Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-23T21:21:18.592Z Has data issue: false hasContentIssue false

The “New” Genetics: Emerging Medicolegal Issues in the Prenatal Diagnosis of Hereditary Disorders

Published online by Cambridge University Press:  06 May 2021

Aubrey Milunsky
Affiliation:
Genetics Laboratory, Eunice Kennedy Shriver Center for Mental Retardation; Massachusetts General Hospital and Harvard Medical School, Boston
Philp Reilly
Affiliation:
Medical Genetics Center, University of Texas Graduate School of Biomedical Sciences at Houston; University of Houston Law School

Abstract

Major advances in prenatal genetic diagnosis have occurred in the past few years which pose difficult challenges to the law. This paper raises questions relative to family history taking, genetic counseling, carrier detection, amniocentesis, and prenatal genetic studies, and also raises questions with respect to the rights and responsibilities of the patient, the fetus, the physician, and society in light of such modern advances. Law reform often occurs only after prior harm to an individual, family or group. Perception and delineation of the most important issues in this area should serve to stimulate the development of medicolegal guidelines and corrective legislation prior to the occurrence of a genetic tragedy.

Type
Comment
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 1975

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Research on the materials reported in this article was supported by Public Health Service Grant Number 1-PO1-HD05515-01, and NICHHD Contract Number 71-2451.

Reprints of this article can be obtained from Dr. Aubrey Milunsky, Eunice Kennedy Shriver Center, Genetics Laboratory, 200 Trapelo Road, Waltham, Mass. 02154.

References

1 See A. Milunsky, The Prenatal Diagnosis of Hereditary Disorders (1973) [hereinafter cited as A. Milunsky].

2 Note, Patient Selection for Artificial and Transplanted Organs, 82 Harv. L. Rev. 1322 (1969).

3 J. Fletcher, The Ethics Of Genetic Control (1974).

4 A. Milunsky, supra note 1.

5 C. Stern, Principles Of Human Genetics (3rd ed. 1972). This text explains inheritance clearly.

6 A. Moritz and C. Morris, Doctor and Patient and the Law, 271-286 (5th ed. 1971).

7 Id. at 287-291; W. Curran And E. Shapiro, Law, Medicine and Forensic Science (2d ed. 1970) p. 381.

8 Calif. Health and Safety Code, Section 3193 (West. Ann. 1973).

9 Simonsen v. Swenson, 104 Neb. 224, 117 N.W. 831 (1920).

10 Forgotson, Rocmer, and Newman, Licensure of Physicians, 1967 Wash. U.L.Q. 249 (1967).

11 Working Group on Genetic Counseling and Genetic Engineering, Institute of Society, Ethics, and the Life Sciences, Ethical and Social Issues in Screening for Genetic Disease, 286 New Eng. J. Med. 1129 (1972).

12 Rev. Code Montana 69-6711 (Mont. Laws of 1973, c. 227, § 2).

13 Farrow, and Juberg, Genetics and Laws Prohibiting Marriage in the United States, 209 J.A.M.A. 534 (1969)Google Scholar.

14 Forster, Eliminating the UnfitIs Sterilization the Answer?, 27 Ohio St. L.J. 591 (1966).Google Scholar

15 Buck v. Bell, 274 U.S. 200 (1927).

16 Frankenburg, Duncan, Coffelt, et at., Maternal Phenylketonuria: Implications for Growth and Development, 73 J. Pediat. 560 (1968)Google Scholar.

17 See, e.g., Gleitman v. Cosgrove, 49 N.J. 22, 227 A.2d 689 (1967). The new actions were all filed in New York and California courts and are still pending.

18 More exact risk data will shortly be made available as a result of a collaborative NICHHD Amniocentesis Registry Project.

19 Salgo v. Leland Stanford University, 154 Cal. App. 2d 560, 317 P.2d 170 (1957); Fortner v. Koch, 272 Mich. 273, 261 N.W. 762 (1935).

