Expert MMI Response #6

In this scenario, my job as a genetic counsellor is to decide if I should reveal the non-paternity results to just Linda or to her and her husband. The issue is that I suspect that Linda nor her husband are aware of the discovery of non-paternity, and this could represent a contentious issue for the family. Also, given that the results of the genetic test reveal important information that the family needs to know, I must articulate the results clearly while minimizing conflict and belligerence. Importantly, withholding information for the sake of avoiding conflict is neither productive nor ethical in this scenario.

The main issue with misattributed paternity is that it seems to challenge physicians to split hairs with the value of truth and the disinclination to potentially harm an otherwise functioning family dynamic. I contend that the idea that the physician has to do any “splitting of hairs” is a misunderstanding, but the increase in the availability of genetic testing makes this conundrum a pressing concern. I also believe that there is a conflict of interest between medical professionals, who must uphold beneficence and due honesty, and clients, who desire a functioning family unit.

In this scenario, I would weigh the pros and cons of disclosure versus non-disclosure. With the former option, I will be duly adhering to the three relevant pillars of medical ethics, namely beneficence, non-maleficence, and justice. With the latter option, the argument in favor states that it is necessary to preserve the functionality and health of the family unit for the sake of the child. I also must respect the father’s point of view, as it’s important for him to understand the implications of not having the genetic mutation that the boy has which could influence his future decisions.

To make an ethical choice, I would immediately reach out to ethical services to discuss the case. With that said, I think that this situation warrants the intervention of the term “medical necessity”. Because both parents will need to know the consequences of their genetic testing results to make healthy choices regarding the prospect of having future children and caring for the one they have, I would disclose the misattributed paternity to Linda in private. That way, I can ensure that Linda can make informed choices for her future parental endeavors, and whether she chooses to disclose that information to her husband is not medically relevant. I would, however, recommend counselling and other resources in the event that she plans to discuss this with her husband. (417 words)

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