title: Ethical, legal, and practical concerns about recontacting patients to inform them of new information: the case in medical genetics.
abstract: There is a consensus among medical geneticists that it is desirable to recontact patients as new information becomes available. Furthermore, some have suggested that there are legal arguments to support an obligation, creating a duty to recontact. Thus far much of the discussion among medical geneticists has focused on the practical concerns of implementing such a policy. However, we think that any such policy raises a number of important ethical concerns that must first be considered. Furthermore, there has not been a careful evaluation of the legal precedents that may reflect on a hypothetical duty to recontact. In this paper we first present an analysis of the scope of approaches and issues to be addressed in the development of ethical policy on this question. Secondly, we examine whether there is a legal obligation to recontact former patients about advances in genetics, as well as the legal implications if such a policy were to be adopted. Finally, we consider some of the functional and resource implications of adopting a policy of recontact. Our goal is to provide a framework for further discussion of this question and to stimulate further debate and research.
authors.affiliation: Regional Genetics Program and Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada. hunter@cheo.on.ca
authors.forename: A G
authors.initials: AG
authors.lastname: Hunter
authors.forename: N
authors.initials: N
authors.lastname: Sharpe
authors.forename: M
authors.initials: M
authors.lastname: Mullen
authors.forename: W S
authors.initials: WS
authors.lastname: Meschino
mesh_terms: D003625:Data Collection; D017007:Duty to Warn / Q000331:legislation & jurisprudence*; D004992:Ethics, Medical; D005826:Genetics, Medical / Q000193:education / Q000592:standards*; D006801:Humans; D016365:Liability, Legal; D010353:Patient Education as Topic; D012106:Research