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Genetic Testing Scholarly Paper

Your Name: Diandra Oliver

School of Nursing, SUNY Delhi

ALHT-301-12004-: Ethics in Health Care (Fall 2022)

Instructor’s Name: Tammy Chandler

November 10, 2022

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Case Study and Ethics

A mother is bearing her first kid in this instance (case 4). The mother and her husband

come from a culture where boys are highly valued as children. They decide to conduct testing to

ascertain the gender of the infant. The baby is a female, according to the NIPT. In lieu of

continuing the pregnancy, the spouse decides to try for a son.

NIPT, or non-invasive prenatal screening, is the sort of genetic testing carried out in this

instance. It is employed to determine whether or not a fetus would be born with any genetic

problems. An expecting woman's blood contains a combination of cfDNA created by the

placenta during the pregnancy. These cells are discharged into the woman's blood at various

times during the pregnancy. An opportunity for early diagnosis of some genetic abnormalities is

provided by cfDNA analysis from the placenta. The fetus is unaffected by this operation.

Autonomy has to be considered in this case. The genetic counselor has to appreciate the

fact that the couple has the right to govern themselves. However, he or she should strive to

ensure that the final decision made by the couple after informative advice is rational medically.

Beneficence applies to this case as follows. The genetic counselor should also strive to do

good and ensure the best results are achieved in this case. He or she will honor confidentiality in

Chapter 9 (Doherty, 2021) and bring out the importance of communication and information

sharing in Chapter 10 (Doherty, 2021). This is in support of the principle of nonmaleficence as

the genetic counselor is obliged not to inflict harm on others.

Genetic Testing

Prenatal diagnostic testing poses a small but genuine danger of miscarriage. A significant

share of the risks associated with test results is their social, emotional, or financial ramifications.

According to Chapter 11 (Doherty, 2021), people may feel anxious and depressed when the

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results reveal information about potential disease risks. There are times when this causes conflict

within a family. Genetic information about an inherited disorder can be found using this method.

Sometimes, effective treatments for many genetic illnesses after a diagnosis may be absent and

this is another significant drawback.

The test results can reduce uncertainty and aid individuals in making wise decisions on

the management of their healthcare. Some of the benefits are, a person's decision to have children

may also be influenced by the results of many tests. Newborn screening can detect genetic

diseases early in life and lead to starting therapy early enough.

In this instance, the couple may face financial repercussions for the test results if they

finally decide to terminate the pregnancy. There might be conflicts between the family and

society if the couple decides to terminate the pregnancy as this is deemed to be inappropriate.

There might also be a conflict between the couple if they do not agree to the same decision.

Beneficial to the couple, the test results enable them to make knowledgeable decisions

according to their situation. They get the benefit of learning about abortion from the healthcare

provider and also make plans for therapy as per the decision they will make.

Genetic Counseling

The responsibilities of genetic counselors include informing patients about genetic

disorders, testing choices, and guiding patients on social and ethical concerns related to assisting

individuals in coping with learning they have a genetic disease or a genetic condition from the

test result. Genetic counselors undergo thorough training in clinical training experience,

molecular genetics, and research methods; as well as counseling ethics and a research project to

be accredited as a master in genetic counseling.

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In this case, a genetic professional may assist in decision-making by explaining to the

husband why some cultural beliefs like holding high regard for male children are irrelevant. The

physical and emotional effects of terminating the pregnancy on the woman should also be

addressed.

Direct to Consumer Genetic Testing

Some of its benefits are as follows, hereditary testing made available to consumers

directly increases public awareness of genetic illnesses, and provides individualized information

about your health, disease risk, and other characteristics. It encourages being more health-aware

and does not require a doctor's or insurance company's approval.

It however has the following risks, tests may not be available for the health conditions or

traits that interest you. With this kind of testing, it is impossible to say with absolute confidence

whether you will get a specific disease, and frequently, results need to be verified by a medical

practitioner, and disease-causing mutations may go undetected. (Oh, B., 2019)

The GINA Act

GINA shields people from prejudice based on their genetic information in both

employment and health insurance. Genetic information may not be used by health insurers to

establish a person's insurance eligibility or to decide on a coverage, underwriting, or premiums.

Additionally, health insurance companies cannot demand or compel people or members of their

families to undergo genetic testing or divulge genetic data. (Dena Goldberg, MS, LCGC, 2020)

Genetic discrimination, which is an integral policy issue of GINA could apply in this

case. GINA ensures that Americans are shielded against genetic discrimination in both

employment and health insurance, (Title I) and (Title II) respectively. In this case, since the

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woman is expecting a girl child in a community where the boy is held in high regard, the Genetic

discrimination policy of GINA prohibits the use of genetic data (sex of the child she is

expecting) by employers when making choices about hiring, firing, promotions, compensation,

and job assignments. Additionally, GINA forbids employers or other covered entities from

seeking or needing genetic data and/or tests as a requirement for employment. In this way, GINA

shields the woman from prejudice based on her genetic information enabling her to be treated

fairly as the rest of the community members. (Policy issues in Genomics (no date) Genome.gov)

Conclusion

Healthcare providers play a pivotal role in the ethical decision-making of patients. They

must think about and investigate theories and tenets crucial to moral development and ethical

conundrums. This role of ethical decision-making impacts the systems of healthcare and the state

of health of the community.

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References

Dena Goldberg, MS, LCGC, 2020 Genetic Discrimination and GINA: Will Genetic Testing

Affect My Insurance? Retrieved from: https://youtu.be/JmO6asTLZLc

Doherty, R.F. (2021). Ethical dimensions in the health professions  (7th ed.). Elsevier

Oh, B. (2019) Direct-to-consumer genetic testing: Advantages and pitfalls, Genomics &

informatics. Korea Genome Organization. Available at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808639/

Policy issues in Genomics (no date) Genome.gov. Available at: https://www.genome.gov/about-

genomics/policy-issues

Reviewed 05.17.2022.TLC