The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
Mary A Weiser - One of the best experts on this subject based on the ideXlab platform.
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the Duty to Warn a patient s family members about hereditary disease risks
American Journal of Ophthalmology, 2005Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:GENETIC TESTS FOR SPECIFIC ADULT-ONSET DISORders (eg, breast and colon cancer) are now commercially available, and results of research studies for genetic polymorphisms that predict drug effects, for example, response to statin therapy, have recently been published. The failure to Warn family members about their hereditary disease risks has resulted in 3 malpractice suits against physicians in the United States. This past year, the obligation, if any, to Warn family members of identification of a cancer gene mutation was the topic of discussion among professional societies and advocacy groups. Concerns have been raised regarding the conflict between the physician’s ethical obligations to respect the privacy of genetic information vs the potential legal liabilities resulting from the physician’s failure to notify at-risk relatives. In many cases, state and federal statutes that bear on the issue of “Duty to Warn” of inherited health risk are also in conflict. This article discusses these issues and suggests that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
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The “Duty to Warn” a patient’s family members about hereditary disease risks
American Journal of Ophthalmology, 2005Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:GENETIC TESTS FOR SPECIFIC ADULT-ONSET DISORders (eg, breast and colon cancer) are now commercially available, and results of research studies for genetic polymorphisms that predict drug effects, for example, response to statin therapy, have recently been published. The failure to Warn family members about their hereditary disease risks has resulted in 3 malpractice suits against physicians in the United States. This past year, the obligation, if any, to Warn family members of identification of a cancer gene mutation was the topic of discussion among professional societies and advocacy groups. Concerns have been raised regarding the conflict between the physician’s ethical obligations to respect the privacy of genetic information vs the potential legal liabilities resulting from the physician’s failure to notify at-risk relatives. In many cases, state and federal statutes that bear on the issue of “Duty to Warn” of inherited health risk are also in conflict. This article discusses these issues and suggests that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
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the Duty to Warn a patient s family members about hereditary disease risks
JAMA, 2004Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:Genetic tests for adult-onset disorders, including common forms of cancer, are now commercially available, and tests for genetic polymorphisms that predict drug effects or toxicity after treatment are under development. For each of these circumstances, testing of 1 individual may imply an increased risk to his/her relative.The obligation, if any, to Warn family members of the identification of a genetic mutation has generated concerns regarding the conflict between the physician's ethical obligations to respect the privacy of genetic information vs the potential liabilities resulting from the physician's failure to notify at-risk relatives. A Duty to Warn relatives about risks due to some infectious agents has been assumed by state and local health agencies, and the Duty to breach confidentiality to Warn of imminent harm has been the subject of case law.In general, the special nature of genetic tests has been viewed as a barrier to physicians' breaching the confidentiality of personal genetic information. However, the failure to Warn family members about hereditary disease risks has already resulted in 3 lawsuits against physicians in the United States.While the findings of case law and the state and federal statutes that bear on the issue of "Duty to Warn" of inherited health risk are still being defined, we believe that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
Nathaniel H Robin - One of the best experts on this subject based on the ideXlab platform.
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the Duty to Warn at risk relatives the experience of genetic counselors and medical geneticists
American Journal of Medical Genetics Part A, 2020Co-Authors: Tabitha J Perry, Samantha I Patton, Meagan Farmer, Christina B Hurst, Gerald Mcgwin, Nathaniel H RobinAbstract:: Studies published over 15 years ago surveyed genetic counselors (GC) and medical geneticists (MG) to examine their clinical experiences with the conflict of "Duty to Warn" versus patient confidentiality. Federal and state laws pertaining to medical professionals' Duty to Warn have since been implemented following the publications of these studies. Using a merged version of surveys employed in the prior studies, this study seeks to understand clinicians' current decision-making process when faced with patient refusal to inform at-risk relatives, as well as their familiarity with and opinions of laws and guidelines covering this issue. Consistent with the previous studies, the majority of MG and almost half of GC experience patient refusal. Significantly, fewer MG and GC believe they had a Duty to Warn their patients' relatives of genetic risk. Only 8% of participants believe current guidelines effectively address the issue of Duty to Warn. Participant awareness of federal or state laws regulating the disclosure of genetic information remains low. The conflict of Duty to Warn remains a shared experience among genetics professionals, and resources are needed to facilitate informed decision-making. Participants' opinions of current policies and clinical decisions may guide professional actions regarding Duty to Warn.
