Should Patients Have the Option To Not Know Their DNA? 157
An anonymous reader writes "Genome sequencing is getting faster and cheaper every year. This article points out that in the not-too-distant future, a DNA test will be a common diagnostic tool for doctors. It's a good thing for figuring out what's wrong with you — but there will unintended consequences. The test will also return information about conditions and diseases you're likely to get, which will spur more frequent testing — which can be extremely uncomfortable and/or expensive — as well as more frequent worrying. Should people be able to opt-out of this knowledge? Even if they do, should the information go into the patient's medical record? It likely will, and then the next doctor may be in the difficult position of not knowing what she can discuss with the patient. A new decision from the American College of Medical Genetics has recommended giving patients the option of not having the information gathered at all. It can get more complicated, too: '[G]eneticists and bioethicists are already discussing scenarios where patients may approach such decisions more like a menu, saying they want to know about increased risk of heart disease but not cancer, for example.'"
Op Out Knowledge? (Score:5, Insightful)
I do not think there is a single law on the books that makes it illegal not to know something. All knowledge is op-out-able, as far as I am aware, no one is likely ever going to force you and everyone else to know something.
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Knowledge is choice, without knowledge there is no choice. You can not choose to ignore knowledge, you are only in ignorance embracing ignorance. However DNA knowledge should be very tightly restricted with severe penalties including imprisonment, otherwise you will be 'opening up' people to organ donor bounties.
Re:Op Out Knowledge? (Score:4, Interesting)
This is false due to the problems that arise from psychosomatic influence if the knowledge.
Just knowing that you have a chance to be inflicted with illness will likely increase chance to get this illness, or at least some of its symptoms, causing the real problems.
This is why dispensing knowledge to patients is always difficult. Not only must doctor consider the illness itself, but also the psychosomatic effect of knowledge on the patient.
Re:Op Out Knowledge? (Score:5, Informative)
Huntington's disease is the big one people worry about with genetic testing as there is no treatment. It looks like there's only specific conditions under which it can go either way [wikipedia.org]. If there's literature showing that the 36-39 range can be affected by psychosomatic effects, I didn't see it on google. I did find this [psychosoma...dicine.org] which looks like advance knowledge of huntington's disease is helpful in the long run. At the very least, you can plan ahead.
Other diseases like predisposition to cancer, there's clear benefits to knowledge. If you know you are likely to develop breast cancer due to BRCA mutations, you're clearly better off knowing that than not. If you have a mastectomy because of that knowledge, then that more than negates the increases in risks due to psychosomatic effects.
More common diseases like diabetes, high blood pressure, and obesity, knowledge you're predisposed to that genetically might give people an excuse to be lazy and not prevent it, but I'm guessing such people would find an excuse anyway.
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Probably every psychosomatic disease out there. It doesn't matter what disease, just knowing the symptoms will often produce symptoms of the disease, even if the person doesn't have it.
Like WiFi radiation "poisoning" (substitute smart meter, cellphone, etc). Adva
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I suppose that telling someone they're predisposed to depression or some other psychological diseases might increase that incidence though now that I think about it.
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Thing is, it's very hard to predict the impact of psychosomatic knowledge on the patient because everyone reacts to knowledge differently. Some people can develop severe life-threatening asthma just from knowledge of the disease or at least exhibit its symptoms for example. It's important to note that even if patient is not actually asthmatic, the symptoms are REAL and can be life threatening requiring medical treatment.
Same thing in the opposite direction. Positive psychosomatic effect is often called plac
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That is a placebo. Positive psychosomatic effect is the proper medical term for "placebo".
And it's important to understand that some people are far more affected than others, and while your aunt's problems are psychosomatic, the symptoms are in fact real. I.e. if you see someone having a psychosomatic asthma attack, telling him it's just his imagination is not a good idea.
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You are asking the question that is in fact answered in the post you answered to.
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that would be awesome, organ donor bounty hunters.
