Delivery of genetic services: transition from research to routine

1. It is nearly always necessary to obtain information on, and often to examine, members of the proband's family. Not only these relatives but also physicians, nurses, and other medical personnel are usually unprepared for this. Obstacles that must be overcome are emotional, geographic, organizational, and financial. 2. When family members are examined and heterozygotes detected there may be ethical problems both in withholding such information and in giving it. Cases in point are reviewed and the author's own view is presented, stating a strong case for giving all persons involved all available information regarding themselves. 3. Genetic diseases call for more research and experimentation than most other diseases met with in clinical practice. It is the responsibility of the physician-geneticist to penetrate each problem as deeply as possible with as little discomfort and risk to the patient and his family as possible. Such legitimate investigations must be financed by the community. 4. Genetics cases require, on the average, 2-10 times more time and effort than most comparable non-genetics cases. The need for adequate appropriation of personnel is stressed.