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Unnithan M, Pachauli C, Chattoo S, Atkin K. 'Only parents can understand the problems and needs of children with thalassaemia': parental activism for thalassaemia care in Northern India. Anthropol Med 2023; 30:48-63. [PMID: 36815601 DOI: 10.1080/13648470.2023.2180258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Evolving knowledge of genetics and improved clinical care have re-shaped life choices for those suffering from chronic, incurable conditions and their families. Yet the realisation of care requires complex navigation to access vital therapies which is often difficult for individuals or their family carers. In the article, we explore the struggles and strategies of parents of children with thalassemia (a genetically inherited blood disorder) in a North Indian city, who have come together to ensure better long-term health of their children. A focus on the ways in which families come together and remain apart in their quest for guaranteed access to life-saving substances such as filtered blood, provides insight into the diversity of bio-social strategies at work. It is not only family relationships and kinship, we suggest, but bio-sociality itself which is reshaped with the advent of new rights-based languages, evolving therapies and state support which hold out new possibilities for young people with thalassemia to live as normal a life-course as possible.
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Affiliation(s)
- Maya Unnithan
- Department of Anthropology, University of Sussex, Brighton, UK
| | | | | | - Karl Atkin
- Department of Sociology, University of York, York, UK
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2
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Hui EKY, Yam JCS, Rahman F, Pang CP, Kumaramanickavel G. Ophthalmic genetic counselling: emerging trends in practice perspectives in Asia. J Community Genet 2023; 14:81-89. [PMID: 36322374 PMCID: PMC9947206 DOI: 10.1007/s12687-022-00616-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Genetic counselling (GC) provides information to the patient and the family to make informed choices. Among the advanced Western countries and a few Asian countries, there are certified or trained professionals who perform GC. The Human Genome Project and next-generation sequencing diagnostics have provided an opportunity for increased genetic testing in the field of ophthalmology. The recent interventional therapeutic research strategies have also generated additional interest to seek GC globally, including in Asia. However, GC has several barriers to practise in the developing countries in Asia, namely, (a) shortage of qualified or trained genetic counsellors, (b) poor knowledge and reluctance in clinical adoption of genomics among the physicians in clinical practice, (c) overstretched public health services, and (d) negligible ophthalmic GC-related research and publications. The GC inadequacy in Asia is glaring in the most populous countries like China and India. Cultural differences, religious beliefs, misogyny, genetic discrimination, and a multitude of languages in Asia create unique challenges that counsellors in the West may only encounter with the immigrant minorities. Since there are currently 500 or more specific Mendelian genetic eye disorders, it is important for genetic counsellors to translate the genetic results at a level that the patient and family understand. There is therefore a need for governmental and healthcare organisations to train genetic counsellors in Asia and especially this practice must be included in the routine comprehensive ophthalmic care practice.
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Affiliation(s)
- Esther K. Y. Hui
- Department of Ophthalmology, University College London, London, UK
| | - Jason C. S. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Farhana Rahman
- Department of Pharmacology, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, India.
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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Sanchez‐Rivera R. From preventive eugenics to slippery eugenics: Population control and contemporary sterilisations targeted to indigenous peoples in Mexico. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:128-144. [PMID: 36194516 PMCID: PMC10092020 DOI: 10.1111/1467-9566.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
Eugenic ideas in Mexico were popularised after the Mexican Revolution (1910-1920) as a way of 'modernising' and 'civilising' the nation. As a result, eugenic ideas were able to linger and be maintained through different departments, institutions, and individuals from all disciplines. After eugenics was considered a pseudoscience, its practices and ideas continued through population control measures that targeted indigenous populations for sterilisation, a trend that still prevails. The purpose of this article is to explore the legacies of eugenics in current sterilizations procedures mostly targeted at indigenous communities in Mexico. I offer the term 'slippery eugenics' to account for the legacies of eugenics in Mexico which, in this specific case, resurface in the systematic forced and coerced sterilisation procedures targeted at indigenous communities.
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Affiliation(s)
- R. Sanchez‐Rivera
- Gonville & Caius CollegeCambridgeUK
- Department of SociologyUniversity of CambridgeCambridgeUK
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Cai YT, Mason KA. Why They Willingly Complied: Ordinary people, the big environment, and the control of COVID-19 in China. Soc Sci Med 2022; 309:115239. [PMID: 35969978 PMCID: PMC9356634 DOI: 10.1016/j.socscimed.2022.115239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Yifeng Troy Cai
- Department of Anthropology, Brown University, Box 1921, Providence, RI 02912, USA; School of Public Health, Brown University, 121 S Main St, Providence, RI 02903, USA
| | - Katherine A Mason
- Department of Anthropology, Brown University, Box 1921, Providence, RI 02912, USA.
