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Rejection to the proposal of Mr. Clotter John Ko. Is generalised Genetic Screening for Factor V Leiden Necessary?

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Introduction

GenETHICS 2004 competition. Rejection to the proposal of Mr. Clotter John Ko Is generalised Genetic Screening for Factor V Leiden Necessary? Genetic screening has no doubt have been the one of the most controversial issue in the branch of medicine. The new issue has recently triggered the on-going debate: the dilemma of whether the Government should allow the Genetic screening of all 16 year old girls for mutation in specific gene called the Factor V which sometimes lead to condition called the DVT , or not. In the essay I will suggest on why we should not do the screening. In the first paragraph of my essay I shall briefly explain the science behind the Factor V Leiden including the cause, inheritance, test and interpretation of the result.. In my second I shall defend my argument considering the ethical, social and also economical side on the Genetic screening. Lastly the conclusion will consist of dealing with all the pros and cons of the technology and weighing up the advantage and disadvantage and my final conclusion will be made. Factor V itself is a clotting factor, whose role is to help blood to clot when an appropriate trigger is present. However, like all steps in the complex clotting cascade, Factor V is subject to regulation to keep it under control so that clots don't form too easily or too quickly. The normal traffic cop is Activated Protein C (APC). ...read more.

Middle

Because of all the danger of Factor V Leiden, test is necessary especially for those who already suffered venous thrombosis, has a family history of the disease etc... Some of the tests are simple blood test, which checks the aPTT (the speed of clot) and if the patient were found positive in the venous thrombosis they go through the molecular testing. The test analysis the mutation of the factor v gene looking at whether the FV gene is showing resistance to the protein c or not, and if so they go through a further test to find out whether the patient is homozygous or heterozygous. The accuracy of the test is almost 100 %. The proposal of Mr. Clotter is disagreed because of some of these reasons: Economically the test is too much of a loss than the gain. There are several screening tests for Factor V Leiden. The molecular genetic testing for the factor V Leiden mutation is most common and accurate. The overall cost to test one person is about 85~100 dollar, making it quiet cost efficient. Unfortunately, Factor V Leiden cannot be cured. Therefore the aim of the screening would be to reduce the chance of Factor V Leiden carrier from getting DVT or pulmonary embolism and most importantly to reduce the mortality through advices and making the person aware of what disease they have. Advices include the ban of the factor that may increase the risk of DVT, such as oral contraceptives or airline travel. ...read more.

Conclusion

I disagree with screening for the mutation for all 16 year old high school girls, because there are no direct evidence to support the introduction of screening high school students for Factor V Leiden. Potential benefits are reduction of chance of DVT while some dis-benefits are restriction in life, deterioration in mental and social health. In conclusion, dis- benefit tended to overweigh the benefit of the screening. I believe the screening should be carried out only on those who are mostly likely to have Factor V mutation, among these people are people with DVT family history and people who have suffered DVT previously. RESOURCES 1) http://www.fvleiden.org/publications/genetics_thrombophilia.html 2) http://www.fvleiden.org/publications/genetics.html 3) http://www.fvleiden.org/publications/mail_explanation.html 4) http://www.fvleiden.org/rec_diagnosed/explanations.html 5) http://www.geneclinics.org/profiles/factor-v-leiden/ 6) http://www-admin.med.uiuc.edu/hematology/PtFacV2.htm 7) http://www.mostgene.org/gd/gdvol14b.htm 8) http://www.netdoctor.co.uk/diseases/facts/factorv.htm 9) http://www.cdc.gov/genomics/hugenet/CaseStudy/FVL/FVLcase.htm 10) http://www.labtestsonline.org/understanding/analytes/factor_v_and_pt20210/test.html 11) http://www.hta.nhsweb.nhs.uk/rapidhta/publications/DEC58.pdf 12) http://www.aic.cuhk.edu.hk/web8/pulmonary_embolus_and_dvt.htm 13) http://circ.ahajournals.org/cgi/content/full/107/15/e94 14)http://www.genetics.com.au/ 15) http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Deep_Vein_Thrombosis.html 16) Journal Watch Women's Health 1998 Jan 1 17) The Lancet, Volume 347, Issue 9012, 18 May 1996, Pages 1346-1347 Bj�rn Dahlb�ck ENTRY FORM: GENETHICS 2004 COMPETITION Student Details: Name of student: John Ko (Kyung-Hwan Ko) Date of Birth: 17/12/1987 16 yrs old. Currently studying NCEA Level 2 (English, History Chemistry) Level 3 (Calculus, Physics) Student address: Flat 9/315 Worcester Street, Linwood, Christchurch, New Zealand. Email: 1004jonny@hanmail.net School Details: Name of the School: St Bede's College. School address: P.O BOX 5380, 210 Main North Road, Redwood, Christchurch 8005, New Zealand. Telephone: (03) 352-6065 Facsimile: (03) 352-0345 Email: sbc@stbedescollege.school.nz Name of Teacher in charge: Dr Catherine Owens y de Novoa I am very sorry but I did not receive my entry form. I had to ask Peter Spratt forthe requirements. ...read more.

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