Who's your daddy? Answer's at the drugstore
Pharmacy chain markets DNA paternity tests in 30 states nationwide
Pierre-philippe Marcou / AFP - Getty Images file New
at-home DNA paternity tests require samples of cells swabbed from the
cheeks of the child, the alleged father and, ideally, the mother. |
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JoNel Aleccia
Health writer
MSNBC
updated 8:36 a.m. ET, Thurs., March. 27, 2008
| JoNel Aleccia Health writer
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After
two decades, Sean Reid of Surrey, British Columbia, discovered that he
had a son. Fred Turley of Des Plaines, Ill., learned he didn’t have a
daughter. And Wendy Lieb of Lewis Center, Ohio, made certain she wasn’t
going to be a grandmother quite yet.
In
all three situations, crucial genetic information altered the lives of
the people involved. And in each case, it came not from a doctor or
other medical source, but from a $29.99 kit on a drugstore shelf.
Reid,
Turley and Lieb are among more than 800 customers who responded to the
first wave of marketing for do-it-yourself DNA paternity tests sold as
Identigene by Sorenson Genomics of Salt Lake City.
Sales
in three western states — Washington, Oregon and California — were so
brisk last fall that Rite Aid Corp. expanded the product this week to
some 4,300 stores in 30 states across the country.
“The
running joke is that we’re the Maury Povich family,†said Reid, 37, who
confirmed years of speculation about a former girlfriend’s son with a
kit purchased at a Bellingham, Wash., store. “But why not do it
privately? We did this as discreetly, as efficiently and as
cost-effectively as possible.â€
For
users like Reid, the tests provide easier answers to one of life’s
crucial questions — Who’s your daddy? — said Douglas Fogg, chief
operating officer of Identigene.
“Everyone
is purchasing the tests because they’re curious,†said Fogg, who
expects to sell at least 52,000 tests this year. “They’re looking to
establish questions about their own child or their own paternity.â€
But for genetics experts, drugstore marketing of DNA testing raises questions of accuracy and ethics.
“From
our perspective, direct-to-consumer genetic tests raise all the same
issues for lax government oversight, potentially misleading or false
advertising and the potential for making profound medical decisions on
the basis of poorly interpreted or understood results,†said Rick
Borchelt, a spokesman for the Genetics and Public Policy Center at
Johns Hopkins University.
At the very least, the kits have the potential to complicate the lives of the people who use them, legal experts cautioned.
“We
all need to take a step back and realize that this is different than
many tests that you take,†said R. Alta Charo, a professor of law and
bioethics at the University of Wisconsin at Madison. “This is a
life-changing moment.â€
DNA tests join other diagnostic tools
The
paternity kits have taken their place on store shelves next to other
diagnostic tests that don’t rely on DNA, including those for pregnancy,
HIV and blood sugar, said Michael S. Watson, executive director of the
American College of Medical Genetics.
Unlike
genetic tests for health conditions, tests that use DNA to determine
paternity are fairly simple to provide and fairly easy to interpret,
said Watson. They're subject to limited oversight, however, with no
review required by the Food and Drug Administration and no
certification required under the federal Clinical Laboratory
Improvement Amendments, or CLIA.
The
Identigene kit includes swabs for collecting cell samples from the
inside of the cheeks of the child and the alleged father. Collection of
the mother’s cells is optional, but strongly recommended to strengthen
the results. The swabs are packaged and mailed to the Sorenson
laboratory in Salt Lake City where they’re analyzed.
The Sorenson lab is accredited by the AABB, the agency formerly known as the American Association of Blood Banks.
Results
are reported online, by phone or by mail in three to five business
days. They come back as a probability figure that verifies paternity
with 98 percent to 99 percent accuracy, Watson said.
Total
cost is about $150, including the price of the kit and a $119
laboratory processing fee. For another $200, users can purchase
validated tests that meet legal requirements for determining paternity,
Fogg said.
Court use questionable
But
Susan Crockin, a lawyer who specializes in reproductive technology,
said consumers shouldn’t count on the tests standing up in court.
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“The
jury’s still very much out on these tests in terms of reliability and
establishing a chain of custody,†said Crockin, a consultant for the
Johns Hopkins public policy center.
Most
of the users who have been buying the kits — which have gone on sale
for as low as $17.99 — don’t plan to use the results to resolve legal
issues, Fogg acknowledged. Instead, most are looking to answer social
questions. And that's where the complexity comes in.
Because the cell samples are taken in private, there’s the potential for fraud and deception, noted Charo, the ethics expert.
“I
can imagine rather peculiar circumstances in which somebody has a swab
taken without their knowledge,†she said. “It raises questions about
informed consent.â€
Even
when people do consent, the results can be unsettling. Watson estimates
that between 5 percent and 10 percent of genetic tests he's conducted
show a child is not related to the presumed father.
“It
could break up families,†Watson said. “Some will be broken because
that was the goal. Others will be broken up and that wasn't the goal.â€
But people who’ve used the at-home tests swear by the ease, the accuracy — and the results.
After 20 years, a mystery solved
For
Reid, the paternity test opened the door to a new extended family. He’d
always wondered whether the baby born to a former girlfriend was his,
even though she insisted the child was fathered by another man. When
the girlfriend contacted Reid on Facebook last summer, the pictures she
sent of her oldest son raised the question anew.
“My wife, said ‘Oh my, that’s you,’†said Reid, a nurse.
Internet
research pointed Reid to the Identigene test, which was cheaper and
more convenient than other options. With cooperation from his former
girlfriend and her son, they all took the tests, with results that
altered everyone’s lives.
“Our
newest son has a family he never knew he had including grandparents,
aunts, and three younger brothers who are all very excited to meet
him,†Reid said.
For
Fred Turley, 55, the DNA test confirmed what his companion had told
him: the 4-year-old girl he helped care for was not his. The news was
disappointing, but clear, he said.
“The
bottom line is, I don’t have to live with the uncertainty about her
being my daughter and wind up in a fight just to find out,†Turley
said. “This won’t change how I feel about the girl. It will just remove
what had become a major concern.â€
For
Wendy Lieb, 41, the DNA test restored her 20-year-old son’s future.
He’d already quit college, taken a job and assumed the responsibilities
of pending parenthood after a girl he had sex with at a party claimed
she was pregnant with his child.
‘He just didn't look like my son at all.’
Lieb said she was proud of her son’s response, but perplexed after the baby, a boy, was born.
“He just didn’t look like my son at all,†Lieb said. “And we have fairly strong genes.â€
A trip to the drugstore and 10 days later, the answer was clear: her son was not the father.
“I thought it would have required thousands of dollars and a trip to the doctor,†she said.
Lieb
is relieved for her own child, of course, but also for everyone
involved. As difficult as the situation has been, she said, it will be
easier for them to adjust now, rather than years later. The test may
raise ethical questions, she said, but it also provides the peace of
mind that comes with answers.
“I think it’s a lot more ethical for you to find out the truth,†she said.
© 2008 MSNBC Interactive