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Zhong A, Darren B, Loiseau B, He LQB, Chang T, Hill J, Dimaras H. Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: a systematic review. Genet Med 2018; 23:2270-2280. [PMID: 30072741 DOI: 10.1038/s41436-018-0090-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/04/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE We performed a systematic review of the ethical, social, and cultural issues associated with delivery of genetic services in low- and middle-income countries (LMICs). METHODS We searched 11 databases for studies addressing ethical, social, and/or cultural issues associated with clinical genetic testing and/or counselling performed in LMICs. Narrative synthesis was employed to analyze findings, and resultant themes were mapped onto the social ecological model (PROSPERO #CRD42016042894). RESULTS After reviewing 13,308 articles, 192 met inclusion criteria. Nine themes emerged: (1) genetic counseling has a tendency of being directive, (2) genetic services have psychosocial consequences that require improved support, (3) medical genetics training is inadequate, (4) genetic services are difficult to access, (5) social determinants affect uptake and understanding of genetic services, (6) social stigma is often associated with genetic disease, (7) family values are at risk of disruption by genetic services, (8) religious principles pose barriers to acceptability and utilization of genetic services, and (9) cultural beliefs and practices influence uptake of information and understanding of genetic disease. CONCLUSION We identified a number of complex and interrelated ethical, cultural, and social issues with implications implications for further development of genetic services in LMICs.
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Affiliation(s)
- Adrina Zhong
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Schulich School of Medicine & Dentistry, Western University, Canada
| | - Benedict Darren
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bethina Loiseau
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada
| | - Li Qun Betty He
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada.,Michael G. DeGroote Medical School, McMaster University, Hamilton, ON, Canada
| | - Trillium Chang
- Human Biology Program, Faculty of Arts & Science, University of Toronto, Toronto, ON, Canada
| | - Jessica Hill
- Department of Molecular Genetics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Helen Dimaras
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology & Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada. .,Child Health Evaluative Sciences Program & The Centre for Global Child Health, SickKids Research Institute, Toronto, ON, Canada. .,Department of Human Pathology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
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6
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Gibbon S, Kilshaw S, Sleeboom-Faulkner M. Genomics and genetic medicine: pathways to global health? Anthropol Med 2018. [DOI: 10.1080/13648470.2017.1398816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Sahra Gibbon
- Anthropology, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Susie Kilshaw
- Anthropology, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Margaret Sleeboom-Faulkner
- Anthropology, ARTS C209, School for Global Studies, University of Sussex, Brighton, United Kingdom of Great Britain and Northern Ireland
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Tsai GJ, Cameron CA, Czerwinski JL, Mendez-Figueroa H, Peterson SK, Noblin SJ. Attitudes Towards Prenatal Genetic Counseling, Prenatal Genetic Testing, and Termination of Pregnancy among Southeast and East Asian Women in the United States. J Genet Couns 2017; 26:1041-1058. [PMID: 28251433 DOI: 10.1007/s10897-017-0084-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 02/14/2017] [Indexed: 02/03/2023]
Abstract
Recognizing the heterogeneity of the Asian population with regards to acculturation, education, health awareness, and cultural values is vital for tailoring culturally sensitive and appropriate care. Prior studies show that cultural values influence perceptions of genetics within Asian populations. The reputation of the family unit factors into decisions such as pregnancy termination and disclosure of family medical history, and the nondirective model of American genetic counseling may conflict with the historical Asian model of paternalistic health care. Previous studies also provide conflicting evidence regarding correlations between education, acculturation, age, and awareness and perceptions of genetic testing. The aims of this study were to describe attitudes towards prenatal genetics among Southeast and East Asian women living in the United States for varying amounts of time and to explore sociocultural factors influencing those attitudes. Twenty-three Asian women who were members of Asian cultural organizations in the United States were interviewed via telephone about their attitudes towards prenatal genetic counseling, prenatal genetic testing, and termination of pregnancy. Responses were transcribed and coded for common themes using a thematic analysis approach. Four major themes emerged. In general, participants: (1) had diverse expectations for genetic counselors; (2) tended to weigh risks and benefits with regards to genetic testing decisions; (3) had mixed views on termination for lethal and non-lethal genetic conditions; and (4) identified cultural factors which influenced testing and termination such as lack of available resources, societal shame and stigma, and family pressure. These findings may allow prenatal genetic counselors to gain a richer, more nuanced understanding of their Asian patients and to offer culturally tailored prenatal genetic counseling.
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Affiliation(s)
- Ginger J Tsai
- Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA. .,Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Carrie A Cameron
- Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer L Czerwinski
- Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.,Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hector Mendez-Figueroa
- Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Susan K Peterson
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarah Jane Noblin
- Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.,Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
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Abstract
If the twenty-first century will be a Chinese one, what will its anthropology bring? The new realities of life in China have fundamentally reshaped the anthropology of modern China. With the disappearance of the planned economy, a whole range of structures, networks, organizations, and practices has emerged at the interface of state and society. Moreover, Chinese society is shaped by globalization, transnationalism, and cosmopolitanism to a degree never seen before. What happens under the impact of these changes is new and unique for the People's Republic of China, both recognizably Chinese and generically modern. Anthropological research on these changes will impact the discipline of anthropology as a whole, just as China's rise will change the world order.
