10.9 Genetic testing is sought in various contexts for different purposes. The uses of genetic testing are likely to expand over time as the testing processes become easier to undertake and their practical uses become clearer. These processes are likely to be facilitated by the knowledge that is becoming available as a result of the Human Genome Project.
10.10 The principal current users of genetic testing are identified below.
Medical practitioners use genetic testing to diagnose patients for treatment as well as for predictive, presymptomatic, screening and prenatal purposes. Practitioners request the various types of genetic tests through request pathways, which may involve referral of the patient to a clinical geneticist and also pre-test and post-test counselling.
Medical researchersuse genetic testing to advance medical or scientific knowledge about how genes influence the health of individuals and populations. Genetic testing for research purposes may be conducted in concert with medical practitioners, who liaise with participating patients.
Individualsgenerally cannot obtain direct access to clinical genetic testing by laboratories in Australia. Thus diagnostic, predictive, presymptomatic, genetic carrier, screening, pre-implantation and prenatal genetic testing must generally be sought through a medical practitioner. However, some laboratories offer kinship testing, particularly parentage testing, directly to individuals, and the range of testing available to the public is likely to expand in the future.
Policeuse genetic testing in law enforcement primarily for the purpose of identification, such as to identify victims, deceased persons and suspects.
Lawyers and litigants use genetic testing as evidence in criminal and civil cases. In criminal cases, genetic testing may be used to prosecute offenders, obtain acquittals, and to press for reversal of convictions on appeal. Litigants also use genetic testing in civil cases, for example, to establish parentage in family law or succession matters. In the future, genetic testing may also be used by litigants in negligence actions to establish or defend a claim.
Employers may seek to use genetic testing to screen or monitor employees or job applicants. Although this type of testing is not common in Australia at present, overseas experience suggests that these uses are likely to expand in the future. Employers may seek to conduct genetic testing to reduce workers compensation claims, comply with occupational health and safety obligations, or increase productivity by screening out employees who are most likely to be absent from work due to illness. The testing may take the form of predictive or presymptomatic testing to identify whether an individual who is currently asymptomatic has a gene that increases the likelihood that he or she will develop a disorder as a result of the workplace environment. Testing may also screen for genes or disorders that are unrelated to the workplace but which may render an individual undesirable to an employer.
Insurers may use the results of genetic testing as a component of the underwriting process in applications for personal insurance, where health information is collected to assess the risk that applicants bring to the insurance pool. The testing may take the form of diagnostic, predictive or presymptomatic testing, particularly in relation to life insurance.
Governmentagencies may use genetic testing to establish kinship or identification. For example, the Department of Immigration and Multicultural and Indigenous Affairs sometimes uses genetic testing to establish family linkage for the purposes of Australia’s immigration programs; law enforcement agencies often use identification testing for the purposes of criminal investigation.