In “Incidental Findings of Nonparentage: A Case for Universal Nondisclosure,” the authors argue for universal nondisclosure in cases of incidentally discovered nonparentage during a genetic workup for a pediatric patient. I could not disagree more. In making their case, they portray the potential damage done by disclosure but dismiss well-established ethical principles for the argument to disclose.
Ironically, the authors label current case-by-case decision-making as paternalistic but fail to realize that applying it wholesale rather than ad hoc does not absolve them from this guilt. It is not easy to anticipate correctly how any particular family will handle such information, nor can it be an assurance that a family will not have to confront this information at a later date. Therefore, denying the information to any family is inappropriate.
No ethical consideration is absolute, but truth-telling is as close to being paramount as possible without denying others primacy. The consequences of withholding truth, even with the protection of a nondisclose policy, are substantial. Savvy parents in the scenario portrayed would likely have asked about the odd results, putting the physician in an awkward position: either reveal despite the policy or remain adamant behind lawyer-like language that they will have to seek that information elsewhere. For those who do not ask, the physician’s knowledge of nonparentage will introduce a subtle barrier to frankness.
Lastly, in discussing the “undue burden” on physicians who have to confront this dilemma, alleviating physician discomfort should not come at the expense of an otherwise ethically appropriate action.
Conflict of Interest:None declared
- Copyright © 2015 by the American Academy of Pediatrics