see Variability in laboratory reporting practices for regions of homozygosity indicating parental relatedness as identified by SNP microarray testing
The recent clinical availability of single-nucleotide polymorphism (SNP) microarray tests that can detect regions of homozygosity indicating that a child may have resulted from a consanguineous or incestuous relationship raises questions about how commercial laboratories handle these findings. Incidental discovery of a potential incestuous relationship raises serious ethical questions with potential legal ramifications. Despite the obvious need, there are no guidelines in place to assist in setting uniform standards for reporting suspected incest. In this issue, a group of investigators from Cincinnati Children’s Hospital report that, in the absence of standards, laboratories vary widely in their rationale and approach to reporting. Of the laboratories surveyed, almost half (8 of 18) chose not to report the possibility of parental consanguinity, and 16 did not report potential parental incest even when the findings suggested it. None of the laboratories had ever contacted legal authorities, social-work teams, or an ethics board regarding suspected incest. The study also found variation in the methodology used to determine a cutoff value for suspected uniparental isodisomy, pointing to the need for laboratory standards in these calculations as well. As SNP microarray testing expands, the likelihood of facing incidental findings with associated legal and ethical dilemmas will only increase, hence the importance of addressing these issues now. —Karyn Hede, News Editor
