Reflections on 'common' genetic medical history questions: Time to examine the what, why, and how.
Margaret Waltz, Ann Katherine M Foreman, Courtney Canter and 2 others
PMID 38340501WHAT IT FOUND
Genetics providers asked pregnancy, ancestry, education and family structure questions in ways that could feel stigmatizing, often without explaining why.
The paper suggests reviewing purpose and wording before asking them.
Key findings
01Analysis identified four history areas that could be problematic: pregnancy exposures, ancestry and consanguinity, caregiver education, and family structure.
02Providers sometimes guessed or assumed answers about ancestry and consanguinity, including asking in the negative or forewarning that the question might be offensive.
03Education and work questions often seemed to serve as proxies for caregiver cognition or learning concerns rather than clear clinical needs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It analyzed transcripts from pediatric genetics appointments at three sites, so the patterns may not apply to other clinics or patient groups. The study did not test whether these questions caused harm or whether changing wording improves trust, satisfaction, or care. It reports examples selected by the research team, not how often problematic questions occurred.
Declared interests
The authors declared no conflicts of interest. The supplied publication types note NIH extramural support, but no specific funding statement is given in the text.
The easy way to misread this
Do not read this as proof that these questions harm patients or that changing wording improves care. The study describes patterns in recorded genetics visits and does not test intentions, harms, or outcomes.