title: The role of disease characteristics in the ethical debate on personal genome testing.
abstract: BACKGROUND
  Companies are currently marketing personal genome tests directly-to-consumer that provide genetic susceptibility testing for a range of multifactorial diseases simultaneously. As these tests comprise multiple risk analyses for multiple diseases, they may be difficult to evaluate. Insight into morally relevant differences between diseases will assist researchers, healthcare professionals, policy-makers and other stakeholders in the ethical evaluation of personal genome tests.
  
  
  CONCLUSIONS
  In this paper, we identify and discuss four disease characteristics--severity, actionability, age of onset, and the somatic/psychiatric nature of disease--and show how these lead to specific ethical issues. By way of illustration, we apply this framework to genetic susceptibility testing for three diseases: type 2 diabetes, age-related macular degeneration and clinical depression. For these three diseases, we point out the ethical issues that are relevant to the question whether it is morally justifiable to offer genetic susceptibility testing to adults or to children or minors, and on what conditions.
  
  
  CONCLUSIONS
  We conclude that the ethical evaluation of personal genome tests is challenging, for the ethical issues differ with the diseases tested for. An understanding of the ethical significance of disease characteristics will improve the ethical, legal and societal debate on personal genome testing.
authors.affiliation: Dept. of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Dr. Molewaterplein 50, Rotterdam 3015 GE, the Netherlands. e.bunnik@erasmusmc.nl
authors.forename: Eline M
authors.initials: EM
authors.lastname: Bunnik
authors.forename: Maartje Hn
authors.initials: MH
authors.lastname: Schermer
authors.forename: A Cecile J W
authors.initials: AC
authors.lastname: Janssens
mesh_terms: D000328:Adult; D017668:Age of Onset; D003866:Depressive Disorder / Q000235:genetics / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics / Q000517:prevention & control; D004194:Disease / Q000235:genetics* / Q000523:psychology; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing / Q000941:ethics*; D015894:Genome, Human / Q000235:genetics*; D006801:Humans; D008268:Macular Degeneration / Q000235:genetics; D057285:Precision Medicine / Q000941:ethics; D057545:Social Stigma; D055815:Young Adult