Current Challenges to Appropriate Clinical Use of New Genetic Knowledge in Different Countries

Abstract

Objective: To describe the challenges facing countries all over the world regarding the appropriate clinical use of genetics in their health care systems. Methods and Results: Aspects of the economic and social contexts in different countries which are of particular relevance to shaping the existing challenges are outlined. Issues which are relevant (but of different prominence) in all countries in providing genetic services are discussed. Conclusions: The challenges facing the provision of appropriate genetic services differ markedly in four major groups of countries. These challenges range from controlling inappropriate commercialization and the overuse of genetic approaches to putting in place even minimal basic community genetics services in countries where the infant mortality rate has fallen to a range where genetic and congenital disorders contribute substantially to ongoing handicap and early mortality.

Physicians' opinion for ‘new’ genetic testing in Japan

“…10 In the United States, as there is a market-based healthcare system, the risk of the premature and inappropriate use of genetic information has been reported to be high. 11 With regard to DTC genetic testing services, the Genetic Alliance as an alliance of various genetic disease-associated organizations issued a written statement to the US Food and Drug Administration (FDA) on DTC sales in November 2005, voicing concern about the inadequate monitoring system for testing organizations, misleading advertising and the inadequate guarantee of consumers' choice with adequate consent. According to the national survey about awareness and the use of DTC nutrigenomic genetic testing conducted in the United States in 2006, 14% of 5250 respondents were aware of these tests.…”

Community genetics: 1998–2009…and beyond

“…The future that is implied in the agenda of community genetics, obviously, is a future in which it is the health care system through which new applications of genetic knowledge are made available to individuals in the population in an ‘evidence-based’ way (Blancquaert 2000; Baird 2001; Gwinn and Khoury 2006). Accordingly, it is the professional who should decide for whom particular applications might be needed and useful; however, in discussing the role of community genetics in society, several authors also refer to the possibility of another future scenario.…”