Universität zu Köln

Meier, Friedhelm, Ried, Jens, Harney, Anke, Rhiem, Kerstin, Neusser, Silke, Neumann, Anja, Wasem, Juergen ORCID: 0000-0001-9653-168X, Schmutzler, Rita, Huster, Stefan ORCID: 0000-0003-1067-3893 and Dabrock, Peter (2017). Entitlement to prophylactic Treatment in cases of genetic Predisposition for Breast Cancer Interdisciplinary Perspectives. Bundesgesundheitsblatt-Gesund., 60 (10). S. 1102 - 1109. NEW YORK: SPRINGER. ISSN 1437-1588

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Abstract

Genetic tests can detect the predisposition to various diseases. The demand for gene diagnostics and corresponding prophylactic measures is increasing steadily. In the German healthcare system, however, legal uncertainties exist as to whether a mere risk of disease is reason enough to bear the costs for prophylactic measures. When medically effective prophylactic measures are available in certain cancer diseases, such as in hereditary breast cancer, the current practice of deciding in individual cases appears to be insufficient. The fact that persons with a high or very increased risk of breast cancer are precluded from a standard care procedure raises questions concerning ethical justification as well as medical plausibility. Moreover, it is remarkable that the statutory healthcare system treats persons at risk differently. In some cases there is a regulated way of reimbursement for preventive measures for persons at risk (factor V Leiden mutation) and in other cases there are only case-by-case decisions. Finally, in light of social regulations for persons at high and very increased risk this article considers the need of optimization regarding the risk communication in the decision-making process and the crucial question of budgetary impact for the German healthcare system. From a medical, ethical and legal perspective, a social regulation for persons at high and very increased risk of disease is inevitable and the consequences should be discussed in advance.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Meier, Friedhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Ried, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Harney, Anke UNSPECIFIED UNSPECIFIED UNSPECIFIED Rhiem, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Neusser, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumann, Anja UNSPECIFIED UNSPECIFIED UNSPECIFIED Wasem, Juergen UNSPECIFIED orcid.org/0000-0001-9653-168X UNSPECIFIED Schmutzler, Rita UNSPECIFIED UNSPECIFIED UNSPECIFIED Huster, Stefan UNSPECIFIED orcid.org/0000-0003-1067-3893 UNSPECIFIED Dabrock, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-216174
DOI:	10.1007/s00103-017-2608-8
Journal or Publication Title:	Bundesgesundheitsblatt-Gesund.
Volume:	60
Number:	10
Page Range:	S. 1102 - 1109
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1437-1588
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MUTATION CARRIERS; COST-EFFECTIVENESS; FAMILIAL BREAST; OVARIAN-CANCER; GERMLINE MUTATIONS; BRCA2 MUTATION; WOMEN; RISK; MASTECTOMY; IMPACT Multiple languages Public, Environmental & Occupational Health Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21617