in<br />
such circumstances health professi<strong>on</strong>als should seek to<br />
persuade individuals, if persuasi<strong>on</strong> should be necessary, to<br />
allow the disclosure of relevant genetic informati<strong>on</strong> to other<br />
family members. They should also seek to ensure that<br />
treatment, counselling and other appropriate support are made<br />
available to those to whom such unsought informati<strong>on</strong> is<br />
disclosed. (Paragraph 5.41 summarising paragraphs 5.23 - 5.31)