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Theres a lot of DNA conditions that are straight up "You wont live to 50 and theres nothing you can do to make it better" type things. Frankly for a young person, its better to just not know and go and live a healthy and normal life until the bloody thing reveals itself, than living a life in misery under a death sentence.
Living in ignorance isn't living a lie, knowing the truth and going on like its not real , however is.
Frankly, I'd take the ignorance.
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There's a lot of DNA conditions that are straight up "You wont live to 50 and there's nothing you can do to make it better" type things. Frankly for a young person, its better to just not know and go and live a healthy and normal life until the bloody thing reveals itself, than living a life in misery under a death sentence.
Living in ignorance isn't living a lie, knowing the truth and going on like its not real , however is.
Frankly, I'd take the ignorance.
Yes, but in those cases you still have the question of whether you're willing to pass those conditions on to (possible) children. It's bad enough that you have some horrible crippling ailment, are you going to needlessly inflict it on some innocent through willful ignorance?
Sounds like security through obscurity. (Score:2)
Works ever time, right?
Sounds like derp. (Score:2, Insightful)
Parrot more cliches, and be sure to post your social security number, home address, mother's maiden name and date of birth here to Slashdot.
Security is an onion. Obscurity is a valid layer. Stop posting ignorant battlecries.
Re:Sounds like derp. (Score:5, Informative)
I like to think of it it his way. A soldier wears camoflage in the field to help protect him from being shot. Being able to not be seen against the background terrain is a form of obscurity and it is effective because it helps keep bullets from being aimed directly at the solider. The downside is that it's not particularly effective at stopping a bullet aimed at the soldier.
Body armor is different in that it's particularly useful when bullets are being aimed at the soldier. It can stop a bullet that camoflage clothing will not. While at the same time it, its downside is the limited mobility and extra heat.
Now, an even better measure of security than just either one of them is to use both. One helps keep you from being shot at while the other helps protect you when you are shot at.
Wouldn't you rather have both when you're a soldier in the field with someone trying to shoot at you? If you say yes, then you understand the point of obscurity in the security arena. If you say no, then that's probably a bit daft.
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Yes. Otherwise I suggest you convince our military folks that a bright orange uniform is just as safe as camouflage.
Camouflage is security through obscurity.
Re:Op Out Knowledge? (Score:5, Funny)
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I do not think there is a single law on the books that makes it illegal not to know something.
I'm sorry, but ignorance of that law is not an excuse [wikipedia.org].
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That's not the same thing. Not knowing a law doesn't excuse you from breaking it, but not knowing a law is not in-and-of-itself a crime.
Unfortunately, there are cases in the United States where a person cannot opt out of medical knowledge. Several anti-abortion measures spring to mind.
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Amazingly, it is illegal not to know the law. More specifically, not knowing the law is never a defense.
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Although in many cases, it should be.
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So not knowing murder is illegal allows you to murder?
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In case of some weird and exotic laws not knowing it should exempt you:
It is illegal to play dominoes on Sunday. [tripod.com]
Disclaimer: Dunno if that list is correct, but it is at least somewhat funny.
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No. It only becomes a problem when you break it. And even then you won't be fined for not knowing the law, but only the offence at matter.
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No. It only becomes a problem when you break it. And even then you won't be fined for not knowing the law, but only the offence at matter.
Exactly! I decided to take precisely this approach with something called "taxes" this year.
Apparently, I am actually compelled by law to file them, but I didn't actually know that. One day, I was typing random keys into my search engine, and I randomly typed "taxes," and all of these cool websites popped up with forms that I could enter random numbers into!
The forms mentioned all these things like "W-2s" and "401k," but I knew nothing about what these were, so I just filled in random numbers. It was
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Yeah, you're technically right that the government can't fine you for "not knowing the law." Just like the laws of physics technically don't require me to die if I jump off of a 30-story building. But it would not be a good idea to live my life every day doing these things.
