The "Duty to Warn" a patient's family members about hereditary disease risks Journal Article


Authors: Offit, K.; Groeger, E.; Turner, S.; Wadsworth, E. A.; Weiser, M. A.
Article Title: The "Duty to Warn" a patient's family members about hereditary disease risks
Abstract: Genetic tests for adult-onset disorders, including common forms of cancer, are now commercially available, and tests for genetic polymorphisms that predict drug effects or toxicity after treatment are under development. For each of these circumstances, testing of 1 individual may imply an increased risk to his/her relative. The obligation, if any, to warn family members of the identification of a genetic mutation has generated concerns regarding the conflict between the physician's ethical obligations to respect the privacy of genetic information vs the potential liabilities resulting from the physician's failure to notify at-risk relatives. A duty to warn relatives about risks due to some infectious agents has been assumed by state and local health agencies, and the duty to breach confidentiality to warn of imminent harm has been the subject of case law. In general, the special nature of genetic tests has been viewed as a barrier to physicians' breaching the confidentiality of personal genetic information. However, the failure to warn family members about hereditary disease risks has already resulted in 3 lawsuits against physicians in the United States. While the findings of case law and the state and federal statutes that bear on the Issue of "duty to warn" of inherited health risk are still being defined, we believe that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
Keywords: genetics; mutation; review; united states; clinical practice; familial disease; genetic predisposition to disease; risk factors; risk factor; legal aspect; health status; societies, medical; genetic susceptibility; medical society; health care personnel; medical practice; physician; familial cancer; law suit; physician attitude; informed consent; genetic disorder; genetic risk; disease predisposition; awareness; genetic predisposition; genetic screening; physician's role; medical ethics; ethics; family; genetic polymorphism; confidentiality; health hazard; responsibility; genetic diseases, inborn; duty to warn; humans; human; priority journal; article; genetics and reproduction; legal approach
Journal Title: JAMA - Journal of the American Medical Association
Volume: 292
Issue: 12
ISSN: 0098-7484
Publisher: American Medical Association  
Date Published: 2004-09-22
Start Page: 1469
End Page: 1473
Language: English
DOI: 10.1001/jama.292.12.1469
PROVIDER: scopus
PUBMED: 15383518
DOI/URL:
Notes: J. Am. Med. Assoc. -- Cited By (since 1996):130 -- Export Date: 16 June 2014 -- CODEN: JAMAA -- Source: Scopus
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  1. Kenneth Offit
    788 Offit
  2. Mary A Weiser
    3 Weiser