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2002, Number 1

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Salud Mental 2002; 25 (1)

El diagnóstico predictivo genético y sus implicaciones

Rasmussen A, Alonso E

Language: Spanish
References: 23
Page: 9-13
PDF size: 49.90 Kb.


ABSTRACT

Predictive genetic testing is a procedure performed on asymptomatic individuals known to be at risk for developing a hereditary disorder. This kind of test has led to unexpected ethical, social and medical dilemmas. The major advantages of the procedure are to put an end to uncertainty and to offer the opportunity of making informed decisions for the future, while its disadvantages are adverse psychological responses, including suicidal risk, social, familial or employment discrimination and, in many cases, lack of curative or preventive strategies for the disease. One of the most relevant issues for the success of a predictive testing program, is its adequation to the solicitors socio- cultural millieu.
Predictive testing has had a major impact on hereditary neurodegenerative diseases, familial cancer syndromes and prenatal testing. Predictive genetic testing is not to be offered to minors, except in the case of diseases at an early age of onset, for which preventive strategies are available, as is the case of some familial cancer syndromes.
In general terms, individuals that have undergone this kind of testing consider it was a good choice, and the rate of catastrophic events (suicide or attempted suicide) is relatively low: 0.97%.
As an answer to these problems, multidisciplinary protocols have been delineated underscoring the relevance of protecting the tested individual and creating uniform guidelines to offer the test. The prototype for this kind of protocols is the one created for the predictive testing of Huntington’s disease, which is a late-onset hereditary neurodegenerative disorder. Among the most important strategies lies genetic counseling, both before and after the test is performed, which should be considered as an active communication process between the patient and his counselor. The other essential part of the protocol is the psychological and psychiatric support the testee receives both before and after the test.
The decision of undergoing predictive testing pertains to each individual in free and autonomous conditions, since he is the only owner of his genome.


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