Looking for the Psychosocial Impacts of Genomic Information
Erik Parens and Paul S. Appelbaum
Since the start of the program to investigate the ethical, legal, and social implications (ELSI) of the Human Genome Project in 1990, many ELSI scholars have maintained that genetic testing should be used with caution because of the potential for negative psychosocial effects associated with receiving genetic information. More recently, though, some ELSI scholars have produced evidence suggesting that the original ELSI concerns were unfounded, exaggerated, or, at a minimum, misdirected. At least in the contexts that have been most studied, large negative impacts have not been found in the vast majority of people studied. What might explain the discrepancy between the original hypothesized outcomes and the growing impression that large negative effects appear to be few and far between? And if the original predictions of large negative psychosocial effects were simply wrong, is it time for ELSI researchers to move on? Should genetic testing be routinized, and would it be appropriate to relax or abandon the practice of engaging patients in a process of detailed informed consent before they receive genetic information? To confront those questions, we convened a conference entitled “Looking for the Psychosocial Impacts of Genomic Information” to review what is known about the negative impacts of genetic information on a variety of populations and in multiple medical and social contexts, to explore the implications of the findings, and to consider whether future research might benefit from different methods than have been used to date.
TABLE OF CONTENTS
Introduction
On What We Have Learned and Still Need to Learn about the Psychosocial Impacts of Genetic Testing
Genetic Essentialism and Its Vicissitudes
Genomic Essentialism: Its Provenance and Trajectory as an Anticipatory Ethical Concern
Maya Sabatello and Eric Juengst
Making Sense of Genetics: The Problem of Essentialism
Steven J. Heine, Benjamin Y. Cheung, and Anita Schmalor
Reassuring News about Psychosocial Impacts
Psychosocial Effects of Multigene Panel Testing in the Context of Cancer Genomics
Jada G. Hamilton and Mark E. Robson
Less Reassuring News about Psychosocial Impacts
Actions and Uncertainty: How Prenatally Diagnosed Variants of Uncertain Significance Become Actionable
Allison Werner‐Lin, Judith L. M. Mccoyd, and Barbara A. Bernhardt