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Genetic screening and genetic
         counselling




                            ALBIO9700/2006JK
• Genetic screening : the testing of
  samples of DNA from a group of people to
  identify the presence or absence of
  particular alleles and thus the risk of
  having or passing on particular genetic
  conditions
  – Carrier screening
    • All the individuals in a family may be screened if
      one family member develops a particular condition
      that may be genetic
    • Potential parents may be screened where there is
      the possibility that one or both of them might carry
      a recessive allele for some particular condition
      (cystic fibrosis)
                                                    ALBIO9700/2006JK
– Prenatal screening – determine the genetic makeup of
  unborn child
   • Chromosomal abnormalities, Downs syndrome (especially if
     mother is over 34), trisomy 13 and trisomy 18
   • Single gene disorders, haemophilia, sickle cell anaemia and
     cystic fibrosis
   • Neural tube defects, spina bifida and anencephaly
   • Prenatal screening includes:
      – Chorionic villus sampling – where the early placental tissue is
        sampled (at 10-12 weeks of pregnancy)
      – Amniocentesis – where fetal cells in amniotic fluid are sampled
        (13-18 weeks)
      – Intra-uterine blood test – where fetal blood is sampled (16-18
        weeks)
– Newborn screening – newborn babies screened for
  phenylketonuria (PKU) by a simple blood test enables
  the affected individual to be put onto a protective diet

                                                               ALBIO9700/2006JK
• Genetic counselling : involves an explanation
  of the results of genetic screening and the
  implications in terms of probabilities, dangers,
  diagnosis and treatment
  – For the individual – to explain the possible future
    consequences in terms of health of the individual and
    whether this is likely to have repercussions on their
    education and employment and even prospects of
    obtaining insurance
  – For the couples who want to have children – to
    explain what the probabilities are of any children
    inheriting the defective allele and the chances of any
    child actually having the disease (depending on allele
    being dominant, recessive or sex-linked)

                                                    ALBIO9700/2006JK
• Ethical considerations :
  –   Who decides who should be screened or tested?
  –   Which specific disorders should be screened?
  –   Who should be providing the screening?
  –   Should we screen or test for disorders for which there
      is no known treatment or cure?
  –   What psychological impact might the results have on
      the individuals involved?
  –   Should the results be confidential?
  –   If not, who should be able to have access to the
      information?
  –   Should the results be made available to potential
      employers, insurers etc.?

                                                       ALBIO9700/2006JK
• Ethical considerations :
  –   Who decides who should be screened or tested?
  –   Which specific disorders should be screened?
  –   Who should be providing the screening?
  –   Should we screen or test for disorders for which there
      is no known treatment or cure?
  –   What psychological impact might the results have on
      the individuals involved?
  –   Should the results be confidential?
  –   If not, who should be able to have access to the
      information?
  –   Should the results be made available to potential
      employers, insurers etc.?

                                                       ALBIO9700/2006JK

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06 Genetic Screening and Genetic Counselling

  • 1. Genetic screening and genetic counselling ALBIO9700/2006JK
  • 2. • Genetic screening : the testing of samples of DNA from a group of people to identify the presence or absence of particular alleles and thus the risk of having or passing on particular genetic conditions – Carrier screening • All the individuals in a family may be screened if one family member develops a particular condition that may be genetic • Potential parents may be screened where there is the possibility that one or both of them might carry a recessive allele for some particular condition (cystic fibrosis) ALBIO9700/2006JK
  • 3. – Prenatal screening – determine the genetic makeup of unborn child • Chromosomal abnormalities, Downs syndrome (especially if mother is over 34), trisomy 13 and trisomy 18 • Single gene disorders, haemophilia, sickle cell anaemia and cystic fibrosis • Neural tube defects, spina bifida and anencephaly • Prenatal screening includes: – Chorionic villus sampling – where the early placental tissue is sampled (at 10-12 weeks of pregnancy) – Amniocentesis – where fetal cells in amniotic fluid are sampled (13-18 weeks) – Intra-uterine blood test – where fetal blood is sampled (16-18 weeks) – Newborn screening – newborn babies screened for phenylketonuria (PKU) by a simple blood test enables the affected individual to be put onto a protective diet ALBIO9700/2006JK
  • 4. • Genetic counselling : involves an explanation of the results of genetic screening and the implications in terms of probabilities, dangers, diagnosis and treatment – For the individual – to explain the possible future consequences in terms of health of the individual and whether this is likely to have repercussions on their education and employment and even prospects of obtaining insurance – For the couples who want to have children – to explain what the probabilities are of any children inheriting the defective allele and the chances of any child actually having the disease (depending on allele being dominant, recessive or sex-linked) ALBIO9700/2006JK
  • 5. • Ethical considerations : – Who decides who should be screened or tested? – Which specific disorders should be screened? – Who should be providing the screening? – Should we screen or test for disorders for which there is no known treatment or cure? – What psychological impact might the results have on the individuals involved? – Should the results be confidential? – If not, who should be able to have access to the information? – Should the results be made available to potential employers, insurers etc.? ALBIO9700/2006JK
  • 6. • Ethical considerations : – Who decides who should be screened or tested? – Which specific disorders should be screened? – Who should be providing the screening? – Should we screen or test for disorders for which there is no known treatment or cure? – What psychological impact might the results have on the individuals involved? – Should the results be confidential? – If not, who should be able to have access to the information? – Should the results be made available to potential employers, insurers etc.? ALBIO9700/2006JK