1. The concerns Tonya and Lisa have regarding genetic testing raises several ethical questions that Dugas (2005) outlines. The right to self-determination is central in matters linked to genetic testing, and nurses do need to understand their role in providing informed consent when patients are faced with a decision similar to that of Tonya and Lisa (Dugas, 2005). In addition to providing patients with all the information they need to make informed decisions, nurses also have an ethical duty to strengthen relationships among all members of the healthcare team to promote patient advocacy during the decision-making process. As Dugas (2005) points out, “establishing the links among families, health-care systems, and community is an integral part of the nursing role in genetic health care,” (p. 106). As this case study also reveals, genetic testing is unique in that patients are “revealing information about their genetic makeup that typically remains unknown to themselves and others,” (Dugas, 2005, p. 106).
The ethical conundrums the information can reveal challenge nurses to provide patients with the best possible care, while simultaneously keeping in mind the best interests of family members too. Based on her experience with her mom, Lisa desperately wants to receive the test as she believes it will help her make more informed choices about her future and will even impact her reproductive decisions. Tonya, on the other hand, warns her friend about the risks of revealing such sensitive information. Knowing also that genetic testing is elective and therefore paid for out of pocket, Tonya also raises critical ethical issues related to healthcare disparities. Finally, Tonya points out that insurance companies might turn down Lisa if her test results were positive. This latter point links with Dugas’s (2005) analysis of privacy and confidentiality issues.
2. There most certainly can be risks to genetic testing. A nurse...
References
BreastCancer.org (2017). Seeking your genetic information: Pros and cons. Retrieved online: http://www.breastcancer.org/symptoms/testing/genetic/pros_cons
Dugas, R. (2005). Nursing and genetics. Journal of Professional Nursing 21(2): 103-113.
Frank, T.S. & Braverman, A.M. (1999). The pros and cons of genetic testing for breast and ovarian cancer risk. International Journal of Feertility and Women’s Medicine 44(3): 139-145.
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