title: Attitudes of physicians and patients towards disclosure of genetic information to spouse and first-degree relatives: a case study from Turkey.
abstract: BACKGROUND
  When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.
  
  
  METHODS
  The study was carried out in Kocaeli, Turkey. Participants were either paediatricians and gynaecologists registered in Kocaeli, or patients coming to the genetic diagnosis centre for karyotype analysis in 2008. A self-administered paper questionnaire was given to the physicians, and face-to-face structured interviews were conducted with patients. We used a case study involving a man who was found to be a balanced chromosome carrier as a result of a test conducted after his first baby was born with Down's syndrome. However, he refused to share this information with his wife or his siblings. Percentages of characteristics and preferences of the participants were calculated, and the results were analysed using Kruskal-Wallis test.
  
  
  RESULTS
  A total of 155 physicians (68% response rate) and 104 patients (46% response rate) were participated in the study. Twenty-six percent of physicians and 49% of patients believed that genetic information belongs to the whole family. When participants were asked with whom genetic information should be shared for the case study, most of the physicians and patients thought the physician should inform the spouse (79%, 85%, respectively). They were less likely to support a physician informing a sibling (41%, 53%, respectively); whereas, many thought the testee has an obligation to inform siblings (70%, 94%, respectively).
  
  
  CONCLUSIONS
  Although Turkey's national regulations certainly protect the right of privacy of the testee, the participants in our study appear to believe that informing the spouse, who is not personally at risk of serious damage, is the physician's responsibility, while informing siblings, is the testee's responsibility. Therefore we believe that opening ethical discussions with clinicians about the sharing of genetic information, establishing guidelines for practice and sharing these guidelines and the reasons behind them with the wider population, will help to pre-empt ethical dilemmas.
authors.affiliation: Department of History of Medicine and Ethics, Hacettepe University Faculty of Medicine, Ankara, Turkey. aslyakcay@yahoo.com.
authors.forename: Aslihan
authors.initials: A
authors.lastname: Akpinar
authors.forename: Nermin
authors.initials: N
authors.lastname: Ersoy
mesh_terms: D001290:Attitude; D001291:Attitude of Health Personnel; D016022:Case-Control Studies; D003219:Confidentiality; D003657:Decision Making; D017007:Duty to Warn / Q000941:ethics; D005195:Family Relations; D005260:Female; D005817:Genetic Counseling / Q000941:ethics*; D005820:Genetic Testing / Q000941:ethics; D007722:Health Knowledge, Attitudes, Practice; D006806:Human Rights; D006801:Humans; D033181:Information Dissemination / Q000941:ethics; D008297:Male; D028681:Moral Obligations; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D018454:Spouses; D011795:Surveys and Questionnaires; D014342:Truth Disclosure / Q000941:ethics*; D014421:Turkey