Misattributed paternity

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Misattributed paternity is the situation when a child’s putative father is not the child's biological father. Overall, the incidence misattributed paternity ranges is about 1-4%, though it may be considerably higher in certain populations. Genetic testing for purposes other than establishing paternity has the potential to unintentionally yield information regarding a child’s paternity. This generally occurs in two different scenarios: the first (and less complicated) occurs in searches for a suitable bone marrow or organ donor and the patient’s family members are tested; the second is in the course of a genetic-risk assessment for reproductive purposes.

Misattributed paternity is also referred to as paternity fraud, though this term suggests that the misattribution was deliberate rather than accidental.[1]

Incidence[edit]

The rate of non-paternity is commonly quoted to be around 10%.[2][3][4] However, a 2005 scientific review of international published studies of paternal discrepancy found a range in incidence from 0.8% to 30% (median 3.7%), suggesting that the widely quoted figure of 10% of non-paternal events is an overestimate. In situations where disputed parentage was the reason for the paternity testing, there were higher levels; an incidence of 17% to 33% (median of 26.9%). Most at risk of parental discrepancy were those born to younger parents, to unmarried couples and those of lower socio-economic status, or from certain cultural groups.[5]

In a review article, sociologist Michael Gilding found that frequencies varied depending on country, ranging from 0.78% to 11.8% of total births. Overall the incidence lay between 1 and 3%. In cases of contested paternity, frequencies of 20% in Australia and 28% in the United States were reported. Gilding concluded that the estimates of non-paternity circulated by the media, the paternity testing industry, fathers' rights activists and evolutionary psychologists are inflated.[6][7][8]

Genetic counseling[edit]

Main article: Genetic counseling

In the context of a genetic-risk assessment for reproductive purposes a finding of misattributed paternity is more problematic, both ethically and legally. For example, a couple approaches a genetic counselor after the birth of a child with an autosomal recessive disorder (such as Tay Sachs) and both parents must be carriers of the trait. The test reveals that the father is not a carrier, and is therefore not the biological father (unless the disorder was caused by a mutation, a negligible risk). Instead of future children having a 25% chance of being affected, the chance is close to zero. There are issues with the genetic counselor withholding the information, disclosing the misattributed-paternity finding, partially disclosing the information, or addressing the issue before testing as part of the informed consent process.

There is no consensus on a single, appropriate approach a genetic counselor should take with respect to misattributed paternity, and there are proponents for each. A 1983 report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research recommended that genetic counselors employ full disclosure. By contrast, in 1994 the Institute of Medicine’s Committee on Assessing Genetic Risks recommended that the counselor disclose the information only to the mother. The Hereditary Disease Programme of the World Health Organization declared that there is probably never a situation in which the information should be disclosed to the putative father.

Surveys of genetic counselors indicate that an overwhelming majority (96–98.5 percent) would not divulge misattributed paternity results to the presumed father; sixty percent would include information about misattributed paternity on an informed-consent document. Therefore, genetic-counseling custom appears to support telling the mother alone, or withholding misattributed paternity from both parties. Courts often consider custom as evidence of what a reasonable physician would do in similar circumstances (the standard for medical malpractice).

Notes[edit]

  1. ^ Draper, Heather (2005). "Paternity fraud and compensation for misattributed paternity". Journal of Medical Ethics 33 (8): 475–480. doi:10.1136/jme.2005.013268. PMC 2598159. PMID 17664309. 
  2. ^ Macintyre S and Sooman A (1991). "Non-paternity and prenatal genetic screening". Lancet 338 (8771): 869–871. doi:10.1016/0140-6736(91)91513-T. PMID 1681226. 
  3. ^ Neale MC, Neale BM, Sullivan PF (2002). "Nonpaternity in Linkage Studies of Extremely Discordant Sib Pairs". Am J Hum Genet 70 (2): 526–529. doi:10.1086/338687. PMC 384925. PMID 11745068. 
  4. ^ Rincon P (11 February 2009). "Study debunks illegitimacy 'myth'". BBC News. Retrieved 11 February 2009. 
  5. ^ Bellis MA, Hughes K, Hughes S, Ashton JR (September 2005). "Measuring paternal discrepancy and its public health consequences". J Epidemiol Community Health 59 (9): 749–54. doi:10.1136/jech.2005.036517. PMC 1733152. PMID 16100312. 
  6. ^ Gilding, Michael (2005). "Rampant misattributed paternity: the creation of an urban myth". People and Place (Monash University) 13 (12): 1–11. 
  7. ^ Gilding, M. (2009). "Paternity Uncertainty and Evolutionary Psychology: How a Seemingly Capricious Occurrence Fails to Follow Laws of Greater Generality". Sociology 43: 140–691. doi:10.1177/0038038508099102.  edit
  8. ^ Gilding, Michael (26 July 2011). "The fatherhood myth: Michael Gilding unravels the uncertain data about mistaken paternity". The inside story. Retrieved 10 November 2012. 

Sources[edit]

  • Jane McEwen, Genetic Information, Ethics, and Information Relating to Biological Parenthood, 1 Encyclopedia of Ethical, Legal and Policy Issues in Biotechnology 356, 549-362 (Thomas H. Murray & Maxwell J. Mehlman eds 2000)
  • Kelly Brown, Genetic Counseling, 29 Journal of Legal Medicine 345 (2008).
  • Erica Lucast, Informed Consent and the Misattributed Paternity Problem in Genetic Counseling, 21 Bioethics 41(2007).
  • President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Screening and Counseling for Genetic Conditions: A Report on the Ethical, Social, and Legal Implications of Genetic Screening, Counseling, and Education Programs. Washington, DC: U.S. Government Printing Office [GPO], 1983.