Question

A 35 -year-old female patient comes to your office with a large form to be filled out certifying that her health is within normal limits. This is as a part of pre-employment evaluation and is required in order for the patient to get the job. The form also asks for the results of the patient's APC (adenomatous polyposis coli) gene. This is in order for the company to determine which of its long-term employees will need expensive care. What should be your response? a. Perform the test. b. Perform the test, but do not share the results with the employer. c. Do not perform the test. d. Ask the patient if she wants the test performed and the results reported. e. Perform the colonoscopy; the employer is entitled to know about current health problems but not future ones. f. Include the test only if the patient has family members with colon cancer. 

   A 35 -year-old female patient comes to your office with a large form to be filled out certifying that her health is within normal limits. This is as a part of pre-employment evaluation and is required in order for the patient to get the job. The form also asks for the results of the patient's APC (adenomatous polyposis coli) gene. This is in order for the company to determine which of its long-term employees will need expensive care. What should be your response?
a. Perform the test.
b. Perform the test, but do not share the results with the employer.
c. Do not perform the test.
d. Ask the patient if she wants the test performed and the results reported.
e. Perform the colonoscopy; the employer is entitled to know about current health problems but not future ones.
f. Include the test only if the patient has family members with colon cancer.
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Medical Ethics for the Boards
Medical Ethics for the Boards
Conrad Fischer 3rd Edition
Chapter 1, Problem 22 ↓

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Consider the potential consequences for the patient, including discrimination or loss of job opportunities based on genetic predisposition.  Show more…

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A 35 -year-old female patient comes to your office with a large form to be filled out certifying that her health is within normal limits. This is as a part of pre-employment evaluation and is required in order for the patient to get the job. The form also asks for the results of the patient's APC (adenomatous polyposis coli) gene. This is in order for the company to determine which of its long-term employees will need expensive care. What should be your response? a. Perform the test. b. Perform the test, but do not share the results with the employer. c. Do not perform the test. d. Ask the patient if she wants the test performed and the results reported. e. Perform the colonoscopy; the employer is entitled to know about current health problems but not future ones. f. Include the test only if the patient has family members with colon cancer.
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Key Concepts

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Informed Consent
Informed consent requires that patients are fully educated about the nature and implications of any medical procedure or test before agreeing to it. This concept underscores that genetic testing should only occur with the patient’s explicit, voluntary approval, and only when it is medically justified, ensuring the patient understands potential consequences and privacy issues.
Genetic Nondiscrimination Laws
These laws, such as the Genetic Information Nondiscrimination Act (GINA), protect individuals from discrimination based on their genetic information. They prohibit employers from requesting, using, or requiring genetic test results in making employment decisions. This concept is central to understanding why genetic testing should not be performed as part of a pre-employment evaluation when it is not medically indicated.
Patient Confidentiality
Patient confidentiality is a core principle of medical ethics that obligates healthcare providers to safeguard and protect the patient’s personal and sensitive information. It emphasizes that details regarding a patient’s genetic makeup or any other health information should not be disclosed to third parties, such as employers, without proper consent.
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