Cystic Fibrosis & Genetic Screening - Case Notes

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Author - John Shepherd - Fall 1998

Teaching Notes :

Assignment for Day 1:   We will next consider the consequences of advances in genetics and the application of related technology.  In order to do this, we will alternate between the science itself and its social and ethical consequences.  Read Genetic Screening for Cystic Fibrosis before class and come ready for a quiz at the start of class.  In class on Wednesday, we will do some problems in population genetics and probability.

Day 1 Class Meeting. In a 50 minute class, some student groups finished the first 4 problems with time to spare.  Some finished them only with coaching.  In a 75-minute class, there ought to be time to go over the answers.

Assignment for Day 2.   In our next class we will explore the consequences of what we know about CF. Think about the following questions before class:

• Now that we know what causes the disease, how should we use that knowledge?
• What genetic information should we collect? from whom? How should we use this information?
• Would genetic screening be a reasonable part of application for health and life insurance? 
  • Insurance companies would like to have access about our potential for genetic diseases.  This would allow them to make appropriate "risk classifications" the way we do for automobile and life insurance. 
  • These companies worry that indivduals could exploit private genetic screening information to exploit systems of health insurance.
• Would genetic screening be a reasonable part of application for employment? 
  • Many small employers could simply not afford the health costs of "high risk" employees.
• Should "high risk" couples be forced to assume financial responsibility for their choices in reproduction?
  • If they are not, then they are free to force others to pay for their choices.
  • The extremely high health care costs of a few people with genetic conditions in effect ration health care for many other people.
• How should we use our financial resources to achieve the greatest effect in the case of CF? screening? research on genetic therapies? palliative care?
• Will/Would you choose to have yourself and/or your fetus tested for genetic problems, either before conception or during a pregnancy?