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Genetic Technology in Health Care: A Global View

Published online by Cambridge University Press:  10 March 2009

Hans Galjaard
Hans Galjaard
Affiliation:
Erasmus University
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Abstract

Clinical genetics services have become an integrated part of health care in nearly all European countries. The emphasis has been on postnatal cytogenetic, biochemical, and DNA diagnosis of congenital disorders, carrier detection, genetic counseling, and prenatal diagnosis. Use has been satisfactory, and very few ethical problems have arisen, apart from moral objections against abortion by minority groups. The progress of human gene mapping is associated with new perspectives in clinical genetics and will enable the identification of people at risk of major adult diseases. This prospect has caused some concern about psychosocial and ethical issues that are being dealt with in different ways in various postindustrial societies. In future decades, however, 95% of the world's population increase will occur in developing countries. In most of these countries, a low per capita income, female illiteracy, low rates of contraceptive use, teenage pregnancy, and religious and traditional cultural factors are major complications of implementing genetic services at a global level. There are, however, some exceptions, which are discussed.

Type
Special Section: Genetic Technology
Information
International Journal of Technology Assessment in Health Care , Volume 10 , Issue 4 , Fall 1994 , pp. 527 - 545
Copyright
Copyright © Cambridge University Press 1994

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References

REFERENCES

1.Angostoniotis, M. A.How thalassemia was controlled in Cyprus. World Health Forum, 1985, 7, 291–97.Google Scholar
2.Bowman, J. E.Invited editorial: Prenatal screening for hemoglobinopathies. American Journal of Human Genetics, 1991, 48, 433–38.Google Scholar
3.Cao, A.Results of programmes for antenatal detection of thalassemia in reducing the incidence of the disorder. Blood Reviews, 1987, 1, 169–76.CrossRefGoogle ScholarPubMed
4.Czeizel, A.The right to be born healthy. Budapest, Hungary: Akadémiai Kiado, 1988.Google Scholar
5.Danish Board of Technology (Teknologi Naevnet). Report of consensus conference on the application of knowledge gained from mapping the human genome. Copenhagen, Denmark: Danish Board of Technology, 1989.Google Scholar
6.Drife, J. O., & Donnai, D. (eds). Antenatal diagnosis of fetal abnormalities. London: Springer, 1991.CrossRefGoogle Scholar
7. European Community Working Group on the Ethical, Social and Legal Aspects of Human Genome Analysis. Report 31. Brussels, Belgium: EEC, 1991.Google Scholar
8.Frets, P. G., Duivenvoorden, H. J., Verhage, F. et al. , Factors influencing the reproductive decision after genetic counseling. American Journal of Medical Genetics, 1990, 35, 496–502.CrossRefGoogle ScholarPubMed
9.Fromell, K. B., Josefson, G., & Kjessler, B.WHO declines from antenatal serum a-feto-protein screening—And why? Acta Obstetrica Gynecologica Scandinavia, 1984, 63, 687–91.CrossRefGoogle Scholar
10.Galjaard, H. Challenges for the future. In Emery, A. W. H. & Rimoin, D. L. (eds.), Principles and practice of medical genetics, vol. 2. Edinburgh, Scotland: Churchhill-Livingstone, 1990, 2025–35.Google Scholar
11.Granda, H., Gispert, S., Dorticos, A. et al. , Cuban programme for prevention of sickle cell disease. Lancet, 1991, 337, 152–53.CrossRefGoogle ScholarPubMed
12.Hacker, A.Two nations. New York: Ballantine Books, 1992.Google Scholar
13.Henshaw, S. K.Induced abortion: A world review, 1990. International Family Planning Perspective, 1990, 16, 59–65.CrossRefGoogle ScholarPubMed
14.Loukopoulos, D. (ed.). Prenatal diagnosis of thalassemia and the haemoglobinopathies. Boca Raton, FL: CRC Press, 1988.Google Scholar
15.Marteau, T.Reducing the psychological costs. British Medical Journal, 1990, 301, 26–28.CrossRefGoogle ScholarPubMed
16.Moatti, J. P., Le Gales, C., Julian, C. et al. , Sociocultural inequities in access to prenatal diagnosis. Prenatal Diagnosis, 1990, 10, 313–25.CrossRefGoogle ScholarPubMed
17.Modell, B.Effect of introducing antenatal diagnosis on the reproductive behaviour of families at risk for thalassemia major. British Medical Journal, 1980, 280, 1347–50.CrossRefGoogle Scholar
18.Modell, B.Cystic fibrosis screening and community genetics. Journal of Medical Genetics, 1990, 27, 475–79.CrossRefGoogle ScholarPubMed
19.Reid, M.The diffusion of four prenatal screening tests across Europe. London: King's Fund Centre for Health Services Development, 1991.Google Scholar
20.Report of the International Conference on Bioethics. Rambouillet 19–21 April 1985. Paris France: Centre d'Etudes des Système et des Technologies Avancées, 1985.Google Scholar
21.Report du Troisième Congrès International d'Etique Médicate, 9-10 Mars. Paris, France: Ordre Conseil National des Medecins, 1991 (in French).Google Scholar
22.Rowley, P. T.Loader, S.Sutera, C. J. et al. Prenatal screening for hemoglobinopathies I, IV and III. American Journal of Human Genetics, 1991, 48, 439–59.Google Scholar
23.Sachedina, A.Islam, procreation and the law. International Family Planning Perspectives, 1990, 16, 16, 107–10.CrossRefGoogle Scholar
24.Thomassen-Brepols, L. J. Psychosocial aspects of prenatal diagnosis. Unpublished thesis. Rotterdam, Netherlands, Erasmus University, 1985.Google Scholar
25.United Nations Children's Fund. The state of the world's children 1991. New York: Oxford University Press, 1991.Google Scholar
26.United Nations Development Program. Human development report 1993. New York: Oxford University Press, 1993.Google Scholar
27.United Nations Population Fund. Safeguarding the future. New York: United Nations Fund for Population Activities, 1992.Google Scholar
28.United Nations Population Fund. World population report. New York: United Nations Fund for Population Activities, 1993.Google Scholar
29.Wald, N. J.Cuckle, H. S.Densem, J. W. et al. Maternal serum screening for Down’s syndrome in early pregnancy. British Medical Journal, 1988, 297, 883–87.CrossRefGoogle ScholarPubMed
30.World Bank. Revised estimates and projections of international migration 1980–2000. Working paper WPS 275. Washington, DC: World Bank, 1989.Google Scholar
31.World Health Organization Advisory Group on Hereditary Diseases. Community approaches to the control of hereditary diseases. Document HMG/WG 85.4. Geneva, Switzerland: WHO, 1985.Google Scholar
32.World Health Organization Regional Office for Europe. Community genetics services in Europe. No. 38. Copenhagen, Denmark: WHO Regional Publications European Services, 1991.Google Scholar
33.World Watch paper 77. New York: Norton, 1990.Google Scholar