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Train over‐runs in south‐east Queensland
Author(s) -
Milne Nathan,
Williams David J
Publication year - 1996
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1996.tb124951.x
Subject(s) - citation , library science , forensic science , associate editor , history , computer science , archaeology
screening for carriers of conditions such as haemophilia A, cystic fibrosis, thalassaemia and Tay-Sachs disease. Haemophilia A leads to a progressive and painful arthropathy generally incompatible with employment. The lifetime drug cost of prophylaxis with recombinant factor VIII3,4 alone is $15-$25 million. The lifetime monetary costs of treating cystic fibrosis and thalassaemia are also enormous, as are the personal and emotional costs of progressive, degenerative and usually fatal genetic diseases. Prevention, where practicable, is preferable to current methods of treatment. However, screening for genetic disease is extremely stressful if a family member is already affected and can be devastating if the result is positive. The thought of terminating a pregnancy and actual termination after a positive fetal test is an even greater stress. Even artificial insemination and, particularly, egg donation with its associated surgical procedures would provoke anxiety. A possible practical solution to significantly reducing the suffering and expense of common genetic diseases is to pay people on a sliding scale for screening, detection and prevention of genetic disease say, $50 for screening to a woman with no familial or racial risk, $150 to a woman with a racial risk of genetic disease, $150 to a person with a carrier partner, $500 to a person screened with a family history of a serious autosomal recessive genetic disease and who is a potential carrier, and $1000 to a person screened with a family history of a serious sex-linked recessive genetic disease and who is a potential carrier. This monetary approach will not result in the birth of fewer children, but it would bring the joys of parenthood to couples who would otherwise have decided that the pain of remaining childless was preferable to the pain or the cost to society of producing a severely affected child with a poor prognosis. This approach would not only be an incentive for voluntary screening and prevention of genetic disease, but would partially recompense the individual for these stressful processes, while indicating society's acceptance of genetic screening and selection, and gratitude for an individual's contribution to health cost reduction until science can deliver inexpensive cures for these diseases.