MMI genetics questions on reproduction, donors and genetic testing

MMI genetics questions appear because a genetic result is never about one person. A test one relative takes tells a sibling, a parent or a donor-conceived child about their own body, whether they asked or not. The questions in this topic share that structure: one person's right to know or to choose runs into another person's right not to know, to stay anonymous or to change their mind.

What these questions test

Interviewers test whether you can find everyone with a stake, including the people who are not in the room. A home DNA kit that shows no link to the father who raised you involves him, the man it names and the cousin holding the result.

They also test whether you weigh a right not to know, a person's interest in not receiving information about their own body or family, as seriously as a right to know. The father who raised the cousin never asked for the result she is holding, and whether to tell him is the choice in front of you.

The policy questions set autonomy against justice. Autonomy is a person's authority over decisions about their own body and life. Justice is the fair distribution of benefits and burdens. Paid surrogacy and insurers' use of genetic results both ask who is likely to be exploited or excluded.

How to approach them

1. List every person the result or the decision touches, including anyone who made a promise years ago, and say what each stands to gain or lose.
2. Name the values in conflict, and say which one you'd give more weight in this case and why.
3. Ask what the person in front of you wants before you advise. The cousin may want to tell her father, find the stranger or do neither.
4. Treat a promise as a reason rather than a verdict. Consumer DNA testing has made donor anonymity hard to keep, and an embryo agreement signed four years ago may not have anticipated one partner's age. Say how much the changed facts should count.
5. For a policy question, consider who has the least power in the arrangement and reach a position that protects them.
6. An MMI station on this topic scores how you listen and whether you leave the decision with the person who owns it. A panel policy question expects both sides and a stance.

Common mistakes

• Deciding for a person what they would want to know overrides a choice that belongs to them.
• Treating the parent who raised a child as less of a parent because of a DNA result confuses biology with the relationship.
• Deciding a dispute on sympathy for one party, without weighing the agreement both signed, leaves half the argument unmade.
• Treating a genetic result as a certainty when many results describe a probability leads to advice the science doesn't support.