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Affiliation(s)
- Frank N. Pieke
- Institute of Area Studies, Leiden University, Leiden, The Netherlands
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9
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Savard J, Mooney-Somers J, Newson AJ, Kerridge I. Australians' knowledge and perceptions of direct-to-consumer personal genome testing. Intern Med J 2014; 44:27-31. [PMID: 24450520 DOI: 10.1111/imj.12289] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 09/08/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND As direct-to-consumer personal genome testing (DTC-PGT) is increasingly available in Australia, knowledge of Australians' perceptions and attitudes towards this technology is needed in order to assess the (potential) impact it might have on the Australian public and healthcare system. AIMS To explore the knowledge and perceptions of DTC-PGT in an Australian sample. METHODS An online survey asking about knowledge and perceptions of DTC-PGT, undertaken between October 2011 and April 2012, of 270 Australian residents. Results were analysed using SAS. RESULTS Our study found limited consumer knowledge of, and interest in, pursuing DTC-PGT in Australia. Ninety-three per cent of respondents correctly identified DTC-PGT as available to consumers directly, but only 40% correctly identified its availability in Australia. When asked about the content and value of the information DTC-PGT provides, the majority of respondents indentified that DTC-PGT could provide information about one's health and/or ancestry (82% and 74%). Additionally, respondents indicated they believed this information to be equally important as non-genetic information about one's ancestry and health. CONCLUSION While a minority of respondents expressed an intention to pursue DTC-PGT (27%), the majority of respondents, irrespective of whether they wished to pursue it or not, believed that genetic information was as important as non-genetic information in regards to their health and their ancestry. The value ascribed to genetic information suggests that genetics plays a role in people's lives, and that further qualitative research could explore the ways in which people might use and understand the genetic information provided by DTC-PGT.
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Affiliation(s)
- J Savard
- Centre for Values, Ethics and the Law in Medicine (VELiM), School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Yoshizawa G, Ho CWL, Zhu W, Hu C, Syukriani Y, Lee I, Kim H, Tsai DFC, Minari J, Kato K. ELSI practices in genomic research in East Asia: implications for research collaboration and public participation. Genome Med 2014; 6:39. [PMID: 24944586 PMCID: PMC4062049 DOI: 10.1186/gm556] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the 'ELSI 2.0' initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries.
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Affiliation(s)
- Go Yoshizawa
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Calvin Wai-Loon Ho
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Republic of Singapore
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
| | - Wei Zhu
- Department of Social Sciences, Fudan University, 220 Handan Road, Shanghai 200433, China
| | - Chingli Hu
- Office of the President, Shanghai Jiaotong University School of Medicine, 227 Chongqing Road, Shanghai 200025, China
| | - Yoni Syukriani
- Department of Forensic and Legal Medicine, Faculty of Medicine, Padjadjaran University, Jl. Eijkman 38, Bandung 40161, Indonesia
| | - Ilhak Lee
- Center for ELSI Research, Asian Institute for Bioethics and Health Law, Department of Medical Law and Ethics, College of Medicine, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 120-749, South Korea
| | - Hannah Kim
- Center for ELSI Research, Asian Institute for Bioethics and Health Law, Department of Medical Law and Ethics, College of Medicine, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 120-749, South Korea
| | - Daniel Fu Chang Tsai
- Department of Social Medicine, National Taiwan University College of Medicine, 1 Section 1, Jen-Ai Road, Taipei 100, Taiwan
| | - Jusaku Minari
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
- Institute for Integrated Cell-Material Sciences (iCeMS), Kyoto University, Yoshida Ushinomiya-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Prenatal diagnosis and termination of pregnancy: perspectives of South African parents of children with Down syndrome. J Community Genet 2012; 4:87-97. [PMID: 23096497 DOI: 10.1007/s12687-012-0122-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022] Open
Abstract
This study aims to evaluate the attitudes of a group of South African parents with a preschool child with Down syndrome (DS) towards prenatal diagnosis (PND) and termination of a Down syndrome-affected pregnancy (TAP). This study employs a qualitative phenomenological approach with the use of semi-structured interviews. Twelve participants were recruited from two state sector hospitals in Cape Town, South Africa. Thematic analysis was used to interpret the data. The participants had a positive attitude towards PND and felt that it was every parent's right to have the option. They considered a benefit of PND the fact that it allowed parents time to prepare for the arrival of a baby with DS. The induced miscarriage risk associated with invasive prenatal testing procedures caused major negative feelings. They were totally opposed to the termination of a Down syndrome-affected pregnancy due to their personal experience, moral, ethical or religious convictions. South African parents of preschool children with Down syndrome are comfortable with PND for Down syndrome; however, they do not support TAP. These findings will provide health care providers with further insight into the motivations behind the decisions their patients make.
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Horstman K, Finkler K. Genetics, health care, family and kinship in a global perspective: Situated processes of co-construction. Soc Sci Med 2011; 72:1739-42. [DOI: 10.1016/j.socscimed.2011.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 05/10/2011] [Indexed: 12/22/2022]
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