Genetic testing, gifts among CEJA topics

Controversy and consensus are both expected to be generated during deliberations of Council on Ethical and Judicial Affairs reports at the upcoming AMA Annual Meeting.

By Andis Robeznieks, AMNews staff. June 2/9, 2003.

The AMA Council on Ethical and Judicial Affairs will be exploring matters both esoteric and scientific at the 2003 AMA Annual Meeting, but -- eventually -- the discussion always seems to come back to the doctor-patient relationship.

Items on the CEJA agenda include reports on accepting gifts from patients, self-regulation, disclosure of familial risks uncovered by genetic testing, and the ethical responsibility to study and prevent medical errors.

The unifying thread of caring for patients runs through just about all 12 reports on the agenda -- even in a report supporting cloning for biomedical research.

The doctor-patient relationship is not a one-way street, however, and CEJA acknowledges this in its revised report on disclosing familial risks uncovered by genetic testing.

The report was approved last June without much discussion, but concerns were raised at the Association's December 2002 Interim Meeting, and delegates sent it back to CEJA for revision.

"There wasn't much controversy at all the first time," said CEJA Chair Leonard J. Morse, MD, a New Bedford, Mass.-based internist. "But after it was approved, there was six months of reflecting on it, and the American Society of Clinical Oncology and other genetics interest groups brought it to our attention that they felt it was putting a tremendous burden on physicians. The way it was written before, every time they did a genetic test, the doctor would have to call all the patient's biological relatives and tell them about the information" in the test.