Strategies in genetic counseling: Reproductive genetics and new technologies. National Education Conference, 1990.
Explore the source record for details and available documents.
Genetic Counseling↗
SEARCH · Search PubMed
Results for “Genetics and Reproduction”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Religious belief, perceptions of human suffering, and support for reproductive genetic technology.
Reproductive genetic technologies are becoming more controversial as they become more ubiquitous. The opponents of these technologies are largely religious groups, a fact that leads to the question of why religious groups would be more opposed to these technologies than others. Since all of these technologies are justified by their ability to relieve suffering of some kind, it is hypothesized that the actively religious have a notion of suffering different from that of advocates for these technologies, and this different notion of suffering leads to opposition to the technologies. In this article I report on a qualitative interview study of the religiously active in the United States. I find that the religiously active do have views of suffering that are distinct from the medical consensus, and these views are related to people's conclusions about the advisability of reproductive genetic technologies.
Genetic Testing↗
Law and policy in the era of reproductive genetics.
The extent to which society utilises the law to enforce its moral judgments remains a dominant issue in this era of embryonic stem cell research, preimplantation genetic diagnosis, and human reproductive cloning. Balancing the potential health benefits and diverse moral values of society can be a tremendous challenge. In this context, governments often adopt legislative bans and prohibitions and rely on the inflexible and often inappropriate tool of criminal law. Legal prohibitions in the field of reproductive genetics are not likely to reflect adequately the depth and diversity of competing stakeholder positions. Rather, a comprehensive and readily responsive regulatory policy is required. Such a policy must attend to the evolving scientific developments and ethical considerations. We outline a proposal for effective, responsive, and coherent oversight of new reproductive genetic technologies.
Attitude to Health↗
Human in vitro fertilization in a private program: Reproductive Genetics in Vitro, P.C.
Reproductive Genetics in Vitro, P.C., began a program of human in vitro fertilization in a private practice setting in September of 1982, after nearly 1 year of preparation prior to the cycling of the first patient. Ovarian stimulation is most often by Clomid, 50 mg tid, on days 3 through 9 of the cycle. Follicle development is monitored by daily ultrasound, estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) measurements. Serum progesterone measurements are made the last few days prior to anticipated ovulation to detect early signs of luteinization. In the first phase of our program 12 patients with pure tubal obstruction have had one or more oocytes retrieved by laparoscopy. All oocytes fertilized such that every patient who had oocytes retrieved had embryos placed in the uterus. Of the first 12 patients who had embryo placement, 2 are ongoing and normal in the second trimester of pregnancy, with delivery expected shortly after the first issue of this journal. Five others showed early signs of clinical pregnancy as indicated by acentrically located gestational sacs (as opposed to the typical centrally located pseudogestational sac) or transiently elevated human chorionic gonadotropin (HCG).
Adult↗
Access to reproductive genetic services for low-income women and women of color.
This article examines access to reproductive genetics services for low-income women and women of color. It explores implications of the use of reproductive technologies; access and barriers to general prenatal care and its impact on accessing reproductive-genetic services; the implications of obtaining reproductive genetic services through public programs and funding, especially as they relate to equal provision of services. The traditional barriers to reproductive-genetics services; the decision-making process involved in genetic counseling when Caucasians dominate the process of counseling people of color; financial/insurance barriers to care for low- and moderate-income clients are also addressed. Recommendations are made to address the problems and inequities.
Abortion, Eugenic↗
Ethical issues in reproductive genetics.
Because of technological developments in reproductive genetics, couples now have many options not available a decade ago. Some developments are controversial and deeply divide our society. This article examines some of these issues and establishes guidelines of approach.
Confidentiality↗
Reproductive genetics 1991-2002: a selected annotated legal bibliography of genetic testing, gene transfer and reproductive cloning.
Explore the source record for details and available documents.
Cloning, Organism↗
Regulatory approaches to reproductive genetic testing.
