You are a genetic counselor and your forgiving have asked to be tested to determine...?
is she carries a gene that predisposes her to early-onset cancer. If your patient has the gene, in attendance is a 50/50 chance that all of her siblings inherited this gene and here is also a 50/50 chance that it will be passed on to their offspring. Your patient is immensely concerned about confidentiality and does not want anyone in her family to know she is man tested, including her identical twin sister. Your patient is tested and found to carry an altered gene that give her an 85% lifetime risk of developing breast cancer, and a 60% risk of developing ovarian caner. At the result disclosure session, she once again reiterates that she does not want anyone in her family to know her test results.
a. Knowing that a familial mutation is occurringg this family circle, what would be your next course of action in this defence?
b. Is it your duty to contact members of this family despite the request of your patient? Where do your obligation lie --- with your patient or next to the patient's family? Would it be inappropriate to try to convince the patient to share her results beside her family members?
Answers:
A) The course of action would be to do any of the follow up exams for the type of cancer she would be predisposed to and have a word to her about options. If she is at really high risk for breast cancer, she should be informed more or less getting a double mastectomy (breast removal) or just getting frequent mammograms etc.
B) You cannot contact the family members because of patient-physician confidentiality when the other own flesh and blood members are not directly put at risk from her wants. If she know there was a reason to enjoy it tested, her family is also probably aware there is a risk. I would think the doctor would certainly try to get her to talk to family member about getting tested, even if she wouldn't want to share her results. But ultimately is is up to the patient.
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a. Knowing that a familial mutation is occurringg this family circle, what would be your next course of action in this defence?
b. Is it your duty to contact members of this family despite the request of your patient? Where do your obligation lie --- with your patient or next to the patient's family? Would it be inappropriate to try to convince the patient to share her results beside her family members?
Answers:
A) The course of action would be to do any of the follow up exams for the type of cancer she would be predisposed to and have a word to her about options. If she is at really high risk for breast cancer, she should be informed more or less getting a double mastectomy (breast removal) or just getting frequent mammograms etc.
B) You cannot contact the family members because of patient-physician confidentiality when the other own flesh and blood members are not directly put at risk from her wants. If she know there was a reason to enjoy it tested, her family is also probably aware there is a risk. I would think the doctor would certainly try to get her to talk to family member about getting tested, even if she wouldn't want to share her results. But ultimately is is up to the patient.
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