New Frontiers and Old Challenges: How to Manage Incidental Findings When Forensic Diagnosis Goes Beyond

Abstract

Incidental findings (IFs) are well known in medical research and clinical practice as unexpected findings having potential health or reproductive importance for an individual. IFs are discovered under different contexts but do not fall within the aim of a study, and/or are unanticipated or unintentionally revealed, and/or are not the specific focus or target of the particular research or clinical query. Today, in forensic settings, we can consider as incidental findings all the information that is neither related to the cause of death nor to the dynamic of the event or the scope of the forensic investigation. The question whether and how professionals should consider traditional values as guiding notions in the reporting of IFs in the context of forensic assessments is the focus of this article. We propose a descriptive analysis, which focuses on the forensic field, describing forensic situations in which IFs may occur, and whether and to whom they may be disclosed. Some considerations will be provided regarding forensic experts concerning their moral commitment to warn relatives about IFs.

State Genomic Registration And Legal Regulation Of The Interests Of Its Participants

“…The situation is particularly acute due to the actively promoted idea of a significant increase in the number of persons subject to mandatory genomic registration. In its implementation, many researchers see a threat associated with the emergence of the phenomenon of discrimination of people on genetic grounds (Brown, 2019;Caenazzo et al, 2020;Wickenheiser, 2019;Williams & Wienroth, 2017). All of the above-mentioned problems make it necessary to analyze the reasonableness of compulsory registration.…”

Incidental Findings in Study Participants: What Is the Researcher’s Obligation?

“…The first consideration concerns informed consent, which needs to include a detailed plan regarding the potential uncovering of incidental findings and whether they will be returned based on feasibility. The implications of germline testing need to be explained to the participant, including how the findings may impact their own lives and their extended family [ 22 ]. The ethical responsibility to inform their family must also be stressed [ 22 , 23 ].…”

“…The implications of germline testing need to be explained to the participant, including how the findings may impact their own lives and their extended family [ 22 ]. The ethical responsibility to inform their family must also be stressed [ 22 , 23 ]. As stated earlier, only medically actionable pathogenic variants should be returned following the recommendation of the ACMG [ 24 ].…”

Privacy and ethical challenges of the Amelogenin sex test in forensic paternity/kinship analysis: Insights from a 13-year case history

“…Several reports of incidental findings at the Amelogenin locus can be found in the forensic literature [ [12] , [13] , [14] , [15] ], and authors have warned against the consequent risk of misleading information in criminal identification [ 16 ]. On the contrary, little or no attention was paid so far to Amelogenin in the context of the emerging debate on the management of unexpected findings in forensic investigations [ 17 , 18 ]. Concerns related to indiscriminate use of sensitive genetic information for the inference of ancestry and externally visible characteristics, now made easier by the introduction of next generation sequencing (NGS) technologies, prompted a fruitful scientific debate [ 19 ] and lead to the adoption of specific regulations in a few European countries [ 20 ].…”