20 Nacarrato v. Grob, 384 Mich. 248, 180 N.W.2d 788 (1970).

21 Shergin, Beyond Roe and Doe: The Rights of the Father, 50 Notre Dame Lawyer 483 (1975)Google Scholar.

22 Schloendorff v. Society of N.Y. Hospitals, 211 N.Y. 125, 129, 105 N.E. 92, 93 (1914).

23 Pound v. Pound, 42 U.S.L.W. 2456 (6th Cir. Jan. 31, 1974); see also Roe v. Wade, 410 U.S. 113 (1973).

24 See, e.g., Natanson v. Kline, 186 Kan. 393, 401, 406, 350 P.2d 1093, 1100-01, 1103 (1960), rehearing denied, 187 Kan. 186, 354 P.2d 670 (1960).

25 Salgo v. Leland Stanford University, 154 Cal. App. 2d 560, P.2d 170 (1957); Cobbs v. Grant, 502 P.2d 1 (1972); Canterbury v. Spence, 464 F.2d 772 (1972); Wilkerson v. Vesey, 295 A.2d 676 (1972); Emmett v. Eastern Dispensary, 396 F.2d 931; Berkey v. Anderson, 1 C.A.3d 790 (1969).

26 Jones, A New Era for Cytogenelics, 11 Current Probs. Pediat. 3 (1972)Google Scholar.

27 A. Milunsky, supra note 1.

28 Garlinger, Hecbt, Prcscott, et at, Restrictive Consent and Amniocentesis, 288 New Eng. J. Med. 1028 (1973)Google Scholar.

29 A. Milunsky, supra note 1.

30 Milunsky, Prenatal Diagnosis of Genetic Disorders, 230 J.A.M.A. 232 (1974)Google Scholar.

31 Creasman, Lawrence, & Thiede, Fetal Complications of Amniocentesis, 204 J.A.M.A. 949 (1968)Google Scholar; Wiltchik, Schwarz, and Emich, Amniography for Placental Localization, 28 Obstet. Gynecol. 641 (1966Google Scholar); Berner, Amniography, An Accurate Way to Localize the Placenta: A Comparison with Soft-Tissue Placentography, 29 Obstet. Gynecol. 200 (1967)Google Scholar; Liley, The Technique and Complications of Amniocentesis, 59 N.Z. Med. J. 581 (1960)Google Scholar; Burnett, and Anderson, The Hazards of Amniocentesis, 5 J. Iowa M. Soc. 130 (1968)Google Scholar.

32 A. Milunsky, supra note 1.

33 Kardon, Chernay, Hsu, et al., Problems in Prenatal Diagnosis Resulting from Chromosomal Mosaicism, 3 Clin. Genet. 83 (1972)Google Scholar.

34 See footnotes 38-43 infra, and accompanying text.

35 A. Milunsky, supra note 1.

36 Rattazzi & Davidson, Limitations of Amniocentesis for the Antenatal Diagnosis of Tay-Sachs Disease, Abstracts Am. Soc. Hum. Genet. Meeting, Indianapolis, Ind., Oct. 11, 1970.

37 Scriver, and Rosenberg, Amino Acid Metabolism and its Disorders, in 10 Major Problems in Clinical Pediatrics (W.B. Saundcrs Co., Philadelphia, Pa.) (Schaffer, A. ed., 1973)Google Scholar; Levy, Genetic Screening, in 6 Advances In Human Genetics (Plenum Press, New York, N.Y.) (H. Harris & K. Hirschhorn ed., 1973)Google Scholar.

38 Canterbury v. Spence, 464 F.2d 772, at 780 (D.C. Cir.), cert, denied, 409 U.S. 1064 (1972).

39 Waltz, and Scheuneman, Informed Consent to Therapy, 64 Nw. U. L. Rev. 628, at 628 n . l (1970)Google Scholar.

40 Canterbury v. Spence, 464 F.2d 772 (D.C. Cir.), cert, denied, 409 U.S. 1064 (1972); Schloendorff v. Society of N.Y. Hospitals, 211 N.Y. 125, 129, 105 N.E. 92, at 9 3 (1914); Cooper v. Roberts, 220 Pa. Super. 260, 267, 286 A.2d 647, at 650 (1971).

