1. Scene III: Stacy shares a secret Objectives: After this lesson, the student will be able to: 1)Understand the importance of documenting family history in dealing with genetic disorders; 2)Appreciate the confidential nature of medical information, especially as it relates to inherited conditions; 3)Identify ethical/dilemmas posed by genetic counseling; and 4)Discuss hereditary aspects of alcohol related disorders

3. Scene III: Stacy shares a secret Martha borrowed a sweater from me about 5 years ago, and when she returned it, there was a large hole in it. She says the hole was there when she had borrowed the sweater. Martha’s an alcoholic and can’t remember what she’s doing half the time. She only thinks of herself. I can’t be bothered with her. The sisters have not spoken with each other since then.

4. Scene III: Stacy shares a secret The genetics center has Martha’s address and phone number, but respects Stacy’s rights to confidentiality. However, the potential impact of this information on Martha’s offspring is significant. The genetics center is about to discuss with its attorneys the best legal consequences of defying Stacy’s orders, when a possible solution to the dilemma is identified. I forbid you to release information to Martha about me being a carrier or Alan’s hemophilia. I’m staying out of this one. Stacy, would you please reconsider? Martha and her children…your nieces…may be affected. No.

5. Scene III: Stacy shares a secret

6. Stacy agrees in writing to allow the genetics center to discuss details of Alan’s condition with David. We have to respect your wishes not to discuss this information with Martha, but there is someone else we need to talk with. You wouldn’t mind if we called David? We need to be absolutely sure that he doesn’t have hemophilia Ok, you can contact David.

7. Scene III: Stacy shares a secret After reviewing your medical history, I’m not surprised that you don’t have hemophilia. If you were affected, you likely would have known it long before now. I’m confused. If you suspected that, why did you call me here? The real reason we asked you to come in was to see if you could help us get some information to Martha.

8. Scene III: Stacy shares a secret Details of Alan’s hemophilia is shared with David, who in turn contacts Martha and urges her to make an appointment at the genetics center, which she does. Testing reveals that Martha and two of her three daughters are carriers.

9. Stacy is not to be told of the test results in my family. Scene III: Stacy shares a secret Further questioning reveals that two of Martha’s father’s brothers are also alcoholics. According to Martha, Stacy totally abstains from alcohol because she feels that with her family history, she is at high risk of becoming an alcoholic herself. Why do you feel that way? My sister is jealous of everything I do. She’s always looking for something that she can use against me. She blamed me for our father being an alcoholic. Every time she saw me with a drink she’d remind me of what drinking did to Dad. Anyway, I’m really trying to cut down on my drinking. Blaming me for that lousy sweater was the last straw. I swore that I’d never talk to her again.

10. …two of Martha’s father’s brothers are also alcoholics….

11. Alcohol Related Disorders Two categories: 1) Alcohol Abuse: pattern of constant intoxication, daily, blackouts, unsuccessful attempts to stop 2) Alcohol Dependence (alcoholism): Alcohol abuse and increased tolerance or withdrawal symptoms –Becomes evident within first 5 years of drinking

12. What’s the leading cause of death in 15-24 year olds? Automobile accidents

13. Inheritance Alcoholism often found in several generations of families Multiple genes probably contribute –Genes & enzymes affect how alcohol is metabolized Familial Alcoholism –Positive family history –Early onset (in the 30s) –More severe

14. Conclusion Like I said, I’m really trying to cut down on my drinking, now that I’m pregnant…again

15. Essay Question #3 Should anyone be liable for damages if the future son or grandson of Martha’s had hemophilia and no one had been warned about the risks? If so, who should be liable? Essay Format: –Ink or typed (no pencil) –Add title and date –Minimal length = ¾ page –If typed: 1” margins, 12-point times new roman font, double spaced. –Complete essays (Introduction, body, conclusion) –Spellcheck and proofread