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Is Genetic Screening the Right Choice for You or Your Child?


What if a simple cheek swab could tell you if you have ADHD or the potential for another health condition? What if the same swab could collect information that helps you find the right medication and the right dose of that medication without the trial-and-error most people diagnosed with ADHD have to usually go through?

Most people would quickly agree to a helpful and painless genetic screen if it was available. As researchers narrow down the genes or sequence of genes related to ADHD, some people are asking serious questions about the ethics of genetic screening in general.

Already, genetic screens are available for helping healthcare providers select medications that have a greater likelihood of effectiveness for their patients—potentially cutting down on the trial-and-error method of finding the right medication and dose. Most health care professionals are not using them because the wide range of results often still leads to a medication trial of more than one medication. If you are interested in having a genetic screen done, discuss this with your health care providers.

But what about a genetic screen for possible health conditions that a person may have or may develop, including ADHD? Researchers and ethicists are considering the moral and ethical impact these types of screens could have. In an article published in the Journal of Medical Ethics, the authors point out the distrust that our society has had over genetic screening and genetic discrimination in the past. They highlight past fears held by many people that insurance companies may deny coverage to individuals or that employers would not hire people based on the results of genetic screening as well as overall concerns of privacy linked to genetic screening.

The authors also state, “Genetic information is private and is directly related to an individual's identity. Not only is confidentiality an issue for health care, insurance coverage, and employment, but information from a genetic screen can affect an entire family. If the disorder is either genetically dominant or carried by an individual, that person's parents, children, brothers, sisters, and even extended family may also be affected. Furthermore, a person may make life altering decisions based on the results of a genetic screen.”

The authors of The policy and ethical implications of genetic research on attention deficit hyperactivity disorder specifically discussed genetic screenings for ADHD. They believe that the current evidence is not enough to justify genetic screening of individual patients because once the information is available, it could be used negatively where that individual is concerned. They stress that researchers and clinicians who have the information available need to be mindful in how it is interpreted and how the results of a genetic screen are shared.

What factors should you keep in mind when considering genetic screening?

  • Genetic screening cannot determine if a person has ADHD.
  • Genetic screening may be helpful to a prescriber in selecting medications to treat ADHD and related conditions.
  • Genetic screening may reveal information about other conditions that will need to be considered.
  • Stored information could be accessed and acted upon by a third party.
If you are wondering if a genetic screen is an appropriate course of action for you or your loved one, discuss this with your health care professional, who can advise you best based on your personal health needs.

This article appeared in ADHD Weekly on June 16, 2016.
     


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