What is a key ethical consideration when reporting incidental findings from genome sequencing?

• A. Respect for patient autonomy and informed consent.
• B. Cost and resource considerations.
• C. All incidental findings must be reported immediately.
• D. Only report incidental findings with high clinical severity should be reported.

Answer: (A)

The key ethical consideration is respecting patient autonomy through informed consent about incidental findings. When genome sequencing can uncover information unrelated to the original reason for testing, patients should be actively involved in deciding what kinds of incidental findings will be reported. This requires thorough pre-test counseling that explains the possibility of incidental findings, the categories that might be disclosed (for example, actionable medical issues, adult-onset conditions, carrier status), and the option to opt in or out or to choose different levels of reporting. Respecting autonomy means honoring a patient’s preferences, values, and right to not know, while also helping them understand potential benefits and harms. Practical factors like cost or resources are important but do not override the need for informed consent; and reporting only high-severity findings without patient input would undermine the patient’s control over their own information.