Diving Into the Gene Pool

Scenario 3 Archive

Scenario #3
Mr. and Mrs. C


Mr. and Mrs. C come to a genetics clinic for prenatal diagnosis.

They have each been tested to determine whether they carry the gene for cystic fibrosis, a hereditary lung disease that causes severe breathing problems.

The cystic fibrosis gene is recessive, so a child must inherit a copy from each parent to get the disease. In this case, both Mr. and Mrs. C are carriers for the cystic fibrosis gene. The specific mutations for each parent were identified in earlier tests.

Mrs. C, who is pregnant, undergoes prenatal diagnosis to determine if the fetus is affected. DNA analysis indicates that the fetus does have two copies of the cystic fibrosis gene, but one of the mutations it carries is different from that of either Mr. or Mrs. C. That makes it virtually certain that Mr. C is not the baby's father.

Should the genetics counselor tell both Mr. and Mrs. C about the test results?

Should Mr. C be told that he is not the father?

The baby's biological father is also a carrier. Should the genetics counselor attempt to identify him and inform him that there is a risk that his future children may inherit cystic fibrosis?

This case study, provided by the U.C. Berkeley Program in Genetic Counseling and Georgetown University Medical Center, is based on a real situation.

EBLiebe@eworld.com writes:

The tester should talk to the Mrs. privately and tell her, and let her say
what she wants to her husband.  They were getting tested so they won't be
surprised either way if the foetus carries the gene.  The tester should then
privately find the biological father and tell him about his future children,
or advise the Mrs. to tell him.  You see, these questions are not for people
to answer, they are for a god to answer.  That's why they're so hard.  When
we had in vitro, they asked us what to do with the 'extra' embryoes: freeze,
donate to science, let thaw, what?  JC on a crutch, how the heck am I
supposed to know?  All I know is my children were down in some dish at the
hospital and my husband and I were home watching "saturday night live."



PAULCCOFFN@aol.com writes: it seems clear that it is not the responsibility of the genetics counselor to divulge information regarding the possible indiscretions of the mother to the couple in question. The conselor is only responsible for informing the couple that their child will have Cystic Fibrosis. I do believe that she should tell the mother of the child privately that her husband is not the father. It would then be up to the mother to inform the husband, if that is her will. As far as informing the real father that he is a carrier, he should be told, but perhaps by the mother, not the genetics counselor. This is a very touchy situation, where marriages could be destroyed and many people hurt. Of course the main focus should be on the well being of the child, but some attention must be paid the to feelings of those involved.
CHRIS writes: TESTING TIMES? CHRIS's comments: THE PRIORITY SHOULD BE THE BABY.MRS C SHOULD BE CONFIDENTIALY TOLD NOT THE RESULTS BUT THAT THEY HAVE FOUND THAT MR C IS NOT THE CHILDS FATHER,POSSIBLY HE KNOWS THAT THERE IS THE POSSIBILITY THAT THE BABY MAY WELL NOT BE HIS.THE PATERNITY OF THE CHILD IS AN ISSUE FOR MRS & MR C TO WORK OUT BETWEEN THEMSELVES.I DO THINK THAT THE BIOLOGICAL FATHER SHOULD BE FOUND AND TOLD HE IS A CAR- RIER OF THE CF GENE. Should the genetics counselor tell both Mr. and Mrs. C about the test results? NO Should Mr. C be told that he is not the father? NO Should the baby's biological father be told he is also a carrier? YES CHRIS's Occupation: GENETICS STUDENT CHRIS's age: 21 to 30 CHRIS's sex: Male
anonymous writes: Mr. C Must Know! anonymous's comments: I am horrified when I read all of the responses by how many peo- ple believe that Mr. C should not be told that he is not the bio- logical father. Most people take the attitude that "ignorance is bliss". 1. If Mr. & Mrs. C thought ignorance was bliss then they would not have had the test done in the first place! 2. Adultery is still a crime in the U.S. and saying that Mrs. C's sex life is "her business" is blatantly ignoring the conseqences to the child (not to mention HER) when Mr. C discovers that he is not the biological father. 3. Wouldn't YOU WANT TO KNOW if you were not the biological parent of YOUR child? welcome to the real world folks... now people like Mrs. C will have to be (oh no!), HONEST! anonymous Should the genetics counselor tell both Mr. and Mrs. C about the test results? YES Should Mr. C be told that he is not the father? YES Should the baby's biological father be told he is also a carrier? YES anonymous's Occupation: average white-collar worker anonymous's age: 21 to 30 anonymous's sex: Female
Gene Pool visitor writes: Gene Pool visitor's comments: The genetics counsellor should tell Mr. and Mrs. C. about the test results. Yes, Mr. C. should be told that he is not the bio- logical father, and the biological father should be informed about his child. Should the genetics counselor tell both Mr. and Mrs. C about the test results? YES Should Mr. C be told that he is not the father? YES Should the baby's biological father be told he is also a carrier? YES Gene Pool visitor's Occupation: Gene Pool visitor's age: 11 to 20 Gene Pool visitor's sex: Female
Gene Pool Visitor writes: Gene Pool Visitor's comments: 1) The counsellor should tell botht the result of the test; that the fetus carries the gene they asked to be tested for. 2) No. That decision is for the counsellor and Mrs. C. She must then decide what to say. Perhaps she already told Mr. C., but perhaps she did not. 3) No, the counsellor has no obligation to him and no grounds to learn his identity. Should the genetics counselor tell both Mr. and Mrs. C about the test results? YES Should Mr. C be told that he is not the father? NO Should the baby's biological father be told he is also a carrier? NO Gene Pool Visitor's Occupation: Gene Pool Visitor's age: 41 to 50 Gene Pool Visitor's sex: Male
Scotty writes: Mr. & Mrs. C Scotty's comments: The purpose of the test was to deturmine the possible existance of the CF gene. Both should be told these results. The question of whether or not Mr. C is the father is of no concern to the tester. It should be assumed that Mrs. C. knows that he is not the father. Some effort should be made to inform the "bio-dad" of his CF gene state, but I believe that should be done through the mother or at her request. Contact of the bio-dad should be attempted on behalf of any future conceptions he may be responsible for. What course of action this leads to all depends upon the level of responsibility & commitment the bio-mom & dad feel to their pro- geny. Unfortunately, in the case of procreation, ability & responsibility do not necessarily coexist. Should the genetics counselor tell both Mr. and Mrs. C about the test results? YES Should Mr. C be told that he is not the father? NO Should the baby's biological father be told he is also a carrier? YES Scotty's Occupation: White collar, computer industry Scotty's age: 31 to 40 Scotty's sex: Male
Marian Cochran writes: Scenario #3-Mr & Mrs C Marian Cochran's comments: Mrs. C ought to know. She took on some heavy responsiblity here, though,0nd she's going to have to shoulder it.0 _don't_ think it is the responsiblity0f the counselor to run to either of the0en and tell them. (But I do think it0s her obligation to be sure the 0hild knows, when it grows up, what its0iologic inheritence is.) There is an urge to tell the men, but itseems, on second thought, to imply a moral0uperiority over Mrs. C and her decision; 0 a very dangerous position to take in other0eople's lives! (What if the baby is the result of a rape by 0r. C's brother? Getting that "out in the0pen" isn't going to help ANYONE in the long0un!) Should the genetics counselor tell both Mr. and Mrs. C about the test results? NO Should Mr. C be told that he is not the father? NO Should the baby's biological father be told he is also a carrier? NO Marian Cochran's Occupation: Marian Cochran's age: 51 to 60 Marian Cochran's sex: Female

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