Deck 27: Ethical, Legal, and Social Issues

Question 1

Which of the following should be included in genetic pretest education?

A) Limitation in available genetic test and interventions.
B) Implications of the test results for the patient and family members.
C) Limitations of confidentiality and possible discrimination.
D) All of the above.

Answer 1

D
Explanation: Patients should be made aware of limitations in available genetic testing and interventions, confidentiality and possible discrimination, and the implications of test results for themselves and their family members. Informed consent is crucial when preparing for genetic testing with patients.

Question 2

As a primary care provider, before ordering genetic testing, it is important to do which of the following?

A) Obtain consent from state health department.
B) Obtain detailed family history and confirm the diagnosis.
C) Establish a wide differential to ensure sensitivity.
D) Primary care providers should not order genetic testing.

Answer 2

B
Explanation: Obtaining a detailed family history to confirm the diagnosis is the most important step for primary care providers to take prior to ordering genetic testing.

Question 3

A 36-year-old female reported to your office with concerns of a family history of breast cancer. After proper counseling and investigation, the patient agreed to have genetic testing performed. Today her results have been sent to your office and show that she is possibly at a higher risk for breast cancer. How should you share the results with your patient?

A) Electronic communication (email, text message, facsimile).
B) Phone conversation with a medical assistant present to witness and document.
C) Written document mailed to the primary address provided by patient.
D) In person during a follow up visit.

Answer 3

D
Explanation: Results of genetic testing should always be shared in person during a follow up visit with the patient.

Question 4

Genetic testing for mutations that may influence disease susceptibility is best suited for what patient population?

A) All patients with signs and symptoms suggestive of disease.
B) All family members regardless of environmental risk.
C) Relatively few patients with known high-risk factors.
D) Only patient currently receiving treatment for suspected disease.

Question 5

Which of the following is not considered a benefit of genetic testing?

A) Provides opportunity for discrimination.
B) Provides opportunities for increased surveillance.
C) Provides knowledge that may affect future decisions.
D) Provide opportunities for early intervention.

Question 6

During a follow up visit, while providing post-test counseling, your patient asked "Do these negative results guarantee I will not develop this disease?" What is the best response?

A) The results represent a high level of accuracy.
B) The results represent a high level of precision.
C) The results represent only a probability.
D) The results represent only family members risk, and not the risk of the individual being tested.

Question 7

A 16-year-old male presents to your office with his mother for a second opinion. He states that after having several occurrences of rectal bleeding, his primary care provider ordered a colonoscopy. The colonoscopy revealed no polyps. At a follow-up visit the primary care provider ordered genetic screening for familial adenomatous polyposis (FAP), which showed no mutation in APC gene. Which of the following statements best represent the patient's risk of developing FAP?

A) Patient has no risk of developing FAP now or in the future.
B) The patient is at no risk however his sons should be screened at an early age.
C) The risk for developing FAP is the same any other male without known family history or known APC mutations.
D) The patient will likely develop FAP and should have genetic testing annually.

Question 8

What is the primary problem with state legislation meant to protect the rights of patients undergoing genetic testing?

A) Regulation has become so strict, it prevents adequate screening
B) The legal definition of "genetic information" is limited and provides legal loopholes.
C) The legal definition of testing is strictly defined and limits the number of tests available.
D) The increased policy regulation has significantly increased the cost of genetic testing.

Question 9

A 44-year-old female received genetic testing that revealed a positive BRCA2 mutation. The patient's sister received a phone call two months later from her employer stating that due to a family member's recent lab results, she would be ineligible for promotion. Which of the following laws have been violated?

A) GINA (Genetic Information Nondiscrimination Act)
B) HIPAA (Healthcare Insurance Probability and Accountability Act)
C) ADA (Americans with Disabilities Act)
D) A and B

Question 10

The Genetic Information Nondiscrimination Act (GINA) does not offer protection in which of the following?

A) Life insurance policy
B) Disability insurance policies
C) Long-term care policies
D) All the above