Chromosomal microarray analysis reveals many gene variants of unknown significance. The uncertainty about these variants—might they be deleterious or are they benign?—complicates genetic counseling.
Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.
AMA J Ethics. 2016;18(11):1079-1085. doi:
10.1001/journalofethics.2016.18.11.ecas2-1611.
Meera Balasubramaniam, MD, MPH and Yesne Alici, MD
A 15-year-old advance directive made when the patient was in much better health and not updated can bring more confusion than clarity to the decision-making process.