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Genetic knowledge: some legal and ethical questions

s econd, we have the issue of extent of screening in the light of the new knowledge. Should we screen in utero for incurable diseases that are not realised for at least 40 years? And if we do, should we disclose that information to the patient or other interested parties? Third, there is a whole host of potential liabilities15 . Would physicians be liable for not disclosing the availability of genetic tests to a patient? With non-genetic diagnostic tools, there is an obligation on the physician to make them available. It is almost certain that the public would be interested in taking advantage of genetic testing. However, some physicians will hesitate to permit widespread testing of this kind, while others will encourage such testing. Would physicians be liable if they declined to reveal a genetic risk to a patient? Would physicians be liable if they declined to reveal a genetic risk to the patient’s family or siblings? These decisions need to be made at a societal level. An additional problem in screening for genetic conditions is that testing may reveal that the putative father of the child is not the biological father, that is, that there is false paternity. Wertz and Fletcher16 discuss a case of false paternity, discovered inadvertently when evaluating a child with an autosomal recessive disorder for which carrier testing is possible and accurate. When testing the relatives for genetic counselling, the doctor discovers that the mother and half the siblings are carriers, whereas the husband, who believes he is the father, is not. The consequences of disclosure could be traumatic. The husband’s relationship with the child and mother could be changed dramatically for the worse; yet surely he has a ‘right’ to know? It is clearly very difficult to know how this information should be handled. Fourth, there are implications for employment and education. The temptation to screen potential employees for genetic diseases to avoid the risk of employing someone susceptible to certain exposures in the workplace might be overwhelming. In addition, given that certain aptitudes, such as mathematical skills, may have a genetic base, the value of supplementing IQ tests with a genetic one may be attractive to some educationalists.