Genetic Testing advised for those at risk of Disease

Physicians should actively inform those from populations with a high incidence of certain genetic diseases about the possibility of pre-marital and pre-pregnancy testing, according to new guidance issued by the World Medical Association.

Genetic testing may be carried out before marriage or childbearing to detect the presence of carrier genes that might affect the health of future offspring. Genetic counselling should then be made available to those individuals or couples who are considering such testing.

The advice to physicians on the medical, social, ethical and legal implications of genetics and medicine was approved by the WMA at its annual Assembly in Santiago, Chile.

Genetic screening should not be employed as a means of producing children with pre-determined characteristics. For example, genetic screening should not be used to enable sex selection unless there is a gender-based illness involved. Similarly, physicians should not consider the use of screening to promote non-health related personal attributes.

The new guidance stresses the importance of informed consent, counselling and confidentiality. The results of genetic testing should be kept strictly confidential, and should not be revealed to outside parties without the consent of the individual tested - except where not disclosing the result might involve a direct threat to the life of health of a third party.

Medical students and physicians should be educated and trained in genetic counselling, particularly counselling related to pre-symptomatic diagnosis of disease.

Dr Yoram Blachar, chair of the World Medical Association Council, said:
'The field of genetics has undergone rapid change and development. The areas of gene therapy and genetic engineering and the development of new technology have presented possibilities inconceivable only decades ago.

'We hope this guidance will assist physicians in dealing with the problems created by such rapid progress. We believe that gene therapy and genetic research should proceed, but only on the basis of strict guidelines.

'For instance, we would like to see all physicians supporting legislation guaranteeing that no individual shall be discriminated against on the basis of genetic makeup in the fields of human rights, employment and insurance.'