From a practical standpoint, you can be fined or put in jail for not knowing the law. Technically, you're put in jail for the effect of not knowing the law (i.e., your action in breaking it), but there are many places where the law compels you to do all sorts of random technical things (like filing tax returns), and it's a practical impossibility to comply with the law without having some knowledge of it.
But then there is not only the practical standpoint, but also the realistic one: There are more laws and regulations you DON'T have to know about than otherwise, because you're never going to take any action in the field they're regulating. Like, for example, I don't know zip about any FAA regulations. But at the same time it is very likely that I never will violate any of them, because I'm simply not building or operating planes (gliders, helicopters, kites, hanggliders, parachutes... actual and/or model)
A
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And as there are so many laws and regulations irrelevant to most people, it IS relevant that you can't be fined for not knowing them. (as long as they stay irrelevant for whatever you're doing.)
Yeah, of course that's true, but NOT relevant to the point the GP was trying to make, which is (supposedly) that you NEVER are forced to know the law.
I was simply noting that there are sometimes common everyday situations (like doing your taxes) where you are basically required by law to do something in a particular way. If you don't do it at all (because you don't know about the requirement), or don't follow the law in doing it, you WILL be fined or put into prison. How anyone could manage to comply wi
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NP. And I know it's a very technical difference, so no offence here.
And of course you have to know the law to avoid breaking it. But not have to know it simply for the sake of knowing it. And it was you who already made the point why: It would be "thoughtcrime" to punish someone only based on what he thinks or knows. And that's why this small difference DOES matter.
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Amazingly, it is illegal not to know the law.
No it's not. The former statement does not logically follow from the latter.
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Not knowing is akin to not opening that envelope from the bank you know contains your next mortgage payment reminder. It's not going to go away just because you put your head in the sand. It is a proven fact that early diagnosis significantly improves the chances of being cured or having comfortable life.
I doubt anyone is going to force you to know your faulty DNA, but opting out of knowing if given the choice is just stupid, and potentially very expensive - because you will change your mind on having that
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The information that they're wondering if they should give you is often faulty, and results in people making bad choices. For example, undergoing preventive therapy that is costly, has serious side effects, and turns out to have been totally unnecessary. You weren't going to get that disease that you decided you needed to be treated for. Meanwhile, it caused you health problems, and untold mental agony, anda lifetime of worrying. Also for your relatives (children and parents). By giving them this infor
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The DNA check should be used as a crosscheck. If symptom gene 127891 is present then the chance that symptom AHKS is a serious heart condition is big. If it isn't present then it's probably just a rash.
If your doctor has a list of increased chances based on your DNA then that helps to diagnose quicker and better.
Not everyone can handle such information. It is a big step to stop worrying about a future disease and have fun with life. Anecdotal evidence suggest that many people can't take such a step.
Personal
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I doubt anyone is going to force you to know your faulty DNA, but opting out of knowing if given the choice is just stupid, and potentially very expensive - because you will change your mind on having that treatment once the symptoms appear, which might very well be too late.
What if there is no effective treatment? James Watson, co-discoverer of the DNA structure and one of the first people to have his entire genome sequenced, chose not to know the sequence of his APOE gene, some variants of which have been linked to an increased risk of late onset Alzheimer's disease.
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I don't see the lack of a treatment as an argument for not knowing, but I do get why some might not wish to know in that instance. My problem is with the general sentiment that it is ok to stick your head in the sand. The problem does not go away by doing that. And in the case I have a terminal incurable illness, I'd like to know so that I can make the most of my time left, and make sure that the people closest to me won't suffer needlessly because of my ignorance.
