Legal and regulatory issues surrounding carrier testing.

Genetic testing has arrived, probably earlier than patients and physicians need. For the moment, professional societies are taking the lead in monitoring the quality of physician education and laboratory services. The federal government will soon take over the role of monitoring the quality of genetic test kits themselves, but the most significant development will be the evolving physician-patient relationship in the context of primary and prenatal care. As of 1992, it is probably not necessary for physicians to educate their patients about the availability of genetic tests unless there is a specific indication of genetic disease in the family. However, should a patient ask for such information or testing, today's physician would have a duty to know enough about the current status of carrier testing to be able to respond to the requests or make a proper referral. In addition, as the reliability of such tests increase and their costs decrease, physicians may arrive at a moment when some sort of patient education is required, at least for the most common disorders. The recent court decisions securing the right to abortion mean that patients will continue to have the moral and legal right to assert their privilege to plan their families and, where possible, to avoid genetic impairments in their children. Physicians will have the sensitive task of helping patients to achieve their personal goals regarding such family planning, while not overwhelming patients with confusing or frightening information.