Suchergebnisse

Three main reasons why a genetic approach is unlikely to be a solution to common diseases in the foreseeable future are discussed. The first is the great importance of environmental circumstances in determining health, the second reason is the great complexity of gene/gene, gene/environment interactions, and the third reason is human behavior with regard to compliance with medical recommendations. Since particular interests are likely to push for a genetic approach to disease, there will be a need to protect the public interest so that premature and inappropriate use of genetics is not made, and so that a balanced opportunity to better the health of all is not missed.

<i>Objective:</i> To describe the challenges facing countries all over the world regarding the appropriate clinical use of genetics in their health care systems. <i>Methods and Results:</i> Aspects of the economic and social contexts in different countries which are of particular relevance to shaping the existing challenges are outlined. Issues which are relevant (but of different prominence) in all countries in providing genetic services are discussed. <i>Conclusions:</i> The challenges facing the provision of appropriate genetic services differ markedly in four major groups of countries. These challenges range from controlling inappropriate commercialization and the overuse of genetic approaches to putting in place even minimal basic community genetics services in countries where the infant mortality rate has fallen to a range where genetic and congenital disorders contribute substantially to ongoing handicap and early mortality.

<i>Objectives: </i>Birth defects occur in populations in 3–5% of births. This paper assesses whether population-wide screening programmes for pregnant women would be likely to result in major decreases in the prevalence of birth defects. <i>Method: </i>Relevant literature on this question is reviewed and synthesized. <i>Results: </i>Given certain assumptions, a decrease from 3–5 to 2–4% in the prevalence of defects at birth may be possible. The resources required to put in place an appropriately delivered programme to achieve this are substantial. <i>Conclusions: </i>As well as the potential benefit of a decrease, there are opportunity costs, and potential serious harms. Unless undertaken in a carefully planned and monitored way, a population-based birth defects reduction programme is likely to bring harm and anxiety rather than benefit.

This paper discusses how in vitro fertilization provides a good example of the fact that research evidence is only part of a complexly interacting mix in policy development. ; Non UBC ; Medicine, Faculty of ; Population and Public Health (SPPH), School of ; Unreviewed ; Faculty

Medicine, Faculty of ; Population and Public Health (SPPH), School of ; Unreviewed ; Faculty