This report analyses the ethical and legal aspects of reproductive genetic testing in 11 countries (Australia, Austria, Canada, France, Germany, India, Israel, Japan, The Netherlands, Switzerland and the UK). The legal status of reproductive genetic testing in the countries under analysis is difficult to generalize due to the different regulatory systems adopted. These approaches are a reflection of the legal traditions and cultural and socio-religious beliefs which inform and shape public policy on assisted reproductive technologies and genetic testing. We divide approaches into two groups: public ordering (legislative, top-down approach) and private ordering (non-legislative, bottom-up approach). Even limiting our analysis to a number of countries that span the range from restrictive to pragmatic approaches, there is remarkable symmetry in both the (i) substantive requirements (i.e. gravity, health indications generally) and (ii) procedural safeguards (i.e. informed consent, counselling, confidentiality, civil status, oversight and accreditation) surrounding reproductive genetic testing. Indeed, irrespective of whether a country adopts a prohibitive or a permissive approach through legislation or self-regulation or a mix of both, the ultimate decision is--and should continue to be--a medical one. Nowhere is this more evident than in the substantive requirements.
Confidentiality↗
Creating a stem cell donor: a case study in reproductive genetics.
During the nearly 10 years since its introduction, preimplantation genetic diagnosis (PGD) has been used predominantly to avoid giving birth to a child with identified genetic disease. Recently, PGD was used by a couple not only to test IVF-created embryos for genetic disease, but also to test for a nondisease trait related to immune compatibility with a child in the family in need of an hematropoetic stem cell transplant. This article describes the case, raises some ethical and policy issues, highlights gaps in U.S. policy, and finally makes some recommendations for addressing advancing genetic and reproductive technologies.
Advisory Committees↗
Reproductive genetic testing from an international perspective: impact on women in underdeveloped countries.
The impact of reproductive genetic testing (preconceptional and prenatal screening for genetic diseases) on women in the third world must take into account the many aspects that characterize underdevelopment: poverty; little access to education; housing; adequate nutrition; health services, and other. In these countries women usually suffer from male domination in a number of aspects of their lives, including reproduction. Illiteracy is high, particularly among women. Infant mortality and fertility rates are high, and the primary causes of death are infectious diseases and malnutrition. Health services are poorly organized, and family planning and prenatal care programs are deficient. Although abortions are illegal, they outnumber live births 3:1. Maternal mortality is 10-100 times higher than in industrialized nations, and complications of illegal abortions are one of its main causes. This description applies to the majority of the population and contrasts with that of the small segment of well-to-do upper classes, who have access to education, housing and health services that include family planning, prenatal care and reproductive genetic testing. By and large, all main cities count with clinical genetic centers. The illegality of abortion, however, makes prenatal testing in the public sector a difficult task, while in the private sector quality control is an unheard concept and the patients frequently fall victims of the entrepreneurial and commercial goals of the providers. For the majority of the population, the impact of reproductive genetic testing is almost nil, simply because the services are not available.(ABSTRACT TRUNCATED AT 250 WORDS)
Delivery of Health Care↗
Reproductive genetics, gender and the body: 'please doctor, may I have a normal baby?'.
This paper's purpose is to highlight key sociological issues, that come to light when 'the body' becomes a theoretical site in reproductive genetics. By positioning the body as a central feature in this analysis, the paper: (1) describes how a mechanistic view of the body continues to be privileged in this discourse and the effects of this view; (2) examines how reproductive limits are practised on the gendered body through a feminised regime of reproductive asceticism and the discourse on shame; and (3) explores the social effects and limitations of reproductive genetics in relation to disability as a cultural representation of impaired bodies. The central assumption concerning reproductive genetics are that it appears within surveillance medicine as a part of a disciplinary process in society's creation of a genetic moral order, that it is mobilised by experts for the management of reproductive bodies and that it constructs a limited view of the body. Thus, the way reproductive genetics operatives tends to hide the fact that what may appear as 'defective genes' is a result of a body's interaction not only with the environment but also gendered social practices valorised by difference as well as rigid definitions of health and illness. The research is from a 1995-96 European study of experts interviewed in four countries.
Attitude of Health Personnel↗
Reproductive genetic testing and eugenics.
The situation concerning reproductive genetic testing in Switzerland is briefly described. Growing awareness of eugenic implications especially by women is reported. This is also true for all the other German-speaking countries in Europe to a higher extent than in the other European countries. Better professional education and public information are required.
Attitude↗
Reproductive genetic testing: implications for nursing education.
Reproductive genetic testing technologies are expanding at an exponential rate. Nurses are increasingly being called upon to provide these services to women. This paper discusses the status of nursing education in genetics and identifies immediate needs for nurses in order to be adequately prepared to respond to these increased demands. The future role of nurses in providing genetic services is delineated.
Education, Nursing↗
Reproduction, genetics and the law.
