With the demographics of increased numbers of older adults, there will be an increased incidence of chronic disease. With increased technology of genetics research, specific genetic expressions now are matched to identify risks for specific chronic diseases. Many of these conditions identified represent illnesses for which there is no treatment. Dilemmas are posed to family members and the relatives of such diagnosed patients to participate in testing. There are many implications of testing results. The outcome of positive results with the understanding that said relatives have the likelihood of developing the illness presents families with difficult issues.  Insurance companies may cancel or drop those insured if testing is acknowledged and/or the results are positive. Testing may be beneficial if the results are definitive for the development of a specific disease and if there are treatment implications, such as adverse or beneficial results.

If genetic testing is done there should be accompanying pre-and post-counseling. Discrimination or exclusion based on the testing should not occur. What is done with the information, with whom it is shared, how long samples are kept, and should it be done blindly are all questions being asked.

SOME CONCERNS MAY INCLUDE:

The advances in predictive capabilities

The lack of clear protocols for us

The absence of policies that deal with associated problems.

Long range predictive impact

Reproductive impact

Race and ethnicity overlap

Involuntariness and permanence of the results

The familial implications

Prognostic uncertainty

Stigmatization.

     Brownlee, S., Cook, G. G., & Hardigg, V. (1994). "Genes and caviar, tinkering with destiny." U.S. News and World Report. 8/22/94: 50-67.

     Elliott, J. (1995). "Genetic dilemmas: Natural Science," Science and Values, March 1995: 212-217.

     Rennie, J. (199?). "Grading the gene tests." Scientific American. 270:88-97.

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