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- $Unique_ID{BRK02324}
- $Pretitle{}
- $Title{How Should Developments In Genetics Affect How Doctors Treat Patients?}
- $Subject{lab laboratory test tests genetics genetic screening disorders gene
- genes chromosome chromosomes inherited disease diseases prenatal cystic
- fibrosis muscular dystrophy hemophilias thalassemias sickle cell
- phenylketonuria inherit inheritance huntington's geneticist geneticists}
- $Volume{P-27,V-27}
- $Log{}
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- Copyright (c) 1992,1993 Tribune Media Services, Inc.
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- How Should Developments In Genetics Affect How Doctors Treat Patients?
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- QUESTION: It is our first baby, and my husband and I are spending this time
- in reading everything about babies and the genes we provided to its
- development. We think this is a fascinating subject. Now we would like to
- know if all the recent developments in the field of genetics have changed the
- way doctors treat patients?
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- ANSWER: That's a loaded question. The science of genetics is relatively new,
- but genetic screening is moving so rapidly that some experts predict that
- there'll be a test for any gene within the next five years. A simple
- definition of genetics would be the science of inheritance and the study of
- inherited diseases. Because the technology of genetics is advancing so
- quickly, scientists working in the field say doctors cannot keep up with the
- advances. Doctors that are keeping pace are being confronted with many new
- legal, social, and moral questions related to genetics. Who should be
- screened? Is confidentiality guaranteed? If a disease that will occur in the
- future is detected, how will this affect the person's whole outlook on life,
- his or her employment and health insurance? Are doctors prepared to properly
- counsel those with a grim diagnosis so many years in advance? What is the
- point of screening for a disease for which there is no treatment? As the
- number of prenatal tests grow, how will this affect decisions to abort? You
- see, the questions multiply as the number of diseases that can be tested for
- increases.
- Just a few of the prenatal genetic tests widely available today are for
- forms of cystic fibrosis, muscular dystrophy, hemophilias, thalassemias,
- sickle cell disease, and phenylketonuria.
- Scientists have learned to track the inheritance of disease from one
- generation to the next by finding genetic markers. Each marker defines a
- specific site on the human chromosome where a variation in the DNA sequence
- occurs. If the marker is located close to a disease-causing gene, the
- inheritance of the marker may predict the passing on of the gene from parent
- to child.
- One of the biggest problems with the science of genetics is that tests
- are being developed for diseases well before cures and treatments are found.
- For example, the genetic test for Huntington's disease is 95 percent accurate.
- Having the test can let someone known decades before they are likely to come
- down with the disease that this fatal ailment lies in their future. Doctors
- at Boston General Hospital doing the testing for Huntington's are being
- careful to only screen people with stable personal situations who have not
- been coerced into participation, since the knowledge that the effects of this
- neurological disease lie just down the road is not easy to accept.
- Many geneticists say their tests are moving from the laboratory stage to
- the clinic very slowly because the tests are very tricky, and primary care
- physicians are hesitant to discuss them with patients. The screens are
- becoming more reliable though, and are covering a wide range of diseases.
- Therefore, some geneticists believe it's only a matter of time before the
- tests become so routine that doctors who don't perform them will be open to
- lawsuits from patients who feel they were improperly informed. Of course the
- next important development to look for is the ability to treat or change the
- genetic makeup of an individual, to prevent the evolution of the disease.
- This too, will pose many ethical and moral questions for medical
- practitioners.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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