The Duty to Recontact: Benefit and Harm

Sharpe, Neil F.

doi:10.1086/302587

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…There remains even more uncertainty about variants not appearing on the aforementioned ACMG list. Given the inherent ambiguity and heterogeneity surrounding patient views, and the potential psychological and discriminatory harms that could result from disclosure of unwanted genetic information [29], imposing a legal duty on physicians to unilaterally identify and communicate new genetic information to patients may be ethically problematic.…”

Section: A Limited Duty To Current Patients For Genetic Updates?mentioning

confidence: 99%

Physicians’ Duty to Recontact and Update Genetic Advice

Stevens

Senner

Marchant³

2017

Per. Med.

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This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients’ lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information. However, integration of genomics into clinical practice is advancing quickly, and there may be limited, specific situations where a physician may have a duty to provide updated genetic information.

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Section: A Limited Duty To Current Patients For Genetic Updates?mentioning

confidence: 99%

Physicians’ Duty to Recontact and Update Genetic Advice

Stevens

Senner

Marchant³

2017

Per. Med.

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“…Psychological arguments in favor of recontacting were discussed in only three articles. According to Sharpe,11 one can argue in favor of recontacting because it may correspond to "patients' informational, communicative, emotional, and psychological needs. " Sexton and Metcalfe 34 and O'Connor 59 mentioned the reduction of uncertainty to patients as a psychological argument in favor of recontacting.…”

Section: Elsi Issues Regarding the Duty To Recontactmentioning

confidence: 99%

“…The negative psychological consequences of recontacting former patients regarding relations with their family members, and the consequences for the family members themselves, were mentioned by several authors. 8,11,23,29,33,41 Because familial implications are an important aspect of genetic counseling and testing in general, these should also be considered in the case of recontacting. In addition to psychological counterarguments, a minority of articles also mentioned other social arguments, for example, financial impact and consequences for insurance.…”

Section: Elsi Issues Regarding the Duty To Recontactmentioning

confidence: 99%

“…Establishing databases or computerized registries were also mentioned as possible solutions in several of the older articles. 3,5,6,11,13,14,19 Ensuring patient privacy was, however, mentioned as a major concern in this respect. Finally, Hunter et al 15,26 suggested recording patient preferences regarding recontacting as part of the informed consent procedure at the initial consultation.…”

Section: Recontact In Clinical Genetics: Practical Barriers and Solutmentioning

confidence: 99%

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Is there a duty to recontact in light of new genetic technologies? A systematic review of the literature

Otten

Plantinga

Birnie

et al. 2015

Genetics in Medicine

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Purpose: With rapid advances in genetic technologies, new genetic information becomes available much faster today than just a few years ago. This has raised questions about whether clinicians have a duty to recontact eligible patients when new genetic information becomes available and, if such duties exist, how they might be implemented in practice. Methods:We report the results of a systematic literature search on the ethical, legal, social (including psychological), and practical issues involved in recontacting former patients who received genetic services. We identified 1,428 articles, of which 61 are covered in this review. results:The empirical evidence available indicates that most but not all patients value being recontacted. A minority of (older) articles conclude that recontacting should be a legal duty. Most authors consider recontacting to be ethically desirable but practically unfeasible. Various solutions to overcome these practical barriers have been proposed, involving efforts of laboratories, clinicians, and patients.conclusion: To advance the discussion on implementing recontacting in clinical genetics, we suggest focusing on the question of in what situations recontacting might be regarded as good standard of care. To this end, reaching a professional consensus, obtaining more extensive empirical evidence, and developing professional guidelines are important.Genet Med advance online publication 11 December 2014

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“…This notion of so-called “duty to recontact” thankfully has not taken hold in the clinic or the courthouse, despite geneticists’ fascination with the topic in the 1990s. 21–23 There are many practical reasons for this. Clinicians do not yet have responsibility for monitoring every aspect of a patient’s health on a continuous basis.…”

Section: Caveat Investigatio!mentioning

confidence: 99%

The legal risks of returning results of genomics research

Clayton

McGuire

2012

Genetics in Medicine

101

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Published guidelines suggest that research results and incidental findings should be offered to study participants under some circumstances. Although some have argued against the return of results in research, many cite an emerging consensus that there is an ethical obligation to return at least some results; the debate quickly turns to issues of mechanics (e.g., which results? who discloses? for how long does the obligation exist?). Although commentators are careful to distinguish this as an ethical rather than legal obligation, we worry that return of results may unjustifiably become standard of care based on this growing “consensus,” which could quickly lead to a legal (negligence-based) duty to offer and return individualized genetic research results. We caution against this and argue in this essay that the debate to date has failed to give adequate weight to a number of fundamental ethical and policy issues that should undergird policy on return of research results in the first instance, many of which go to the fundamental differences between research and clinical care. We confine our comments to research using data from large biobanks, the topic of the guidelines proposed in this symposium issue.

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The Duty to Recontact: Benefit and Harm

Cited by 16 publications

References 25 publications

Physicians’ Duty to Recontact and Update Genetic Advice

Physicians’ Duty to Recontact and Update Genetic Advice

Is there a duty to recontact in light of new genetic technologies? A systematic review of the literature

The legal risks of returning results of genomics research

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