title: Presymptomatic and predisposition genetic testing: ethical and social considerations.
abstract: OBJECTIVE
  To provide an overview of the ethical and social concerns that are raised by the use of new genetic tests in asymptomatic persons.
  
  
  METHODS
  Review articles, research studies and legislation related to genetic testing.
  
  
  CONCLUSIONS
  Predisposition and presymptomatic testing is possible to any age for adult onset disorders if a mutation is known. Testing without early effective interventions is controversial, especially prenatally and in children. Issues of privacy, discrimination, stigmatization and emotional stress are potential problems. Informed consent is essential before deciding to test. Awareness of the implications of testing can enhance the nurse's advocacy role.
  
  
  CONCLUSIONS
  More studies are necessary to identify the impact of presymptomatic testing on adults and children. Nursing research to identify the family concerns, and to develop effective educational, counseling, and supportive interventions would make a valuable contribution.
authors.affiliation: Neurology Department, Massachusetts General Hospital (MGH), Boston, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Bove
authors.forename: S T
authors.initials: ST
authors.lastname: Fry
authors.forename: D J
authors.initials: DJ
authors.lastname: MacDonald
mesh_terms: D000328:Adult; D002648:Child; D003219:Confidentiality; D030881:Disclosure; D004989:Ethics; D005817:Genetic Counseling; D030661:Genetic Privacy; D005820:Genetic Testing; D006801:Humans; D007258:Informed Consent; D010344:Patient Advocacy; D026684:Personal Autonomy; D011287:Prejudice