Responsibility, culpability, and parental views on genomic testing for seriously ill children.

Janet Malek, Stacey Pereira, Jill O Robinson, Amanda M Gutierrez, Melody J Slashinski, D Williams Parsons, Sharon E Plon, Amy L McGuire
Author Information
  1. Janet Malek: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA. janet.malek@bcm.edu. ORCID
  2. Stacey Pereira: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA. ORCID
  3. Jill O Robinson: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
  4. Amanda M Gutierrez: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
  5. Melody J Slashinski: School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
  6. D Williams Parsons: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
  7. Sharon E Plon: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
  8. Amy L McGuire: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.

Abstract

PURPOSE: We describe parental perceptions of and experiences with genomic sequencing (GS) in the care of seriously ill children. Understanding parents' perspectives is vital for clinicians caring for children, given the uptake of genomic technologies into clinical practice.
METHODS: Longitudinal, semistructured interviews were conducted with parents of pediatric cancer patients who underwent exome sequencing (ES) as a part of the BASIC3 study. Interviews were conducted at baseline, one to eight months after results disclosure, and approximately one year after disclosure. Using thematic qualitative analysis, parent interviews were coded with both inductive and deductive approaches.
RESULTS: Before receiving genomic information, parents indicated that they saw ES as something responsible parents would agree to if their child had cancer. Some parents talked about the possibility of sequencing affecting feelings of culpability for their child's cancer, worrying that they passed on a cancer-causing gene or made parenting decisions that caused the disease. However, after receiving their child's ES results many reported feeling relieved of guilt and worry, and felt they had fulfilled parental duties by agreeing to ES for their child.
CONCLUSION: These results reveal a layer of meaning that parents associate with GS that may inform clinicians' approach to care.

Keywords

References

  1. Soc Sci Med. 2011 Sep;73(5):645-54 [PMID: 21831495]
  2. JAMA Pediatr. 2018 May 1;172(5):476-481 [PMID: 29554172]
  3. Eur J Oncol Nurs. 2008 Apr;12(2):134-41 [PMID: 18069066]
  4. Sociol Health Illn. 2017 Nov;39(8):1542-1556 [PMID: 29148115]
  5. J Genet Couns. 2016 Dec;25(6):1207-1214 [PMID: 27098417]
  6. Eur J Med Genet. 2016 Sep;59(9):452-8 [PMID: 27544064]
  7. J Empir Res Hum Res Ethics. 2011 Dec;6(4):41-52 [PMID: 22228059]
  8. Clin Genet. 2014 Feb;85(2):120-6 [PMID: 24033230]
  9. J Med Ethics. 2017 Aug;43(8):535-539 [PMID: 27888232]
  10. Pediatr Blood Cancer. 2016 Mar;63(3):511-5 [PMID: 26505993]
  11. Genet Med. 2006 Apr;8(4):234-42 [PMID: 16617244]
  12. J Autism Dev Disord. 2015 Oct;45(10):3262-75 [PMID: 26066358]
  13. JCO Precis Oncol. 2017;1: [PMID: 31886451]
  14. Genome Med. 2014 Sep 17;6(9):69 [PMID: 25317207]
  15. Genet Med. 2016 Nov;18(11):1075-1084 [PMID: 27171546]
  16. Soc Sci Med. 2016 Jun;158:141-8 [PMID: 27140840]
  17. J Genet Couns. 2016 Oct;25(5):1019-31 [PMID: 26868367]
  18. JAMA Oncol. 2016 May 01;2(5):616-624 [PMID: 26822237]

Grants

  1. U01 HG006485/NHGRI NIH HHS
  2. 1U01HG006485/NHGRI NIH HHS

MeSH Term

Adult
Decision Making
Disclosure
Female
Genetic Testing
Genomics
Health Knowledge, Attitudes, Practice
Humans
Longitudinal Studies
Male
Neoplasms
Parenting
Parents
Sequence Analysis
Social Behavior
Social Responsibility

Word Cloud

Created with Highcharts 10.0.0genomicparentssequencingESparentalchildrencancerresultsGScareseriouslyillperspectivesinterviewsconductedonedisclosureparentreceivingchildculpabilitychild'sguiltPURPOSE:describeperceptionsexperiencesUnderstandingparents'vitalclinicianscaringgivenuptaketechnologiesclinicalpracticeMETHODS:LongitudinalsemistructuredpediatricpatientsunderwentexomepartBASIC3studyInterviewsbaselineeightmonthsapproximatelyyearUsingthematicqualitativeanalysiscodedinductivedeductiveapproachesRESULTS:informationindicatedsawsomethingresponsibleagreetalkedpossibilityaffectingfeelingsworryingpassedcancer-causinggenemadeparentingdecisionscauseddiseaseHowevermanyreportedfeelingrelievedworryfeltfulfilleddutiesagreeingCONCLUSION:reveallayermeaningassociatemayinformclinicians'approachResponsibilityviewstestingblameresponsibility

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