Because the choice is not always yours alon
Re:Op Out Knowledge? (Score:5, Insightful)
People (and genetic risks) are different. One person's 'making the most of my time left' is another's 'spending decades with the constant threat of a terrible disease blighting my life'. In Jim Watson's case, he was already at an age where presumably he'd made adequate provision for his loved ones (the link is with late, rather than early onset dementia). Knowing that he might be at increased (but very far from absolute) risk of losing his mental faculties late in life wasn't useful information to him, but might have led him to worry about something he could do nothing about. It's not hard to think of other scenarios where an individual may make the (perfectly valid) choice to not know everything about his genome.
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Assuming there's anything useful you can do about it, For example, say that gene X means I'm ten times as likely to develop incurable condition Y, but it's a 0.1% chance as opposed to 0.01% chance in the general population. Is that going to help me in some way? If you get a long list of potential illnesses that you might be somewhat predisposed to does that do anything other than turn you into a hypocondriac? Tell me what I need to know for treatment or symptoms to look out for or lifestyle changes, the res
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I do not think there is a single law on the books that makes it illegal not to know something.
If there was, most of the kids that I went to school with would be in jail. They had shit for brains. The poor teachers were fighting a lost cause trying to teach that lot.
All knowledge is op-out-able, as far as I am aware, no one is likely ever going to force you and everyone else to know something.
No known force in the universe seems to be able to get some kids to do their homework.
So even if doctors were force to tell potential diabetics that they will develop the disease if they keep quaffing sugary drinks . . . a lot of folks will opt out in their own head anyway. Simply because they don't want to hear what a doctors is tell
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Kids like that need different types of teaching.
"So even if doctors were force to tell potential diabetics that they will develop the disease if they keep quaffing sugary drinks "
is there a Dr. that doesn't say that now?
If you are drinking sugary drinks, you potential have diabetes.
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Interesting thought, what if we rested people for ignorance and sentenced them to school.
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No knowledge is opt out able. How do you opt out of something you already know?
Gaining the knowledge can be.
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You are legally allowed to not familiarize yourself with laws, and it is never illegal not to ask questions ("Can you bring this generic package over the boarder for me? Sure, why not", is legal). You are not not protected from the consequences of your ignorance.
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"I do not think there is a single law on the books that makes it illegal not to know something. "
You'll go to jail if you violate any law, even those you didn't know about, so your statement is up for discussion.
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The article is NOT about opting out of knowledge. The article is about the patient opting out of having certain DNA tests done.
Currently, when your doctor sends you for a blood test you can opt out of having tests done. i.e. no change in current practices.
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Like several previous posters, your second statement doesn't logically follow from the first.
It's illegal to break the law in question; it's not illegal not to know that it's against in the law in the first place. It's just that you can't use it as a defence.
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yeeehaw (Score:1)
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Heh. With the pace we're on, whether or not you have access to your DNA information and whether or not it's in your medical history, it will be in a database with essentially unfettered access by the NSA, FBI, TSA, ATF, CIA and probably the local police should their buddy the 5 term, hard-on-crime judge agree.
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Shit. I totally whiffed on DEA!
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also, goog will run ads against it.
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IF there were strictly enforced laws on how they use that data, would that be bad?
Hypothetically speaking.
Should know ! (Score:3, Insightful)
Genomic Medicine will probably be required (Score:4, Insightful)
As Genome Wide Association Studies begin to crack more of the genomic puzzle, there will be tighter and tighter direct correlation between medicine types & doses and the effectiveness of those drugs. As this efficacy increases, it is highly likely that the best insurance coverage will be based on genomic information.
Determining precise doses of a drug and which drug should be used is going to make for much better quality of medicine. I would expect that in a couple of decades people are going to look at the drug practices of today and laugh that we are pretty much throwing darts at the drug dartboard and choosing whatever it lands on.
Opting out of specific tests will be like not wanting X-Rays to see if a bone is broken.
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As this efficacy increases, it is highly likely that the best insurance coverage will be based on genomic information.
