Re: Liability and Jewish Genetic Diseases
From: art fougner, md (evsono@pipeline.com)
Mon Dec 13 06:24:25 2004
first law of thermodynamics - you can't get more than what you pay for.
art
At Mon, 13 Dec 2004, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote:
>
>How much would a 9 or 10 panel test cost? I had a hard enough time
>selling my base on CF testing alone, let alone doing 9 or 10 tests.
>Granted CF screening is more 'universal' and fewer people would need the
>larger panel, but still it has to be expensive.
>
>Glen
>
>D. Glen Elrod, Maj USAF, MC
>Obstetrician/Gynecologist
>Maternal Child Flight
>48 MDOS/SGOBO
>UNIT 5210 Box 23
>APO, AE 09464
>DSN (314) 226-8334
>Comm 01638-52-8334
>
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>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Gary
>Sent: Saturday, December 11, 2004 5:41 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Liability and Jewish Genetic Diseases
>
>I am making up a presentation on genetic screening and want to clarify
>screening for prenatal/preconception genetic disorders that are common
>in Eastern European (Ashkenazi) Jews.
>
>ACOG has recently come out with a committee opinion (#298) that
>recommends routine screening of Ashkenazi Jewish couples contemplating
>pregnancy or pregnant for 4 recessive genetic disorders (Tay Sachs,
>Canavan disease, cystic fibrosis and the recently added familial
>dysautonomia).
>
>They also mention that screening is readily available for 5 other
>diseases: Gaucher type I, Fanconi anemia group C, mucolipidosis IV,
>Bloom syndrome and Nieman-Pick type A. They don't outright
>recommend the 9 panel test and don't comment about the liability risk
>of not performing the 9 panel test.
>
>Other labs have added other screens, including glycogen storage disease
>1b.
>
>A recent article in the NY Times suggested an increased risk of not
>offering other diseases that are more common in Jewish patients such as
>hereditary deafness from connexin 26 abnormalities.
>
>See:
>http://mcdb.colorado.edu/courses/4410/papers/nytimes_genet_test2.pdf
>
>I would assume that in order to avoid the risk of malpractice suits we
>are obligated to do the following:
>
>1. Screen couples with one partner who is Jewish for at least 9 (or
>possibly 10) common recessive disorders in the "Jewish panels"
>2. Test any couple with a Jewish partner because it is difficult to
>tell an Ashkenazi Jew from a Sephardic (Southern
>European/Mediterranean) Jew.
>3. A family history should be obtained and a discussion with these
>patients (or brochures) should offer screening for diseases that are
>commonly found in Jews but not part of standard screening panels.
>4. Formal genetic counseling be offered when any complex issue arises.
>
>Does this seem correct? Is it practical? Would anyone have any
>suggestions to facilitate screening? Any lawyers or law students care
>to comment?
>
>Thanks for your reply.
>
>Gary Kleinman, MD
>Bridgeport, CT
--
art fougner, md
ich bin ein New Yorker
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