Discussing options between patients and health care professionals in genetic diagnosis: ethical and legal criteria

Specific questions regarding the ethics of genetic testing in cancer diagnosis have been raised because of the specific characteristics of the data obtained. The obtaining and use of genetic data have several peculiar implications for the rights of the patients and their relatives, and frequently practitioners and researchers face new conflicts, to which law and ethics try to give an answer. This concern has increased because, in general, law cannot provide a concrete answer to each concrete situation and, furthermore, there is no regulation of genetic analysis or genetic data in several countries. For these reasons, practitioners often need to make personal decisions in these situations. Some criteria to manage genetic information in cancer diagnosis will be presented in this article.It has been proposed that if genetic data are different from other health data they require specific ethical and legal reflection. This position is known as genetic exceptionalism [1].As has been said, some characteristics of genetic data are shared by other health data, but what is peculiar is the presence of all of these special characteristics and this circumstance means that around the genetic data several different interests are involved, and this has real effects, such as the need for recommendations in this field.In 2004, the European Commission published a document with twenty-five recommendations on ethical, legal and social implications of genetic testing in which it said that "genetic exceptionalism should be avoided, internationally, in the context of the EU and at the level of its Member States. However, the public perception that genetic testing is different needs to be acknowledged and addressed. All medical data, including genetic data, must satisfy equally high standards of quality and confidentiality" [2]. It is true that the principles to be applied to solve the conflicts dealing with the treatment of genetic data are also applicable to conflicts in the field of heal