Matching Items (3)
Filtering by

Clear all filters

152315-Thumbnail Image.png
Description
ABSTRACT Whole genome sequencing (WGS) and whole exome sequencing (WES) are two comprehensive genomic tests which use next-generation sequencing technology to sequence most of the 3.2 billion base pairs in a human genome (WGS) or many of the estimated 22,000 protein-coding genes in the genome (WES). The promises offered from

ABSTRACT Whole genome sequencing (WGS) and whole exome sequencing (WES) are two comprehensive genomic tests which use next-generation sequencing technology to sequence most of the 3.2 billion base pairs in a human genome (WGS) or many of the estimated 22,000 protein-coding genes in the genome (WES). The promises offered from WGS/WES are: to identify suspected yet unidentified genetic diseases, to characterize the genomic mutations in a tumor to identify targeted therapeutic agents and, to predict future diseases with the hope of promoting disease prevention strategies and/or offering early treatment. Promises notwithstanding, sequencing a human genome presents several interrelated challenges: how to adequately analyze, interpret, store, reanalyze and apply an unprecedented amount of genomic data (with uncertain clinical utility) to patient care? In addition, genomic data has the potential to become integral for improving the medical care of an individual and their family, years after a genome is sequenced. Current informed consent protocols do not adequately address the unique challenges and complexities inherent to the process of WGS/WES. This dissertation constructs a novel informed consent process for individuals considering WGS/WES, capable of fulfilling both legal and ethical requirements of medical consent while addressing the intricacies of WGS/WES, ultimately resulting in a more effective consenting experience. To better understand components of an effective consenting experience, the first part of this dissertation traces the historical origin of the informed consent process to identify the motivations, rationales and institutional commitments that sustain our current consenting protocols for genetic testing. After understanding the underlying commitments that shape our current informed consent protocols, I discuss the effectiveness of the informed consent process from an ethical and legal standpoint. I illustrate how WGS/WES introduces new complexities to the informed consent process and assess whether informed consent protocols proposed for WGS/WES address these complexities. The last section of this dissertation describes a novel informed consent process for WGS/WES, constructed from the original ethical intent of informed consent, analysis of existing informed consent protocols, and my own observations as a genetic counselor for what constitutes an effective consenting experience.
ContributorsHunt, Katherine (Author) / Hurlbut, J. Benjamin (Thesis advisor) / Robert, Jason S. (Thesis advisor) / Maienschein, Jane (Committee member) / Northfelt, Donald W. (Committee member) / Marchant, Gary (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2013
135152-Thumbnail Image.png
Description
Genetic counseling is a medical field that was established in the 1970s, but whose demand is now growing exponentially due to modern genetic technology. We now have the ability to look into the human genetic code, detect the genotype of individuals, and use this knowledge to our benefit. However, Genetic

Genetic counseling is a medical field that was established in the 1970s, but whose demand is now growing exponentially due to modern genetic technology. We now have the ability to look into the human genetic code, detect the genotype of individuals, and use this knowledge to our benefit. However, Genetic testing results in a need for new ethical boundaries to be drawn. The idea of the "best possible conditions" of conceiving a child and whether this child has a right to not know are the two major ethical issues that will be focused on in order to analyze the ethical boundary that needs to be drawn for genetic counseling. In order to analyze these ethical issues, a focus group of Arizona State University students was organized. After producing results for the focus group, there are no true conclusions that can be drawn that applied to all of society. The focus group sample size was too small to produce a broad range of results and the participants were all Arizona State University Undergraduate students. However, it did become apparent that knowledge on these ethical issues is crucial in order to ensure they do not hinder the field of genetic counseling. It is predicted that in order to have the best outcome for the field of genetic counseling, genetic counselors themselves need to draw the ethical boundaries for the issues studied.
ContributorsBarker, Samantha (Author) / Amdam, Gro (Thesis director) / Bang, Christofer (Committee member) / Wang, Ying (Committee member) / Barrett, The Honors College (Contributor)
Created2016-05
148279-Thumbnail Image.png
Description

Telehealth is the use of information and communications technology by healthcare professionals to provide care to patients. When this technology is being used specifically for genetic services, it is called telegenetics. Previous studies that examine the small-scale use of telegenetics for the field of genetic counseling have shown that the

Telehealth is the use of information and communications technology by healthcare professionals to provide care to patients. When this technology is being used specifically for genetic services, it is called telegenetics. Previous studies that examine the small-scale use of telegenetics for the field of genetic counseling have shown that the technology may provide a way to address the problem of patient access to genetic counseling services, assuming its efficacy. Patients are satisfied with telegenetics, but genetic counselors hold more reservations. Because of this and the many regulatory barriers in its way, telegenetics was only slowly being adopted when the coronavirus was declared a pandemic in March 2020. The pandemic forced a switch to telegenetics at a scale never seen before. This study begins with a literature review to assess the situation of telegenetics before and during the pandemic. It then surveys practicing genetic counselors in Arizona in order to reveal what they think about telegenetics when it is the encouraged, and sometimes only, modality. Since the literature review revealed that genetic counselors, not patients, are the ones with concerns, it is important to hear their points of view. This study reveals that genetic counselors want telegenetics as an option but not as a replacement for in-person appointments. All respondents agreed that increased patient access is the main benefit of telegenetics. There are reported challenges that must be overcome, but genetic counselors in Arizona overwhelming believe that telegenetics use will be continued in the future.

ContributorsThornton, Gillian Frances (Author) / Hunt Brendish, Katherine (Thesis director) / Frow, Emma (Committee member) / School of International Letters and Cultures (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05