Search results

The problem of workers at risk should be reframed to reflect the impact of social stratification, power relations and divergent interests in occupational health practices. The past two decades have seen rapid developments in technology for detecting genetic traits and abnormalities in individuals that may indicate damage from chemical exposure. Occupational physicians, industrial managers and biomedical scientists increasingly favour this technology. However these methods have only selective appeal and are quite controversial. Their accuracy in identifying high‐risk workers is disputed as well as their value and consequences. Social factors that shape the way workers at risk have been defined are discussed. These social processes help to explain the way issues of risk are framed and industrial practices are conducted. They also explain patterns of support and opposition to genetic technology.

Risk notification is part of a focus on preventive medicine that is dominant in contemporary Western biomedicine. Genomics has forecasted great advances in alleviating disease and prolonging human life, moving from a reactive to a preventative practice. However, in doing so, genomics redraws boundaries, potentially classifying all people as possible carriers of malfunctioning genes. This chapter presents a critical review of the practice of ‘risk notification’ as undertaken by familial cancer genetic testing services, focusing on the right to be informed or not to be informed and implications of knowing.

With backgrounds in anthropology, psychology and public health, the authors draw upon literature around risk notification from a range of disciplines.

In the context of familial cancer, clients may be asked to provide contact information for biological family members to inform them of their potential genetic risk. Through these processes a number of tensions and issues may emerge that relate to fundamental bioethical principles. The ability and decision whether to know, or conversely, to not know, is ethically fraught. We consider the roles and rights of family members and clients, as well as the broader goal of population health.

While much attention has been devoted to clients’ right to know in the context of medical research and treatment, relatively little work has examined the right not to know and adverse consequences of knowing. This review addresses concerns which have rarely been critically examined and debated in the context of risk notification of biological family members.

In recent years, concern about the negative environmental effects of technologies, and in particular the use of genetic engineering in food production, has become a major topic in public debate. Public acceptance of genetic engineering is vital to development of this technology. This study, carried out in Christchurch, New Zealand, explores the role of consumers opinions, attitudes and behaviours toward genetic engineering. It focuses on the relative perceived risk associated with consuming genetically engineering food and the role of food labelling in reducing this risk. The study found that most consumers are uninformed about genetic engineering and the potential benefits it holds. The level of accurate knowledge held by the consumer was found to be an important determinant in the perceived level of risk and willingness to accept genetic engineering. Notable relationships were also found between demographic variables, attitudes and behaviours towards genetically engineered produce.

Genetic risk for depressive disorders is poorly understood despite consistent suggestions of a high heritable component. Most genetic studies have focused on risk associated with single variants, a strategy which has so far only yielded small (often non-replicable) risks for depressive disorders. In this paper we argue that more substantial risks are likely to emerge from genetic variants acting in synergy within and across larger neurobiological systems (polygenic risk factors). We show how knowledge of major integrated neurobiological systems provides a robust basis for defining and testing theoretically defensible polygenic risk factors. We do this by describing the architecture of the overall stress response. Maladaptation via impaired stress responsiveness is central to the aetiology of depression and anxiety and provides a framework for a systems biology approach to candidate gene selection. We propose principles for identifying genes and gene networks within the neurosystems involved in the stress response and for defining polygenic risk factors based on the neurobiology of stress-related behaviour. We conclude that knowledge of the neurobiology of the stress response system is likely to play a central role in future efforts to improve genetic prediction of depression and related disorders.

Examines the impact of genetic testing and therapy on health care in light of the development of the system in the USA since the turn of the twentieth century. Genetic testing and therapy have the potential to create a great advance in health care but also to become a business of multi‐billion dollar proportions. If present trends of investment and long‐range plans mature, health care will be adversely affected in terms of its distribution, access and economy. Developed and sold as commodities in a free‐market economy, genetic advances will economically stress health care and fail to meet the ethical and legal standards demanded by voluntary informed consent and counseling. Without abandonment of the marketplace approach to health care and thorough reform, many will find themselves excluded from the benefits and vulnerable to discrimination.

