Scenario deals with paternity and is quoted from Science News.
A husband and wife have a child who suffers from cystic fibrosis (CF), an incurable, fatal hereditary disease that results in frequent infections and difficulty breathing. The couple wants to determine their risk of having another child with this disorder. Because CF is a recessive disorder, a child usually must inherit the CF gene from both parents to get the disease. A child with just one CF gene is a carrier: Such a person doesn’t have the disorder but can pass the trait on to the next generation. The DNA test revealed that the mother of the child carried the CF trait; however, her husband did not. The DNA tests showed that he was not the biological father of the child.
The fact significantly decreased the couple’s chance of having another child with CF. But the test has put the counselor in a difficult situation. Should the counselor tell the couple about the nonpaternity findings? Should the mother be told privately? If so, is the center colluding with the mother to withhold information from the husband?
In addition, this case brings up issues concerning the biological father of the child. This man has not contracted with the genetics center for the test, yet the counselor now knows that this man is probably a carrier of the mutant gene for CF. Should the genetic counselor call this man and tell him about his risk?
• Determine what the ethical dilemmas are for the scenario (reveal paternity to wife? reveal paternity to husband? reveal carrier status to biological father?).
• What would you do if you were the genetic counselor?
• Present arguments for both sides of the issue.
Title: Ethical Dilemmas in Paternity and Genetic Counseling: Reveal or Withhold Information?
Introduction:
Genetic counseling involves navigating complex ethical dilemmas, particularly when it comes to issues of paternity and revealing sensitive information to clients. In the given scenario, a couple seeks genetic counseling to determine their risk of having another child with cystic fibrosis (CF) after their first child was diagnosed with the disease. However, DNA testing reveals that the husband is not the biological father of the child. This situation presents multiple ethical dilemmas for the genetic counselor, including whether to reveal the paternity to the wife, disclose the nonpaternity findings to the husband, and inform the biological father about his carrier status for CF.
Thesis Statement:
The ethical dilemmas in this scenario revolve around whether to reveal the paternity to the wife, disclose the nonpaternity findings to the husband, and inform the biological father about his carrier status for CF. As a genetic counselor, it is essential to carefully navigate these dilemmas while prioritizing the well-being and autonomy of all parties involved.
Arguments for Revealing Paternity to the Wife:
Informed Decision-Making: The wife has a right to know the truth about her child's paternity, as it can have significant emotional and psychological implications. Revealing this information allows her to make informed decisions regarding her future reproductive choices.
Emotional Support: By disclosing the paternity results, the genetic counselor can provide emotional support to the wife, ensuring she has access to appropriate resources and counseling to navigate this challenging situation.
Arguments Against Revealing Paternity to the Wife:
Emotional Distress: Revealing the paternity results may cause significant emotional distress for the wife, potentially undermining her mental well-being and straining her relationship with her husband. It is crucial to consider the potential negative consequences of revealing this information.
Respect for Autonomy: If the husband is unaware of the paternity discrepancy and the wife does not wish to disclose it, respecting her autonomy and decision should be a priority. The counselor should not disclose information without the wife's consent.
Arguments for Disclosing Nonpaternity Findings to the Husband:
Honesty and Transparency: The husband has a right to know about the nonpaternity findings, as it may have implications for his own understanding of his family's medical history and personal decision-making.
Trust and Future Planning: Disclosure of nonpaternity allows the husband to be fully informed about his child's genetic risks, enabling him to make informed decisions regarding future family planning and potential medical interventions.
Arguments Against Disclosing Nonpaternity Findings to the Husband:
Emotional Upheaval: Disclosing nonpaternity can cause significant emotional distress for both the husband and wife, potentially leading to relationship strain and instability within their family unit. The counselor should carefully consider the potential negative consequences before making a decision.
Confidentiality and Autonomy: If the wife chooses not to disclose the nonpaternity findings to her husband, respecting her autonomy and confidentiality should be upheld unless there are exceptional circumstances that warrant intervention.
Arguments for Informing Biological Father about Carrier Status:
Health Awareness: Informing the biological father about his carrier status for CF allows him to make informed decisions regarding his own health and future family planning, ensuring he understands potential risks and can seek appropriate medical advice.
Responsibility: The counselor has a duty of care to provide accurate and relevant information to individuals who may be at risk of passing on genetic conditions. By informing the biological father, the counselor upholds this responsibility.
Arguments Against Informing Biological Father about Carrier Status:
Lack of Consent: The biological father did not seek genetic testing or consult with the genetics center. Respecting his autonomy and privacy means refraining from disclosing information about his carrier status without his explicit consent.
Potential Consequences: Disclosure of carrier status may cause emotional distress or strain familial relationships for the biological father without any clear benefit if he does not plan on having children or is already aware of his status.
Conclusion:
As a genetic counselor faced with these ethical dilemmas, it is crucial to prioritize respect for autonomy, confidentiality, and emotional well-being. While disclosing paternity and nonpaternity findings may have potential benefits for informed decision-making and trust within relationships, it is important to consider potential emotional distress that may arise from such disclosures. Ultimately, allowing clients to make their own choices while providing support and appropriate resources is paramount in navigating these complex situations.