All physicians who care for pregnant women or patients with genetic diseases
have a duty to counsel their patients about the nature of the diseases, their
probability of being passed on to children, and the diagnostic options available.
A physician who does not offer genetic screening because he or she is opposed
to abortion, or for any other reason, has a duty to refer the patient to another
physician who can carry out the necessary counseling and testing. The
physician has a duty to provide full information to the patient. There is no
therapeutic exception to informing patients about potential risks to their
unborn children.
In some cases it may be necessary to give a patient medical information about
another person. It is not possible to counsel the children of a patient with
Huntington’s disease without letting the children know about the parent’s
disease. Often the information will have been obtained with a release from the
affected parent. If not, every effort should be made to protect the privacy of
the other patient. Names and other identifying information should not be used,
although it is probable that the patients can determine who is affected. There
may also be situations in which the courts can help persons obtain necessary
medical information about genetic diseases. In most states, adoption records
are sealed, but the court that granted the adoption can order the records
opened if there is a compelling reason for doing so.