Given the growth in use of Preimplantation Genetic Diagnosis (PGD) in reproductive medicine, most fertility clinics have developed websites describing the benefits of PGD. This chapter examines the media frames employed on 372 U.S. fertility clinic websites marketing PGD to consumers and how these frames promote biomedicalization.

Evaluation of website discourse was conducted with the use of frame analysis, a research methodology for examining the way media frames bind together claims, judgments, and value statements into a narrative that guides readers’ interpretation of an issue.

Findings show that website discourse frames PGD in terms of the attainment of reproductive normality, the management of reproductive risk, and the achievement of technological progress. These discursive frames contribute to the ongoing biomedicalization of reproduction by re-naturalizing conception as a choice rather than a natural fact, by promoting preoccupation with biomedical risk, and by affirming new forms of technological power and expertise.

Examination reveals the ways in which PGD has developed its own system of representations, notions of exchange, and epistemic forms, and highlights the important ethical issues leveraged on fertility clinic websites marketing PGD.

As one of the first attempts to systematically analyze media frames that depict PGD on fertility clinic websites, this study contributes to medical sociology by advancing theoretical and empirical understanding of the media processes shaping accounts of reproductive technologies. Findings also provide a foundation for further analysis of the social norms and bioethical standards arising from consumer marketing of reproductive technologies.

Health inequalities exist between ethnic groups, an important example of this being infant mortality with babies of mothers born in Pakistan having double and babies of mothers born in the Caribbean having 63% higher rates than the national average. West Midlands Ethnic Minority Liaison Committee (WELCOME) and partners organised a conference to arrive at consensus among experts and stakeholders and to make recommendations around reducing infant mortality. One key area discussed, which is often contentious, was cousin marriage: its potential impact on infant and perinatal mortality and what health service response to this should be. Recommendations included: the setting up of a community genetic service in areas with higher risk of recessive disorders as a consequence of cousin marriage; genetic education to the wider public and health professionals; and community engagement, including community and religious leaders. This paper outlines how these recommendations were arrived at, the potential barriers identified in addressing this issue and the process by which service change was achieved with an aim to improve the outcome of infant and perinatal health among groups with higher burdens of genetic disorders in Walsall.

The issue of the genetic manipulation of plants, animals and microbes is addressed within the context of food production. Genetic manipulation is defined within the wider area of biotechnology and some of the main benefits of its use are summarised; safety and risk are examined and some of the socioeconomic problems it can create are discussed. It is concluded that the technique can offer great potential benefits in terms of increased quantity and improved quality of food, but it raises social/ethical concerns which can be summed up by asking: Is it safe? Is it fair? Is it natural?

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

The purpose of this research is to investigate how the consumer’s trusting mechanism influences their behavioral adoption intention in the context of genetic testing.

Based on the technology acceptance theory and trust formation theory, the research posits and develops a comprehensive trust model by integrating trust-related factors that correlate to the consumer’s trusting beliefs and trusting intention. Survey data with 525 respondents allow to test and validate the model.

The tested model shows that technology institutional trust base, end-user’s cognitive trust base and social influence are significant determinants of trusting beliefs. The findings also reveal that mediation effects of performance expectancy and perceived risks exist in the relationship between trusting beliefs and trusting intention.

The foreseeable positive impact and rapid market growth of emerging healthcare technologies necessitate the strong need to study user acceptance. However, there is a lack of research on how consumers trust and their adoption intention of such innovations. Prior empirical evidence from different contexts and perspectives also show contradictory findings. This research extends the existing technology acceptance literature to a healthcare context, provides an improved generalized understanding of the consumer’s trusting mechanism in emerging biotechnology and discusses practical insights for regulatory authorities, healthcare institutes and medical professionals.