Hastings Law J. 2013 Aug 1;64(6):1650-1664.
Seeking Genomic Knowledge: The Case for Clinical Restraint.
Author information
1Professor and Chair of Bioethics and Humanities at the University of Washington. Dr. Burke received her doctorate in genetics and a medical degree from the University of Washington.
2Research Scientist in the Department of Bioethics and Humanities at the University of Washington. Ms. Trinidad holds a master's degree from the Interdisciplinary Program in Health and Humanities at Michigan State University.
3Professor of Pediatrics, Professor of Law, and Co-Founder of the Center for Biomedical ethics and Society at Vanderbilt University. Dr. Clayton received her law degree from Yale Law School and her medical degree from Harvard Medical School.
Abstract
Genome sequencing technology provides new and promising tests for clinical practice, including whole genome sequencing, which measures an individual's complete DNA sequence, and whole exome sequencing, which measures the DNA for all genes coding for proteins. These technologies make it possible to test for multiple genes in a single test, which increases the efficiency of genetic testing. However, they can also produce large amounts of information that cannot be interpreted or is of limited clinical utility. This additional information could be distracting for patients and clinicians, and contribute to unnecessary healthcare costs. The potential for genomic sequencing to improve care will be context-dependent, varying for different patients and clinical settings. This Article argues that a disciplined approach is needed, incorporating research to assess when and how genomic information can improve clinical outcomes, practice guidelines that direct optimal uses of genomic sequencing, and efforts to limit the production of genomic information unrelated to the clinical needs of the patient. Without this approach, genomic testing could add to current unsustainable healthcare costs and prove unaffordable in the long run.
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