A case study shows this moral issue encountered from
Genetics Generation. Rachel’s mother
side of the family has a history of breast cancer and her mother died of it
when she was young. Rachel has two sisters, Lisa and Kristin. She is no longer
close to Kristin but she does have a close relationship with Lisa. Rachel’s
doctor recommends her to have a genetic test in order to test for a susceptibility
of breast cancer because of her family history. After having the testing done she
finds out that she has a mutated BRCA1 gene and at high risk for developing breast
and ovarian cancer. Since Rachel has two sisters who could also be in harm, her
doctor asks her to recommend her sisters to be tested too so they can take proper
precautionary measures. However, Rachel states that she will inform Lisa about
BRCA1 and genetic testing but she will not inform Kristin. Rachel’s doctor
knows that she can find Kristin but she doesn’t want to breach Kristin’s confidentiality
if she ignores Kristin’s wishes.
We discussed in class that genetic testing does not guarantee
that the patient will most definitely have the disorder. But this case is
different because the patient is dealing with a chance of having cancer.
Therefore, there are precautionary steps that the patient must take in order to
fight this cancer. In certain cases respect for patient’s autonomy is not guaranteed.
In this situation, the duty to warn seems
much stronger than the patient’s autonomy because of the harm that can be done
to the patient’s sister. One of the issues when people discovered that they have
breast cancer is that they found out late and miss the opportunity to decrease
some of the harms that it brings. Of course genetic testing is not guaranteed that this patient or her sisters will get
breast cancer. But in this case, since they have a family history of this
cancer I think it would be important for them to be aware and try to avoid the
harm of not doing anything about it now. In this case, I think that the doctor
should override Rachel’s decision on not telling her sister.
I don't agree that the doctor should override Rachel's decision to not tell Kristen. Although there is a high risk that the girls could potentially develop breast or ovarian cancers, the doctor has no authority to go behind Rachel's back and violate her autonomy. The doctor did the right thing by suggesting that Rachel and her sisters should go through genetic testing. All the doctor can do is inform Rachel. What she decides to do with the doctors advice is up to her. Same goes with her sisters. They should all be aware of their genetic risk of developing breast or ovarian cancer and should take it upon themselves to get tested accordingly.
ReplyDeleteTrue, there have been many cases where the patient sued the doctor for not following their orders.
DeleteI think that the doctor should override Rachel's decision on not her sister Kristen. As a doctor it is your job to save lives even ones that they don't treat. The doctor has also taken an oath in which he/she must do more good over harm. So by not telling Kristen he could potential put her life in danger and cause many problems. And besides who knows he could get the sisters to talk/reconnect again, but this is besides the point that the doctor should tell Kristen about breast cancer.
ReplyDeleteIn the case many people feel that the doctor is playing a role to try to save rather than not doing any harm. However, it seems to be the same thing to me. I mean doctor's goals are to help and save people from illnesses and diseases whenever possible. Therefore, I completely agree with you on this point.
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