When genetic counseling a pregnant or potentially pregnant woman, the
physician should include her husband or other family members only at her
request. Violating the patient’s privacy can have devastating results. Legal and
social paternity do not necessarily imply biologic paternity. Although it would
be proper to discuss these matters with the patient, this type of information
should not be disclosed to others.
If the patient is a child, the situation is somewhat different. A father and
mother who are married to each other have equal authority over their children.
If the legal father does not question his biologic paternity, there is usually no
problem. If a father asks whether he is the child’s biological father, a physician
should be cautious. Both mutation and test variability can confound any
genetic test of paternity. It is better to address the question of whether the
child has a genetic disease than whether the disease came from the man
asking the question.