BIOETHICS FOR CLINICIAN - 14 - ETHICS AND GENETICS IN MEDICINE

INFORMATION ABOUT A PATIENT'S INHERITED RISK of disease has important ethical and legal implications in clinical practice. Because genetic i nformation is by nature highly personal yet familial, issues of confid entiality arise. Counselling and informed consent before testing are i mportant in view of the social and psychological risks that accompany testing, the complexity of information surrounding testing, and the fa ct that effective interventions are often not available. Follow-up cou nselling is also important to help patients integrate test results int o their lives and the lives of their relatives. Genetic counselling sh ould be provided by practitioners who have up-to-date knowledge of the genetics of and the tests available for specific diseases, are aware of the social and psychological risks associated with testing, and are able to provide appropriate clinical follow-up. Some physicians may e lect to refer patients for genetic counselling and testing. However, i t is inevitable that all physicians will be involved in long-term foll ow-up both by monitoring for disease and by supporting the integration of genetic information into patients' lives.