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Opinion 2.139 - Multiplex Genetic Testing

Multiplex testing--where tests are offered for several different medical conditions in a single session--presents a series of challenges to adequate communication between the patient and the physician. It increases the total number of marginally indicated or non-indicated tests, thereby bolstering the rate of false results. These results may lead to psychological stress and misinformed life-altering decisions, and may also impact the ability of a physician to obtain informed consent. Multiplex testing and its resultant information may also have widespread societal implications that include discriminatory practices against not only individuals but specific ethnic groups that have been designated "at risk" populations.

Before such tests reach health care providers, clinics, and drugstores, the ethical and social implications of these tests must be well-understood, and careful restrictions and regulations must be established. The following guidelines are offered on the future possibilities of multiplex genetic testing:

(1) Physicians should not routinely order tests for multiple genetic conditions.

(2) Tests for more than one genetic condition should be ordered only when clinically relevant and after the patient has had full counseling and has given informed consent for each test.

(3) Efforts should be made to educate clinicians and society about the uncertainty surrounding genetic testing. (IV, V)

Issued June 1998 based on the report "Multiplex Genetic Testing," adopted December 1996 (Hastings Center Report. 1998; 28(4): 15-21).