Actually no; that's been illegal for a few years now:
https://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimination_Act
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That is different. My read of the GINA is that your health insurance provider is not allowed to use genetic screening to make coverage RISK decisions. As in, they can't force or require you to screen for cancer and then decide that you aren't coverable because of BRCA. Apparently life insurance is not covered by GINA, so that is another issue.
Also note that GINA is an American law. Not global.
The comment I made was about tuning treatment based on genetic information - which is very different. Rather th
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Opting out of specific tests will be like not wanting X-Rays to see if a bone is broken.
That's not what the article is really talking about though, they're talking more about whole genome sequencing. Besides that, I imagine there are already people who decline X-Rays for one reason or another, just like there are people who decline blood transfusions or major surgeries.
opt-out (Score:2)
Should people be able to opt-out of this knowledge?
If they couldn't, it would be interesting to know how many more people would avoid going to the doctor altogether.
Also interesting would be to know if the risk of getting a predicted illness would go up just from knowing about it.
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Well, there are people who avoid going to the doctor if they think they'll be switching jobs in the near future because they don't want to be burdened by a pre-existing condition.
Of course, I think in 20 years, this will all be moot. Everyone will be gene-sequenced at birth and they'll have this database of information to work off of and it will just be the new normal. Medicine will eventually learn what spam fighters already know: dumb beats smart. Which is to say, however clever you think you are, give
Knowledge is Power (Score:5, Insightful)
I suppose on the other hand, if you worry so much thinking that you might get cancer you could die of a stress-induced heart attack or something.
Generally speaking though, forewarned is forearmed, and if the susceptible are more aggressively screened and treated, then it could well take away a lot of the "cancer is a death sentence" mentality that many people have.
I suppose it'll come down to personal decisions, but I sure wouldn't want to die of a condition that I was genetically predisposed toward, that was treatable and that I never got tested for because I was afraid the answer might be "yes".
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If you know that you may be more likely to get cancer, then you can get tested more often and aggressively, increasing the chances that your cancer will be treatable.
That's sort of a 20th century mindset. The current consensus seems to be in favor of backing away from annual mammograms, not checking PSA, not doing routine dental x-rays, etc. The problem is that with all these screenings we have introduced ironic iatrogenic issues: treating benign conditions because test results were weird (or false positives). In the end, the data shows this isn't improving outcomes. Just imagine if you had your prostate nuked because your PSA was positive, and you lost your ability to
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Yes, BRCA is a counterexample. It is also an outlier, and testing for BRCA can usually be guided by a simple family history. If there is BRCA in the family, there will be a very high incidence of breast/prostate cancer in the family. If that's the case in your family, consider talking to a medical geneticist and possibly getting BRCA testing. As before, I'm not proposing people be barred from having tests done to learn their status, but I am against goading people (especially if it's not going to be helpful
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23andMe is a mess; advertising yourself in large print as performing genetic testing but putting "but we don't do medical testing" in the fine print while your real business plan is to rent out peoples genetic and family history data to any corp with deep enough pockets is a bit of a shitshow.
In general, aggressive screening has been extremely useful: pretty much everyone gets screened for PKU, sickle cell anemia, cystic fibrosis, MCAD, hypothyroidism, and another ~20 conditions at birth. Vision and hearin
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In general, aggressive screening has been extremely useful: pretty much everyone gets screened for PKU, sickle cell anemia, cystic fibrosis, MCAD, hypothyroidism, and another ~20 conditions at birth.
Funny you should choose neonatal screening as an example in support of your argument. Firstly, the things that *are* screened are a carefully curated list of unambiguous genetic defects that 1) have immediate deleterious effect on the development of the child and 2) have an intervention that will alter the trajectory of the disease. This is why, for example, no one screens the population for Tay Sachs. In fact, the ~30 tests that are part of the standard panel now are all that's left after *hundreds* of can
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Those cases where forewarned doesn't help are definitely at issue. The classical example is Huntington disease. It's an autosomal dominant death sentence and there is no treatment or way to alter the course of the disease. Some people don't want to know. There is actually a very elaborate three-phase commit for testing/getting results for Huntington disease, and geneticists won't perform the test on a minor.
