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Introduction to genetic counseling -- History of genetic counseling -- Practice definition and goals -- Characteristics of clients and genetic counseling -- Characteristics of counselors and genetic counseling -- Applying ethical theories to genetic counseling practice -- Conflict of interest and the code of ethics -- Relational genetic counseling -- Theories for genetic counseling practice -- Research in genetic counseling -- Genetic counseling in the genomic era.
In: Ethics & human research: E&HR : a publication of the Hastings Center, Band 43, Heft 4, S. 27-36
ISSN: 2578-2363
AbstractKnowledge of genetic mechanisms contributing to neurodevelopmental conditions is advancing. This is informing development of new drugs to treat or ameliorate these conditions, through targeting underlying genetic pathways. Drugs are tested in clinical trials, necessitating parents to engage with decisions about whether to enroll their child. In this article, we consider important ethical issues to anticipate as clinical research opportunities in genetic neurodevelopmental conditions arise. For example, genetic pathways targeted by the drugs may interact with valued character and personality traits. It is essential that recruitment and consent processes are optimized for families who will grapple with whether these novel drug treatments interact with their child's personality and authentic identity. We call for focused social science research and further normative analysis so that parents are better supported to make informed choices. Additionally, clinical research regulators should have a sound understanding of the contextual experiences regarding how this population of parents engages with decisions.
In: Rhetoric, culture, and social critique
A collection of essays by prominent scholars from many disciplines on the construction of public memories. The study of public memory has grown rapidly across numerous disciplines in recent years, among them American studies, history, philosophy, sociology, architecture, and communications. As scholars probe acts of collective remembrance, they have shed light on the cultural processes of memory. Essays contained in this volume address issues such as the scope of public memory, the ways we forget, the relationship between politics and memory, and the material practices of memory. Stephen Browne's contribution studies the alternative to memory erasure, silence, and forgetting as posited by Hannah Arendt in her classic Eichmann in Jerusalem. Rosa Eberly writes about the Texas tower shootings of 1966, memories of which have been minimized by local officials. Charles Morris examines public reactions to Larry Kramer's declaration that Abraham Lincoln was homosexual, horrifying the guardians of Lincoln's public memory. And Barbie Zelizer considers the impact on public memory of visual images, specifically still photographs of individuals about to perish (e.g., people falling from the World Trade Center) and the sense of communal loss they manifest. Whether addressing the transitory and mutable nature of collective memories over time or the ways various groups maintain, engender, or resist those memories, this work constitutes a major contribution to our understanding of how public memory has been and might continue to be framed.
In: Public health genomics, S. 135-144
ISSN: 1662-8063
Introduction: Research on the perceived utility of genomic sequencing has focused primarily on pediatric populations and on individuals and families with rare genetic diseases. Here, we evaluate how well a multifaceted perceived utility model developed with these populations applies to a diverse, adult population aged 18–49 at risk for hereditary cancer and propose new considerations for the model. Methods: Participants received clinical genomic sequencing in the Cancer Health Assessments Reaching Many (CHARM) study. Semi-structured qualitative interviews were conducted with a subset of participants at 1 and 6 months after results disclosure. We used an approach influenced by grounded theory to examine perceptions of the utility of genomic sequencing and analyzed how utility in CHARM mapped to the published multifaceted perceived utility model, noting which domains were represented or absent and which were most salient to our population. Results: Participants' discussions of utility often involved multiple domains and revealed the variety of ways in which receiving sequencing results can impact one's life. Results demonstrated that an individual's perception of utility can change over the life course when sequenced at a relatively young age and may be influenced by the resources available to them to act on the results. Conclusion: Our findings demonstrate the relevance of a multifaceted perceived utility model for a diverse adult population at risk for hereditary cancer. We identified refinements that could make the model more robust, including emphasizing the overlapping nature of the domains and the importance of life stage and personal resources to the perception of utility.
In: PLOS Biology, V. 11, No. 11, November 2013, p. e1001699
SSRN
INTRODUCTION: Implementation of genome-scale sequencing in clinical care has significant challenges: the technology is highly dimensional with many kinds of potential results, results interpretation and delivery require expertise and coordination across multiple medical specialties, clinical utility may be uncertain, and there may be broader familial or societal implications beyond the individual participant. Transdisciplinary consortia and collaborative team science are well poised to address these challenges. However, understanding the complex web of organizational, institutional, physical, environmental, technologic, and other political and societal factors that influence the effectiveness of consortia is understudied. We describe our experience working in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, a multi-institutional translational genomics consortium. METHODS: A key aspect of the CSER consortium was the juxtaposition of site-specific measures with the need to identify consensus measures related to clinical utility and to create a core set of harmonized measures. During this harmonization process, we sought to minimize participant burden, accommodate project-specific choices, and use validated measures that allow data sharing. RESULTS: Identifying platforms to ensure swift communication between teams and management of materials and data were essential to our harmonization efforts. Funding agencies can help consortia by clarifying key study design elements across projects during the proposal preparation phase and by providing a framework for data sharing data across participating projects. CONCLUSIONS: In summary, time and resources must be devoted to developing and implementing collaborative practices as preparatory work at the beginning of project timelines to improve the effectiveness of research consortia.
BASE
In: Public health genomics, Band 27, Heft 1, S. 16-22
ISSN: 1662-8063