Genetic Screening: Ethical Issues
Conclusions
10.1 We set out our conclusions against the background of the following points established earlier in the report:-
(i) screening for some defective genes has become a practical possibility;
(ii) medical knowledge about genetic susceptibility to common multifactorial conditions (for example, some heart disease and some cancers) is still developing. Even with increased medical knowledge, the individual's risk may be difficult to evaluate;
(iii) many of the ethical issues associated with genetic screening arise from the inescapable involvement of families (both blood relations and spouses);
(iv) the benefits and disadvantages of screening programmes - for individuals, families and society in general - will need to be carefully assessed for each proposed screening programme. Factors to be taken into account include:-
(a) the predictive power and accuracy of the genetic test;
(b) the benefits of informed personal choice in reproductive decisions and their consequences;
(c) the psychological impact of the outcome of screening for both individuals and families;
(d) therapeutic possibilities;
(e) possible social and economic disadvantage relating for example, to insurance and stigma; and
(f) the resource costs and the relative priority, in view of limited resources, of establishing a screening programme.
10.2 Against this background our recommendations fall under six main headings. In making these recommendations we are conscious that no-one can lay down fixed and immutable guidelines for the future of genetic screening. Medical and scientific knowledge is developing rapidly : some of that development may alter the shape and the nature of some of the ethical issues discussed in this report. Nevertheless, certain ethical principles will remain unchanged and certain ethical responses will be required from the health professions, from health administrators, from the insurance industry, from employers and from Government.