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The Duty to Warn at‐risk relatives—The experience of genetic counselors and medical geneticists
American Journal of Medical Genetics Part A, 2019Co-Authors: Tabitha J Perry, Samantha I Patton, Meagan Farmer, Christina B Hurst, Gerald Mcgwin, Nathaniel H RobinAbstract:: Studies published over 15 years ago surveyed genetic counselors (GC) and medical geneticists (MG) to examine their clinical experiences with the conflict of "Duty to Warn" versus patient confidentiality. Federal and state laws pertaining to medical professionals' Duty to Warn have since been implemented following the publications of these studies. Using a merged version of surveys employed in the prior studies, this study seeks to understand clinicians' current decision-making process when faced with patient refusal to inform at-risk relatives, as well as their familiarity with and opinions of laws and guidelines covering this issue. Consistent with the previous studies, the majority of MG and almost half of GC experience patient refusal. Significantly, fewer MG and GC believe they had a Duty to Warn their patients' relatives of genetic risk. Only 8% of participants believe current guidelines effectively address the issue of Duty to Warn. Participant awareness of federal or state laws regulating the disclosure of genetic information remains low. The conflict of Duty to Warn remains a shared experience among genetics professionals, and resources are needed to facilitate informed decision-making. Participants' opinions of current policies and clinical decisions may guide professional actions regarding Duty to Warn.
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Duty to Warn at risk relatives for genetic disease genetic counselors clinical experience
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2003Co-Authors: Beth R Dugan, Georgia L Wiesner, Eric T Juengst, Maryann Oriordan, Anne L Matthews, Nathaniel H RobinAbstract:When a patient refuses to inform relatives of their risk for genetic disease, the genetic healthcare professional is faced with conflicting ethical obligations. On one side of the issue is the obligation to respect and protect patients' right to privacy. On the other side is the obligation to prevent harm and promote the welfare of the family members, which suggests a responsibility to Warn at-risk relatives, even without the patient's consent. In an effort to examine the actual clinical impact of this issue, we conducted a pilot study that explored genetic counselors' experience with this conflict. A survey was developed and made available to members of the National Society of Genetic Counselors. Questions were either multiple-choice responses or open-ended. Almost half of respondents (119/259; 46%) had had a patient refuse to notify an at-risk relative. The most commonly cited reasons for refusal were estranged family relationships, altering family dynamics, insurance discrimination, and employment discrimination, respectively. Of these 119 counselors, 24 (21%) reported that they seriously considered Warning the at-risk relatives without patient consent, and one actually did disclose. Three factors consistently made the counselors less likely to disclose: their patient's potential emotional reaction, the relationship between the relative and patient, and the chance that the relative could be aware of the disease by another means. These results suggest that while the conflict is often encountered in clinical practice, it is rare that the situation remains unresolved to the extent that genetic counselors actually consider Warning at-risk relatives. However, when the situation was encountered, the counselors in this study reported a lower rate of disclosure without consent than would have been anticipated based on previous studies that used hypothetical situations. It may be that counselors do not recognize a Duty to Warn at-risk relatives as integral to their role and professional obligations.
Mary Jane Esplen - One of the best experts on this subject based on the ideXlab platform.
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should healthcare providers have a Duty to Warn family members of individuals with an hnpcc causing mutation a survey of patients from the ontario familial colon cancer registry
Journal of Medical Genetics, 2007Co-Authors: Kelly Kohut, Michael Manno, Steven Gallinger, Mary Jane EsplenAbstract:Background: As genetic testing becomes more common and increasingly intertwined with medical care, the issues of genetic privacy and doctor–patient confidentiality are being examined. Hereditary non-polyposis colorectal cancer (HNPCC) is a genetic predisposition to colorectal and certain other cancers. Effective screening that can prevent colorectal cancer is an important incentive for genetic testing. Methods: A survey regarding the Duty to Warn family members of the risks associated with an HNPCC-causing mutation was mailed to 227 participants in the Ontario Familial Colon Cancer Registry (OFCCR). to our knowledge, the opinions of patients on this subject have not been reported previously in the literature. Responses were analysed quantitatively using the SAS system and qualitatively by the review of written comments. Results: Completed surveys were returned by 105 participants, with a response rate of 46.3%. The majority felt a personal responsibility to Warn relatives, but there was no significant agreement that doctors or genetic counsellors should have a Duty to Warn relatives without a patient’s permission. Conclusions: Patients undergoing genetic testing for HNPCC generally understand that relatives could benefit from being informed of genetic risk, but may not be willing or able to inform each family member. Healthcare professionals should engage patients in a discussion of familial implications before genetic testing. An agreement should be formulated regarding which of the relatives should be informed. Patients should be encouraged to personally disseminate the information, given the unrealistic burden on practitioners to perform this task and patients’ preference for control over the information.
Jill Wieber Lens - One of the best experts on this subject based on the ideXlab platform.
