Ethical, social, and legal dimensions of screening for human genetic disease / editor, Daniel Bergsma ; Genetics Research Group of the Institute of Society, Ethics and the Life Sciences.
- Date:
- 1974
Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Credit: Ethical, social, and legal dimensions of screening for human genetic disease / editor, Daniel Bergsma ; Genetics Research Group of the Institute of Society, Ethics and the Life Sciences. Source: Wellcome Collection.
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![ISSUES OF LAW/PUBLIC POLICY 61 rely on this expectation, the screening agency has a duty to disclose. In other words, the principles derived from the law on the physician-patient relationship lead to the same conclusion as those of the general law of contracts. Where a screening program is conducted not by physicians but entirely by laymen, the duty to disclose a positive result would likely be held to arise also from the same source as in the context of the physician-patient relationship — reasonable expectations and reliance on the part of the individual screened. The lay screener's obligations are not determined by the physician-screener's, since both the duty of the latter to make full disclosure and his quahfied right to withhold information are based on his medical role and expertise and on the trust the patient places in him as a physician. Thus, in such circumstances, reference has to be to the implicit or explicit terms of the agreement between screener and screenee. Insofar as the only purpose of testing is the ascertainment of information on which the screenee may then rely in making decisions about medical treatment or about whether to have children, it seems probable that if a screenee suffers damages because the screener failed to inform him of a positive result, the screener will be held Hable. Situations could arise in which the screener would believe he had good reasons not to disclose, but he would bear a very heavy burden of justifying his action if challenged. A further area where the problem of disclosure may possibly arise is genetic testing carried out during, for instance, the course of a hospital stay or as one of a number of tests in a cUnic or doctor's office. If such testing is done without the patient's knowledge of either its nature or the result, the question of the screener's liability for nondisclosure would also most Hkely be decided in favor of the screenee if he is able to show that injury resulted from his reasonable reliance on those responsible for his physical and medical care to inform him completely about any matters concerning his health. Thus, both physicians^^ and employers who had their employees examined medically have been held liable for failure to disclose information, such as a chest x ray being positive for tuberculosis. As in the case of a physician, although a private agency may have no duty to screen, once it undertakes the test and knows the results it will be Hable for failing to disclose them since [b]y remaining silent, it permits the screenee to rely upon a tacit assurance of safety despite its knowledge of the existence of danger.^ ^ In sum, where the person screened has a justifiable expectation that he will be informed of any positive results, then there is a duty on the screener (ie physician, layman or private agency) to disclose the](https://iiif.wellcomecollection.org/image/B18035966_0072.JP2/full/800%2C/0/default.jpg)
