Risk for Patient Harm in Canadian Genetic Counseling Practice: It's Time to Consider Regulation.
With the increasing awareness of genetic contributions to disease in Canada, the availability of and demand for genetic testing has soared. Genetic counseling is becoming a recognized and rapidly growing (yet unregulated) health profession in Canada. We hypothesized that the potential risk for harm to the public posed by genetic counseling practice in the province of Ontario is sufficient to consider regulation. The Ontario Ministry of Health and Long-Term Care (MOHTLC) sets criteria (both primary and secondary) to identify health professional bodies that meet the threshold for regulation in the province. We developed a survey based on the MOHTLC criteria to determine if genetic counselors meet the primary criteria to be considered for health professions regulation in Ontario. We surveyed 120 Ontario genetic counselors about their clinical practice and perceptions of risk for harm to the public. Results indicate that Ontario genetic counselors are highly independent in their clinical practice and are involved in patient care activities, clinical judgement and decision-making that have the potential to harm patients. In particular, cancer genetic counselors were identified as a cohort that practices with relatively high autonomy and low supervision. In summary, our study indicates that genetic counseling practice in Ontario meets the primary criteria to be considered for regulation.
Department of Genetic Counseling, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. andrea.shugar@sickkids.ca.|Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada. andrea.shugar@sickkids.ca.
Andrea L
AL
Shugar
Department of Genetic Counseling, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.|Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
Nada
N
Quercia
LifeLabs, Toronto, ON, Canada.
Christopher
C
Trevors
Genetics and Genomics, Invitae Inc, San Francisco, CA, USA.
Marina M
MM
Rabideau
Genetic Counseling, GeneDx, Gaithersburg, MD, USA.
Sohnee
S
Ahmed
D000072117:Counselors / Q000331:legislation & jurisprudence / Q000592:standards*; D005260:Female; D005817:Genetic Counseling / Q000331:legislation & jurisprudence / Q000592:standards*; D005820:Genetic Testing; D006801:Humans; D008297:Male; D009864:Ontario; D064406:Patient Harm; D012306:Risk; D011795:Surveys and Questionnaires
Cancer genetics; Genetic counseling; Genetic counselor; Genetic testing; Genetics; Genomic medicine; Genomics; Health professions; Healthcare; Licensure; Medical genetics; Regulation