About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline

LOG IN
LOG IN


7 Health L.J. 49 (1999)
Re-Framing the Discussion: Commercial Genetic Testing in Canada

handle is hein.journals/hthlj7 and id is 53 raw text is: Re-Framing the Discussion: Commercial Genetic Testing in Canada Bryn Williams-Jones* A. Introduction Private access to genetic services' must be viewed as a possibility in discussions about the provision of genetics services in Canada. The question of whether private access should be allowed (or whether it should be prohibited) is in some sense moot given that genetic tests can already be purchased by Canadians through U.S. and European sources (e.g. Myriad's Breast Cancer test2 and University Diagnostics Ltd's cystic fibrosis test3). But more importantly, it is not obvious that private access should be restricted. While there are certainly concerns about the potential for social and psychological harm to Canadians, and the public health care system, these potential harms have not been fully explored or tested. Moreover, people use health care services such as genetic testing in ways that challenge the clinical view of how services should be used, and thus force us to reconsider where these services fit in our model of public health care. The discussion of whether private access should be permitted, i.e., whether it is good or bad, must be re-framed - the focus must be on how best to integrate commercial genetic services with the Canadian health care system. This means asking questions about the nature of genetic services to determine what they are for and who should provide them to whom. 'Bryn Williams-Jones is a PhD student and Graduate Research Associate at the Centre for Applied Ethics, University of British Columbia, Vancouver, B.C. The author would like to thank Dr. Chris MacDonald, Dalhousie University, for his valuable comments and suggestions on drafts of this essay. This work was supported by a Social Sciences and Humanities Research Council Doctoral Fellowship. 'Genetic services include a wide variety of services, ranging from prenatal testing, DNA fingerprinting, and carrier screening, to genetic counselling and gene therapy. For the purposes of this paper, genetic services will refer primarily to genetic testing and counselling. Further, by genetic testing I do not mean to include prenatal testing or diagnosis, DNA finger printing, or paternity testing; it will only refer to susceptibility testing, where an individual is tested for a specific gene or set of genes that incurs increased risk or susceptibility to disease. 2M. Wadman, Ethical Terms Set for Breast Cancer Test (1997) 390 Nature 324; M.J. Malinowski & R.J.R. Blatt, Commercialization of Genetic Testing Services: The FDA, Market Forces, and Biological Tarot Cards (1997) 71:4 Tulane L. Rev. 1211 at 1214. See also Myriad Genetics' website <http://www.myriad.com/gt.html>. 3P.S. Harper, Direct Marketing of Cystic Fibrosis Carrier Screening: Commercial Push or Population Need? (1995) 32 J. Med. Genet. 249; S. Farrell, Screen Yourself by Mail Order The Times (24 September 1997) 6 at <http://www.the-times.co.uk/news/pages/tim/97/09/24/timnwsnwsOl010. html?000999>; M. Kirk, Commercial Gene Testing: The Need for Professional and Public Debate (1997) 6 British J. Nurs. 1043 at 1043. See also UDL's website <http://www.udlgenetics.conmcf.html>.