Abstract
The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the ‘Changing landscape of genetic testing’, co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research.
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References
Zimmern RL, Kroese M : The evaluation of genetic tests. J Public Health 2007; 29: 246–250.
Weiss KM : Tilting at Quixotic trait loci (QTL): an evolutionary perspective on genetic causation. Genetics 2008; 179: 1741–1756.
Eichler EE, Flint J, Gibson G et al: Missing heritability and strategies for finding the underlying causes of complex disease. Nat Rev Genet 2010; 11: 446–450.
Weiss KM, Terwilliger JD : How many diseases does it take to map a gene with SNPs? Nat Genet 2000; 26: 151–157.
Goldstein DB : Common genetic variation and human traits. New Engl J Med 2009; 360: 1696–1698.
Waalen J, Beutler E : Genetic screening for low-penetrance variants in protein-coding genes. Annu Rev Genomics Hum Genet 2009; 10: 431–450.
Cooke S, Crawford G, Parker M, Lucassen A, Hallowell N : Recall of participation in research projects in cancer genetics: some implications for research ethics. Clin Ethics 2008; 3: 180–184.
Easter MM, Henderson GE, Davis AM, Churchill LR, King NM : The many meanings of care in clinical research. Sociol Health Illn 2006; 28: 695–712.
Hallowell N, Cooke S, Crawford G, Lucassen A, Parker M : Distinguishing research from clinical care in cancer genetics: theoretical justifications and practical strategies. Soc Sci Med 2009; 68: 2010–2017.
Parker M, Ashcroft R, Wilkie AOM, Kent A : Ethical review of research into rare genetic disorders. BMJ 2004; 329: 288–289.
Ponder M, Statham H, Hallowell N, Moon JA, Richards M, Raymond FL : Genetic research on rare familial disorders: consent and the blurred boundaries between clinical service and research. J Med Ethics 2008; 34: 690–694.
Yentis SM, Dawson AJ : Medical studies with ‘no material ethical issues’—an unhelpful, confusing and potentially unethical suggestion. Clin Ethics 2006; 1: 234–236.
McGuire A, Diaz CM, Wang T, Hilsenbeck S : Social networkers’ attitudes toward direct-to-consumer personal genome testing. Am J Bioethics 2009; 9: 3–10.
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Hastings, R., de Wert, G., Fowler, B. et al. The changing landscape of genetic testing and its impact on clinical and laboratory services and research in Europe. Eur J Hum Genet 20, 911–916 (2012). https://doi.org/10.1038/ejhg.2012.56
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DOI: https://doi.org/10.1038/ejhg.2012.56
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