Individuals' religious beliefs and practices can be implicated and challenged as they deal with the consequences of advances in genomics. While many people can reconcile these two bodies of knowledge, others are made uneasy or distressed by this new science in ways that affect their personal and political choices.

This exploratory pilot project aims to evaluate the feasibility and initial efficacy of an innovative family-centered approach to genetic counseling that combines patient- centered principles and mental health techniques to address the cognitive and emotional needs of parents whose infants have abnormal DNA analyses from newborn screens (NBS) for cystic fibrosis (CF).

The goal of the proposed project is to address a well-documented lack of genetics education among health professionals, which is a rate-limiting step in the integration of genetics and genomics into mainstream health care. The five-year project will create and disseminate a set of educational resources for health professionals who are not trained in genetics.

With recent advances in genotyping methods, specifically improvements in DNA microarrays and chip- scanning instrumentation, it is now technically possible and economically feasible to test large numbers of patients for several thousand known mutations associated with Mendelian disease phenotypes.

Over the past two decades, forensic DNA profiling has become an important tool in the investigation of human rights abuse and genocide. There is, however, little understanding of the ethical, historical, political, psychosocial, or policy dimensions of this application of genetic technology. The lack of a well-developed body of relevant research, and few regulations to guide the implementation of humanitarian DNA identification projects, means that organizations and individuals must develop their own ad hoc rules and procedures for the identification process.

Criminal DNA profiling could soon include phenotypic markers for attributes such as eye, skin, and hair color, gait, ancestry, and predisposition to behavioral traits such as smoking. This technology, referred to as forensic DNA phenotyping (FDP), transforms the existing function of criminal DNA profiling from confirming a suspect's identity to predicting it. The field of forensic genetics will have to confront the ethical and social challenges that FDP will raise.

Genetic susceptibility testing for common diseases will become widespread soon and form an integral component of evidence-based medicine and health care delivery. With advances in personalized risk assessments come the added challenges of effectively interpreting and communicating the risk implications of test findings to the public and health care professionals. Genetic counselors are at the forefront of addressing these and forthcoming risk communication challenges.

Genetic knowledge is becoming increasingly central to the way human health and disease are understood and addressed. In order to advance the translation of medical knowledge into effective practice, it is important to know how genetic knowledge is presently understood by clinicians and patients, and applied in their routine medical encounters. Genetic information is already being translated from the abstracted world of laboratory research to the practical context of clinical practice and everyday life.

Pharmacogenetic testing is considered one of the most promising clinical applications arising from genomics research, with the potential to reduce adverse drug responses and improve efficacy of drug treatment. Because pharmacogenetic tests address a specific question about drug therapy, they have generally been viewed as having fewer ethical and social implications than other types of genetic testing. Yet some policy concerns will need to be addressed before pharmacogenetic tests can be introduced appropriately into clinical practice.

A significant proportion of patients who pursue testing for BRCA gene alterations are of reproductive age. Many are actively engaged in decisions about family planning or will be in the future. A prime concern of this population is minimizing the impact of hereditary cancer on their children. Genetically-enhanced assisted reproductive technologies (ART), such as preimplantation genetic diagnosis (PGD), as well as prenatal diagnosis (PND) followed by consideration of selective abortion, may enable individuals and couples to avoid passing genetic mutations on to their children.