Question

Screening tests for genetic issues can be performed in the first trimester, second trimester or both trimesters. Carrier testing is also an option performed prior to or during pregnancy. Carrier testing provides information as to whether one or both parents are carriers for certain inherited disorders. The results of these tests are used to determine an appropriate plan of care for the patient.

Genetic testing of the fetus and the parents offers both opportunities and ethical challenges. As a Registered Nurse, you need to be aware of your own feelings to provide non-biased professional support.

Compose a response to the following:

Implications of genetic testing and the role of the registered nurse in providing support to a couple seeking guidance. Provide one example of how genetic testing is used in the reproductive (preconception, conception, pregnancy) setting.

Consider if the registered nurse has the right to refuse to care for patients who choose termination of pregnancy based on genetic testing when it conflicts with the ethics and values of the nurse.

Discuss how medical, economic, or psychosocial issues might impact decision making relative to genetic testing.

Answer 1

1. Implication of genetic testing and role of nurse:

Genetic testing can be done to screen individuals, to give them health and life related choices (Like pregnancy), and to provide information for the family members

Nurses'Role:

• Identify and counsel people for genetic testing
• Assist individuals to make decision related to genetic testing
• Obtain informed consent before genetic testing
• Help clients cope with results of genetic testing

Example of genetic testing in reproductive setting: Genetic testing can be prior to planning pregnancy to identify the parents are carriers for genetic disorders (cyctic fibrosis, thalasemia, fragile X syndrome etc). The results can help parents take informed decision about the pregnancy.

2. Nurses can object to participate in abortion as per provisions in code of ethics, based on religious and moral values. Objecting to termination of pregnancy based on genetic testing should be evaluated based on the nurses' religious, moral and ethical values. In case the nurse objects timely decision should be made so as the nurse manager can make necessary replacement.

3. Decision making in genetic testing

• Clients who are known case of genetic disorders or client with family history of genetic disorders would go for genetic testing to help identify or reduce the chances of disorders in family members. The advances in genetic testing makes it simple and identify the risk of numerous disorders. However genetics is a field to be explored.
• Genetic testing is costly and adds to the financial burden of the family
• The family might be anxious about the results of genetic testing and may require counseling to help cope with the process of genetic testing

These issues might impact the decision making in genetic testing.