Genetic Screening Questions and Discussion

Ground Rules All answers must be completed in pen. –This is a way that you and I can watch the development of the decision making process. You will not have to show your answers to anyone but me, but I will ask you to share some of your answers.

SCENARIO 1 HEART DISEASE Scientists in the US and Canada have noted that there are some genetic indicators that can inform a person about their risk of having heart disease. For example, if a person has one copy of a specific allele, their chance of having heart disease increases slightly. However, if they have two copies of the same allele, their risk increases to up to 40% higher than those with no copies. Heart disease is associated with heart attack.

SCENARIO 1 HEART DISEASE 1.A. If the testing were free, would you currently opt for testing? Answer yes or no, and explain your reasoning.

SCENARIO 1 HEART DISEASE 1.B. What are some questions you might need to ask before you are tested?

SCENARIO 2 HD Angela is a healthy 32-year old certified public accountant (CPA) who is married with no children. She has been working for 8 years in a small accounting firm. She and her husband have decided they would like to move to a nearby large city so that Angela could work in a major accounting firm.

SCENARIO 2 HD –Five years ago, Angela’s mother was diagnosed with Huntington chorea (HD- Huntington Disease). HD is a debilitating disease that is caused by an autosomal dominant allele. The first symptoms usually are seen after age 30. There is currently no cure for HD. Angela’s mother is now in a nursing home.

SCENARIO 2 HD –Angela’s job interviews go well, and she is offered an excellent position that she readily accepts. She plans to begin in 5 weeks, after her sister’s wedding. However, as Angela is filling out the required paperwork in the personnel office, she notices that she must sign a consent form for a physical that includes a genetic screening test of her DNA. When Angela questions whether she must have such a test done, she is told that the company requires it.

SCENARIO 2 HD 2.A. Do you think the firm should be allowed to require the testing? Why or why not? 2.B. Should Angela’s employment be contingent on the results of her DNA test? 2.C. What are some concerns that this scenario raises?

SCENARIO 2 HD 2.D. Who could benefit from this information? How? 2.E. Who could be harmed by this information? How? Is there a potential to fall into both of these categories?

SCENARIO 3 General Screening The citizens of Iceland have agreed to make their genetic information a matter of public record. Much has been learned about genetics and disease from this data collection. In addition, the citizens share any profits that this information generates, such as the production of customized medicines.

SCENARIO 3 General Screening 3.A Choose one statement from below to defend. For your defense, include the potential benefits of your choice, and the potential harms of the opposite choice. –Like the citizens of Iceland, US citizens have much to gain from a genetic data base. –This type of genetic screening is invasive and may be a violation of civil liberties.

Sex Determination Discuss if there is time: If parents could determine the sex of their child, should they be allowed to do so? If you answered no, might there be any special circumstances in which you could be convinced to make an exception?

4 Rethinking 4. Write any additional concerns you should think about before making the decision to get a genetic test.