How much of your genetic testing results should your doctor divulge to you? This is an especially important question when the primary purpose of a genetic test is to assess “Condition A” but an incidental genetic finding reveals “Condition B.” Because increasing numbers of healthcare providers are using comprehensive genetic testing, the question of how to handle the incidental findings is significant. As Dina Fine Maron exclaims (“When DNA Means ‘Do Not Ask’” Scientific American, January 2015, p. 28):
“The technical ability to find these mutations has rapidly outpaced scientists’ understanding of how doctors and patients should respond to the surprise results.”
Sometimes, our science and technology outpaces our current thought structures for engaging our science and technology. This is where healthcare philosophy must catch up with healthcare science and technology. How well we all step up to the plate remains to be seen, and it will always be a fascinating question well worthy of our ongoing examination.
In the meantime, one viable solution being considered is to enable patients to opt in or out of incidental findings data. What lends further validity to such an approach is the fact that genetics is not by default, destiny. Genetics can reveal a powerful predisposition to a future disease state, but it does not necessarily guarantee that future disease state in every case.
These are great questions to consider. Once again they remind us that we need to think deeply not just about our science and technology, but how we will choose to apply our science and technology.