On the other hand - in case of Huntington's there is a 50/50 chance of your children inheriting it from you if you have it. So it can be argued that is it not ethical to test yourself if one of your parents has it in case you are planning to have kids?
I can understand some people do not want to know and still have kids and are ok with that, however I would not be in the case of Huntington's specifically (no cure, very, very nasty disease - although depending on the repetition count of the gene pattern that
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From what I have seen, people at risk for Huntington aren't exactly irresponsibly breeding. You have to recall that most of them were traumatized as children by having their parent(s) and/or siblings become ill, be institutionalized, and die.
I haven't heard of any who were nihilistically refusing to learn their status while potentially passing this on to their kids via their genes. Usually, it seems they are doing the test to see whether they can have a family/future or if they should be planning which faci
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"Even if we postulate an 1:1,000,000 ratio of claimed discoveries to data items, there are zillions of discoveries that can now be claimed every day. Based on what we have started to surmise empirically, most of these claimed discoveries are likely to be either totally false preliminary observations (Ioannidis, 2005) or substantially exaggerated results (Ioannidis, 2008), a consequence of the extreme multiplicity of the probed data-space, the winner's curse (Zollner and Pritchard, 2007), and other biases.
Gattaca (Score:2)
It certainly would have made Gattaca a shorter movie.
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I think it would have just underscored the bigotry and intolerance.
I still wonder what the long term viability for those companies are. I mean, after a couple generations 99% of issues will have been removed from the gene pool.
On the plus side I suspect intelligence will be chosen, so after a coupe of generation off 200 IQ. they may figure it out.
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Given the choice between intelligence and football playing ability (American in the US, soccer elsewhere) I know which I'd bet on the bulk of humanity to choose for.
Because Spoilers (Score:2)
Some people HATE spoilers.
Other similar situations (Score:2)
How did that work out / what ever happened with it?
Society (in the US anyhow) already allows unrelated information to be used, for discrimination anyhow. I mean your automobile insurance costs is based on your credit history for gosh sakes. Why not allow insurance companies to reject you completely if they know you are going to get sick. I mean its not like insurance is for evening
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wasn't there a discovery that determined if you were likely to commit a crime? Or be serial killer or something like that?
How did that work out / what ever happened with it?
90% of murderers, and 99% of convicted rapists, have a copy of the SRY gene, which is much higher than its frequency in the general population (about 50%). SRY has been linked with aggressive behaviour, autism, and a preference for large, fast cars.
if the patient (Score:2)
want's to remain ignorant, fine but the info should still be collected. It will be too valuable a tool.
Completely at the patients' discretion (Score:2)
I think the general rule should be that the patient should decide about his/her own health.
I have met and heard about people that have had various conditions that have opted out on diagnosis, because they want to opt out on a certain treatment. People who have had cancer multiple times and would rather die from cancer the next time than suffer through radiation therapy and chemo, or people who have had an implanted automatic defibrillator that has provided a very painful experience.
If any kind of medical te
What's more important: (Score:2)
What's more important: People need help interpreting DNA and other tests. And doctors, too! We're no way near deriving the best individual course of action based on statistical information.
News at 11 (Score:2)
It's actually a common phenomena and a strategy for managing bad news, be it about cancer or climate change. The problem arises when the person in denial does not move on to other mental states, but merely clings to denial "I don't have cancer", "there's no such thing as climate change" etc.
