Good ethics requires good science: why transplant programs should not disclose misattributed parentage

Area of Science:

• Medical Ethics
• Genetics
• Transplant Surgery

Background:

• The Institute of Medicine (IOM) previously recommended informing women of misattributed paternity but not their partners.
• The author previously argued for disclosure to both parties, viewing misattributed paternity as a serious issue, not an incidental finding.

Purpose of the Study:

• To argue that current transplant compatibility tests are inadequate for accurately determining misattributed paternity.
• To assert that forensic evaluations of paternity are outside the scope of the transplant community's responsibilities.

Main Methods:

• Analysis of the adequacy of ABO and HLA inheritance testing in transplant programs for paternity determination.
• Ethical and professional scope evaluation of the transplant community's role in forensic genetic evaluations.

Main Results:

• Transplant program tests are inadequate for accurately determining misattributed paternity.
• The transplant community is not responsible for conducting serious forensic paternity evaluations.

Conclusions:

• Genetic inconsistencies in ABO and HLA inheritance should be reported as variations.
• Families requiring paternity clarification should be referred to genetic professionals, not the transplant community.