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Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice
Authors:Gabriel Lázaro-Muñoz  John M. Conley  Arlene M. Davis  Marcia Van Riper  Rebecca L. Walker  Eric T. Juengst
Affiliation:1. University of North Carolina School of Medicine;2. University of North Carolina School of Law;3. University of North Carolina School of Nursing
Abstract:Advances in genomics have led to calls for developing population-based preventive genomic sequencing (PGS) programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the sequencing or analysis of specific genomic conditions (the menu approach) or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations.
Keywords:decision making  genetics (clinical)  informed consent  law  medical humanities  public health
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