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stress-related illness (Score:2)
the effects of stress in exacerbating and causing physical ailments is one that is well understood. many people naively believe that genes are the sole exclusive means by which illness may occur, despite there being innumerable counter-examples clearly demonstrating that this is false. that does not prevent people from *believing* that genetics is the sole exclusive cause of one particular illness or another, and *for such people*, that belief, when they are presented with such "quotes truth quotes", is q
The solution is software (Score:2)
2. Screen for the disease as requested, and only give this information to the doctor
3. Keep the data in case more questions are asked
4. You can thank me later
I don't see a problem. A patient undergoes a DNA test to answer a
Full Body Scanners (Score:2)
I kind of doubt how useful genome sequencing will be for basic diagnostic medicine. I'm reminded of a scene in House where they're complaining about having to run a full body scan, because any time you scan anyone, you always find a dozen things "wrong" that require following up on, almost all of which are benign.
As a separate issue, considering the fact that the medical profession still can't decide whether fat is good for you or not [npr.org], I have very low confidence in most assessment that X gene is linked to X
The government has already opted us out. (Score:2)
With the shuttering of 23andme.com, forced by the FDA [cnn.com], we no longer have the ability to have our genes sequenced on our own prerogative.
Thanks federal government.
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The FDA did not stop 23andme from providing DNA testing.
The FDA required 23andme to provide data that showed the information 23andme provided was accurate. 23andme chose to stop providing testing rather than provide information about the accuracy of their tests.
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Good to know. Now I just need to find a way because my state makes it illegal for labs to sell directly to consumers.
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I don't foresee many lawsuits from patients suing from the grave for diseases they never got. But I guess we are talking about America, aren't we?
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As population in US realises that many more of them can't get insurance, while the few that get insurance understand that they would likely get off much cheaper if they didn't have insurance, you'll likely see the push for universal healthcare using one of European models.
So I would suggest that beyond short term, this will likely be extremely destructive for private insurance companies.
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Yep.
Then finally we can have a decent health system.
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Spend ~65% of what we do now to recreate one of the European systems.
Spend another ~20% to make our version kick the European version's ass.
Spend the last 15% on bribes to the top stakeholders in our current system to keep them from sabotaging the new one.
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What I don't understand is why you'll have your DNA tested often. Isn't once good enough until the tech advances or is it advancing significantly yearly?
Pretty much. You would have your genome sequenced once and have the analysis updated as new correlations are validated. The exception would be testing of gene expression levels by looking at mRNA levels. Lots of diseases result in specific changes in gene expression even though the genes themselves haven't undergone any mutation; the changes in expression level can predict the course of the disease and guide therapy decisions.
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What I don't understand is why you'll have your DNA tested often.
Because (a) it will be a routine part of your examination, and because medical records are not easily shared between providers they can't just look it up in your file and (b) they won't be full genome analysis (just looking at certain different things at different times) and (c) the "raw data" won't be easily available. When the storage and sharing (and privacy) issues with your DNA are technically and legally and procedurally solved someday, then they won't be needing to sample you very often. We're a long way from that in this decade.
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Your doctor doesn't tell your insurance agency anything beyond "He had a consult, it costs $X. Pay up."
If he tells the insurance agency anything else, he is liable for a whole mess of lawsuits in most countries, including I believe the USA and definitely the Netherlands.
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Your doctor doesn't tell your insurance agency anything beyond "He had a consult, it costs $X. Pay up."
If he tells the insurance agency anything else, he is liable for a whole mess of lawsuits
The insurance company receives every detail of every procedure and every prescription that you have (as well as how often you fill it, whether you do so at the appropriate intervals, etc.) There is a lot more detail than "a consult". The insurance company then uses sophisticated AI programs to guess (when it isn't already spelled out) what's wrong with you, and what might go wrong with you in the future. They know a lot more than you seem to think. They read and process tremendous amounts of this inform
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Yeah, that's not true. You should look up ICD 9 codes and its replacement ICD 10. Many (most?) insurance plans require your provider to submit these codes when billing for treatments.
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This is not a problem with DNA testing, this is a problem with the insurance companies, which need to be done away with. They bring NOTHING to the game when it comes to healthcare delivery and add a significant cost, as these concerns show, they often inhibit healthcare delivery. The answer to that is simply universal single payer healthcare.