Lots to Consider

In an American Medical News ethics forum post, the University of Oklahoma Health Sciences Center's John Mulvihill this week examines the role of primary care physicians when it comes to discussing direct-to-consumer genetic tests with their patients. When confronted by a patient who is considering undergoing DTC genetic testing, Mulvihill says clinicians must consider the patient's autonomy in making this decision, as well as the beneficence and non-maleficence conferred by testing. Beyond those standbys of medical ethics, Mulvihill suggests clinicians also consider solidarity. "Broadly considered as 'the common good,' solidarity comes up in genetics because it emphasizes that Ms. X shares genes not only with her close and perhaps distant relatives, or members of her ethnicity or heritage but, in fact, with all human beings," he says.

Overall, Mulvihill says, should a physician not feel prepared to address such concerns, "you could hardly be faulted if you wish to say 'No comment. It's not my area. I can refer you to a clinical colleague who is a geneticist.'"