41 Alfidi, Informed Consent—A Study in Patient Reaction, 216 J.A.M.A. 1325 (1971)Google Scholar.

42 Note, Informed ConsentA Proposed Standard for Medical Disclosure, 48 N.Y.U. L. Rev. 548 (1973).

43 Id.

44 Hirsch, Consent to Medical TreatmentWith Forms, 5 Tr. Law. Guide 51, at 62 (1961)Google Scholar.

45 Roe v. Wade, 410 U.S. 113 (1973).

46 A. Allen, Legal Duties 28-70 (1931); R. Dias & G. Hughes, Jurisprudence 283 (1st ed. 1957); Graveson, R., Status in the Common Law 111 (1953)Google Scholar.

47 Tomlin v. Laws, 301 111. 616 , 134 N. E. 24 (1922); Tufo, Del, Recovery for Prenatal Torts, 15 Rutg. L. Rev. 61, at 66n. 24 (1960)Google Scholar; Winfield, The Unborn Child, 4 U. Toronto L.J. 278, 279 (1942)Google Scholar.

48 Barry, The Child en Venire Sa Mere, 14 Aust. L.J. 351, at 356 (1941)Google Scholar; Gordon, D., The Unborn Plaintiff, 63 Mich. L. Rev. 579 (1964)Google Scholar.

49 Dietrich v. Inhabitants of Northampton, 138 Mass. 14, at 16 (1884).

50 See, e.g., Bonbrest v. Kotz, 65 F. Supp. 138 (D.D.C. 1946).

51 Gordon, The Unborn Plaintiff 63 Mich. L. Rev. 579 (1964)Google Scholar.

52 Sinkler v. Neale, 401 Pa. 267, 164 A.2d 93 (1960).

53 Hornbuckle v. Plantation Pipe Line Co., 212 Ga. 504, 93 S.E.2d 727 (1956); Sana v. Brown, 35 111. App. 2d 425, 183 N.E.2d 187 (1962); Daley v. Meier, 33 111. App. 2d 218, 178 N.E.2d 691 (1961); Bennet v. Hymers, 101 N.H. 483, 485, 147 A.2d 108, 109 (1958); Smith v. Brennan, 31 N.J. 353, 157 A.2d 497 (1960); Kelky v. Gregory, 282 App. Div. 542, 125 N.Y.S.2d 696 (1953); Sinkler v. Neale, 401 Pa. 267, 164 A.2d 93 (1960); Von Elbe v. Studebaker-Packard Corp., 15 Pa. D. & C. 2d 629 (1958); Puhl v. Milwaukee Auto Ins. Co., 8 Wis. 2d 343, 99 N.W.2d 163 (1959).

54 Tedeschi, Tort Liability for “Wrongful Life,” 7 J. Family Law 465 (1967)Google Scholar; Cause of Action for “Wrongful Life: A Suggested Analysis, 55 Minn. L. Rev. 58 (1970).

55 See Annot., 59 Amjur 2d, Parent and Child, §§ 151 et seq.

56 Stokes v. Liberty Mutual Ins. Co., 213 So. 2d 695 (Fla. 1968); Zepeda v. Zepeda, 411 111. App. 2d 240, 190 N.E.2d 849 (1963); Gleitman v. Cosgrove, 49 N.J. 22, 227 A.2d 689 (1967).

57 Gleitman v. Cosgrove, 49 N.J. 22, 227 A.2d 689 (1967).

58 Worgan v. Greggo & Ferraro, Inc., 50 Del. 258, 128 A.2d 557 (1956); Porter v. Lassiter, 91 Ga. App. 712 (Chatham Sup. Ct. 1955); Mitchell v. Couch, 285 S.W.2d 901 (Ky. 1955).

59 Mace v. Jung , 210 F. Supp. 706 (D. Alaska 1962); Keyes v. Construction Service Inc., 340 Mass. 633, 165 N.E.2d 912 (1960); Hall v. Murphy, 236 S.C. 257, 113 S.E.2d 790 (1960); Shousha v. Matthews Drivurself Service, 210 Tenn. 384, 358 S.W.2d 471 (1962); Hogan v. McDaniel, 204 Tenn. 235, 319 S.W.2d 221 (1958).

60 A. Milunsky, supra note 1.

61 N.C. Code Ann. Ch. 143B-196 (Supp. 1973).

62 Md. Code Ann. Art. 43 § 818(g) (Supp. 1973).

63 Reilly, Genetic Screening Legislation, 27 Am. J. Hum. Genet. 120 (1975)CrossRefGoogle Scholar.