Question

Abby is a 33-year old, married Roman Catholic woman who has received successful treatment for melanoma. While at the cancer center, she gave her consent to use her tissue samples in a research protocol in which researchers scrutinized chromosomes most frequently involved in rearrangements of melanoma cells. While visually inspecting Abby’s tissue sample, a researcher discovered a translocation or mutation between two other chromosomes. The mutated chromosomes were not among those the researcher had specific authorization to examine, in accord with the informed consent form Abby had signed. According to the researcher’s description of the situation, the aberration is not directly responsible for the initiation of melanoma. Whether the aberration is a factor in promoting tumor growth or tumor metastasis remains a question. However, with such a genetic abnormality, Abby, if she became pregnant, has a 50% chance of spontaneous miscarriage, a 25% chance of delivering a severely deformed child, and a 25% chance of a healthy child. Moreover, her viable offspring risk carrying the same abnormality. Unsure whether to tell Abby about these findings, the researcher contacts Abby’s primary oncologist (who has a longstanding relationship with her) as well as the Ethics Consultation Service.

4. An ethically supportable recommendation in this case is:

a)Abby should not be told because the researcher has no right to the knowledge of the existence of the mutation.

b)The researcher should inform Abby that he unexpectedly learned something about her genes that may have implications for childbearing and allow her to decide if she wants more information.

c)The researcher and Abby’s primary physician should meet with Abby and her husband and relay the information in a very sensitive way.

d)Abby should not be told because she may decide she should not try to conceive because of this information, and she still has a 25% chance of bearing a healthy child.

Answer 1

1)c)The researcher and Abby’s primary physician should meet with Abby and her husband and relay the information in a very sensitive way

Unsure whether to tell Abby about these findings, the researcher contacts Abby’s primary oncologist as well as the Ethics Consultation Service. So by Weighing the benefits and burdens of treatment or identifying which treatment is right for each patient so in this case reviewing the patient’s medical record, meeting with the patient and family and facilitating discussions among caregivers and family. Members of the Ethics Consultation Service are available to consult with patients, families and staff who face serious decisions about appropriate treatment and care.The researcher and Abby’s primary physician should meet with Abby and her husband and relay the information in a very sensitive way.