Both reproductive medicine and genetics are seeing rapid, and in some instances revolutionary, medical and scientific advances. Courts have been called upon to resolve a variety of novel disputes arising from these areas, and more can be anticipated as these technologies continue to develop and their use becomes more widespread. This article discusses some of the most relevant areas of the law and litigation that currently bear on reproduction and genetics or that may be anticipated to do so in the future. Specific developments and judicial decisions addressing them include: legal theories of wrongful birth and wrongful life and their application to children born with genetic impairments; a physician's duty to warn family members about a relative's genetic disease; disputes over reproductive materials and non-reproductive cells and tissues; unauthorized genetic testing in the workplace; and genetic discrimination. It is hoped that this discussion will be of value to medical and legal professionals and policy makers who work with these concepts in the increasingly inter-related fields of law and medicine.
Abnormalities, Multiple↗
Reproductive genetics: Canadian and European perspectives.
Unlike medically assisted conception, the issue of the impact on women of reproductive genetic testing has been characterized by the emergence of a more 'relativist' position. This relativist position is grounded in the understanding of the universality of problems arising from human genetics. An analysis of the major reports emanating from different European countries will demonstrate that the discussion regarding the impact of medically assisted conception and reproductive genetic testing on women is often incidental and secondary. There are similarities and differences in the issues raised in the evaluation of both these technologies. Similarities, in their experimental character, the concomitant social pressure, the myth of the perfect child and the increased medicalization. Differences, in the inherent responsibility or guilt accompanying genetic testing, the timing of choices, the possibility of sex selection, the use and control of genetic information, the sense of intergenerational responsibility and the current qualification of such genetic testing as medical and diagnostic as opposed to a technology of 'convenience' as was often the case with the treatment of infertility. In contrast to the European reports, the work of the Canadian Royal Commission on New Reproductive Technologies has as its primary focus the impact of both these technologies on women, children and society.
Abortion, Eugenic↗
Reproductive genetic testing and the ethics of parenting.
This paper examines whether and to what extent parents are morally bound to seek reproductive genetic testing. It is concluded that, with rare exceptions, there is no requirement in parenting to seek or accept reproductive genetic testing if the only actions facilitated by such testing are abortion, selective conception or remaining childless. Commitments to other family members or to oneself can provide other, morally or prudentially compelling reasons to elect genetic testing and selective abortion in these circumstances.
Abortion, Eugenic↗
Exploring the discourse between genetic counselors and Orthodox Jewish community members related to reproductive genetic technology.
OBJECTIVE: Genetic technology is complex, relatively new and involves sensitive issues pertaining to personhood and reproduction. While ethno cultural barriers to genetic care are well documented, little attention has been devoted to understanding religious beliefs pertaining to genetic services. This study evaluated the discourse between genetic counselors and Orthodox Jewish community members' perceptions of reproductive genetic technology. METHODS: A cross section of the Orthodox Jewish community was sampled through purposeful and snowball recruitment for in-depth interviews with key informants. RESULTS: Genetic counselors felt apprehensive about serving the Orthodox Jewish population and were unaware of social norms, religious and cultural practices unique to this population. Similarly, Orthodox Jewish consumers exhibited major misgivings about genetic testing. Importantly, stereotypic expectations by both counselors and consumers exacerbated existing communication difficulties. CONCLUSION: Cultural differences and poor communication between genetic counselors and Orthodox Jewish community members impeded the ability of the Orthodox Jewish community to utilize genetic services. PRACTICE IMPLICATIONS: This work illuminates complex issues pertaining to medical encounters between providers and patients with ideological, social and cultural differences. In particular, issues of access to care and transcultural competence in serving religious minority groups, such as Orthodox Jews are presented. On the whole, this group is largely unrecognized in the minority health literature in spite of barriers and challenges that they face. Findings of this study may have application to other cloistered and highly observant religious groups when dealing with reproductive technology and other populations with diverse values, beliefs and behaviors pertaining to reproductive health.
Attitude of Health Personnel↗
Reproductive genetic services in rural Oklahoma.
The system of reproductive care as it relates to genetic services for women in rural Oklahoma is addressed. Description of reproductive services and genetic reproductive services for rural women is described and barriers to accessing reproductive genetic care are identified. The barriers and any progress that has been made in breaking these barriers will be described under four general categories: (1) financial barriers; (2) system capacity barriers; (3) organizational practices and atmosphere of services, and (4) cultural, personal and other system barriers.
Culture↗