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How should we address the inevitable harms from non-negligent variant reclassification in predictive genetic testing?
Journal article   Open access   Peer reviewed

How should we address the inevitable harms from non-negligent variant reclassification in predictive genetic testing?

Misha Rashkin, Kerry Kingham, Karlena Lara-Otero, Meghan Mckenna, Janelle Villiers, Monty Mykolas Worthington and Anya Prince
Journal of genetic counseling, Vol.32(1), pp.18-30
02/2023
DOI: 10.1002/jgc4.1638
PMCID: PMC10092710
PMID: 36260514
url
https://doi.org/10.1002/jgc4.1638View
Published (Version of record) Open Access CC BY-NC V4.0

Abstract

The process of interpreting genetic variants, in which experts use all available evidence to determine whether an identified variant is associated with a current or future disease, is both scientific and nevertheless subjective. In this paper, we summarize the existing evidence that any given variant could be reclassified and that such a reclassification could lead to harm. Furthermore, the racial gap in genetic databases could lead to a higher likelihood of harm for non-white patients. We also review recent legal analyses indicating it is unlikely that an individual who sues for restitution would be successful, especially in the absence of evidence of lab negligence. We then propose a compensation program for medical genetic tests to ensure that individuals who experience demonstrable harm due to a variant reclassification can be made whole financially. We conclude by discussing outstanding questions that must be answered for such a program to be feasible.
Social Sciences Biomedical Social Sciences Genetics & Heredity Health Care Sciences & Services Health Policy & Services Life Sciences & Biomedicine Science & Technology Social Sciences, Biomedical UIOWA OA Agreement

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