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Warning: A Post-Sale Duty to Warn Targets Small Manufacturers Account
Utah law review, 2015Co-Authors: Jill Wieber LensAbstract:The majority of states now obligate manufacturers to Warn about dangers of their products that are discoverable after the sale. Commentators and courts have been hesitant about this obligation because of the potential burden it puts on manufacturers—the costs of identifying users and Warning them of the danger. The consensus is that only a factually dependent post-sale Duty to Warn should exist, obligating manufacturers to Warn only if a reasonable manufacturer would do so. A reasonable manufacturer, of course, would Warn only if the danger to be Warned of justifies the costs of the Warning. This Article is the first to identify a problem with a factually dependent post-sale Duty to Warn—it will most likely result in liability for small manufacturers, but not large manufacturers. This is because the costs of issuing the Warning for a small manufacturer will always be smaller than for a large manufacturer. This Article is also the first to argue that a factually dependent post-sale Duty to Warn is inconsistent with the underlying purposes of products liability law and general public policy. Although the factually dependent post-sale Duty to Warn seems like a perfect solution to the overburdening problem, courts should not adopt it.
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Warning: A Post-Sale Duty to Warn Targets Small Manufacturers
Utah law review, 2014Co-Authors: Jill Wieber LensAbstract:The majority of states now obligate manufacturers to Warn about dangers of their products that are discoverable after the sale. Commentators and courts have been hesitant about this obligation because of the potential burden it puts on manufacturers — the costs of identifying users and Warning them of the danger. The consensus is that only a factually dependent post-sale Duty to Warn should exist, obligating manufacturers to Warn only if a reasonable manufacturer would do so. A reasonable manufacturer, of course, would Warn only if the danger to be Warned of justifies the costs of the Warning. This Article is the first to identify a problem with a factually dependent post-sale Duty to Warn — that it will most likely result in liability for small manufacturers, but not large manufacturers. This is because the costs of issuing the Warning for a small manufacturer will always be smaller than for a large manufacturer. This Article is also the first to argue that a factually dependent post-sale Duty to Warn is thus inconsistent with the underlying purposes of products liability law and general public policy. Although the factually dependent post-sale Duty to Warn seemed like a perfect solution to the overburdening problem, it should not be adopted.
Kenneth Offit - One of the best experts on this subject based on the ideXlab platform.
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the Duty to Warn a patient s family members about hereditary disease risks
American Journal of Ophthalmology, 2005Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:GENETIC TESTS FOR SPECIFIC ADULT-ONSET DISORders (eg, breast and colon cancer) are now commercially available, and results of research studies for genetic polymorphisms that predict drug effects, for example, response to statin therapy, have recently been published. The failure to Warn family members about their hereditary disease risks has resulted in 3 malpractice suits against physicians in the United States. This past year, the obligation, if any, to Warn family members of identification of a cancer gene mutation was the topic of discussion among professional societies and advocacy groups. Concerns have been raised regarding the conflict between the physician’s ethical obligations to respect the privacy of genetic information vs the potential legal liabilities resulting from the physician’s failure to notify at-risk relatives. In many cases, state and federal statutes that bear on the issue of “Duty to Warn” of inherited health risk are also in conflict. This article discusses these issues and suggests that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
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The “Duty to Warn” a patient’s family members about hereditary disease risks
American Journal of Ophthalmology, 2005Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:GENETIC TESTS FOR SPECIFIC ADULT-ONSET DISORders (eg, breast and colon cancer) are now commercially available, and results of research studies for genetic polymorphisms that predict drug effects, for example, response to statin therapy, have recently been published. The failure to Warn family members about their hereditary disease risks has resulted in 3 malpractice suits against physicians in the United States. This past year, the obligation, if any, to Warn family members of identification of a cancer gene mutation was the topic of discussion among professional societies and advocacy groups. Concerns have been raised regarding the conflict between the physician’s ethical obligations to respect the privacy of genetic information vs the potential legal liabilities resulting from the physician’s failure to notify at-risk relatives. In many cases, state and federal statutes that bear on the issue of “Duty to Warn” of inherited health risk are also in conflict. This article discusses these issues and suggests that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
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the Duty to Warn a patient s family members about hereditary disease risks
JAMA, 2004Co-Authors: Kenneth Offit, Elizabeth Groeger, Sam Turner, E Wadsworth, Mary A WeiserAbstract:Genetic tests for adult-onset disorders, including common forms of cancer, are now commercially available, and tests for genetic polymorphisms that predict drug effects or toxicity after treatment are under development. For each of these circumstances, testing of 1 individual may imply an increased risk to his/her relative.The obligation, if any, to Warn family members of the identification of a genetic mutation has generated concerns regarding the conflict between the physician's ethical obligations to respect the privacy of genetic information vs the potential liabilities resulting from the physician's failure to notify at-risk relatives. A Duty to Warn relatives about risks due to some infectious agents has been assumed by state and local health agencies, and the Duty to breach confidentiality to Warn of imminent harm has been the subject of case law.In general, the special nature of genetic tests has been viewed as a barrier to physicians' breaching the confidentiality of personal genetic information. However, the failure to Warn family members about hereditary disease risks has already resulted in 3 lawsuits against physicians in the United States.While the findings of case law and the state and federal statutes that bear on the issue of "Duty to Warn" of inherited health risk are still being defined, we believe that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine.
