NASW NEWS

From the Director We Share in the Genetics World by Elizabeth J. Clark, Ph.D., ACSW May 2002

Several years ago, I had the good fortune of being selected to attend an intensive conference on the Human Genome Project. Its intent was to begin to disseminate information about the program to a multidisciplinary group of professionals.

We spent several days trying to grasp the magnitude of this scientific achievement. Our activities were broad-based. We learned how genetic risk is predicted, had discussions with families struggling with genetic predispositions and disorders, and spun DNA. We also examined the ethical, social and legal aspects of genetic testing.

I left the conference feeling enriched and excited about genetics and the future. I also left recognizing the importance of genetics for the field of social work.

Genetics affects our personal lives, our professional practice and our policy decisions.

On a personal level, think about the impact of genetics in your life and in the lives of your family members. Common diseases and disorders such as diabetes, arthritis and cancer have a genetic component. When your physician completes a medical history, it includes listing diseases that "run in your family."

Gene testing is now rapid and inexpensive. We are all familiar with amniocentesis and paternity testing, and after the terrorist attack of Sept. 11, we have a heightened awareness of the uses of DNA in identifying the bodies of lost loved ones.

What we may be less inclined to recognize is the impact of genetics in professional social work practice. Consider, for instance, the genetic link to bipolar disease, mental retardation or Alzheimer's disease. Or think about the need for genetic information about adopted children. When completing a biopsychosocial assessment, a genetic history should be included. Mary Richmond recognized the role of such a family genetic history as early as 1917.

I am not suggesting that social workers become genetic counselors or gene experts, but each of us does need to have a basic competency in genetics. The National Coalition for Health Professional Education in Genetics has developed a document called "Core Competencies in Genetics Essential for All Health-Care Professionals" (2001). The document covers the necessary knowledge, skills and attitudes. It says that at a minimum, each health care professional should be able to: (1) appreciate the limitations of her or his expertise; (2) understand the social and psychological implications of genetic services; and (3) know how and when to make a referral to a genetics professional.

We also need discipline-based guidelines, and I am pleased to say that NASW Standards for Integrating Genetics into Social Work Practice are being developed under the able leadership of Joan O. Weiss, the founding director of the Genetic Alliance and a social work pioneer. A panel of experts from practice, education and research arenas, as well as a consumer representative, will develop the Standards. The working group will use the NASW Code of Ethics, the recommendations of the Human Genome Education Model Project, the NASW Policy Statement on Genetics (1999) and resources within the professional literature to develop guidance for practitioners.

Politically, the profession of social work will need to weigh in on a variety of topics and policies. The 2000 issue of Social Work Speaks includes NASW's first formal policy on genetics, and all NASW members should be familiar with this statement. We need to protect the public interest, especially with regard to privacy and confidentiality of genetic information and prevent genetic discrimination in health insurance and employment. Unequal access and application of the scientific advances surrounding genetics is another area of concern. Then there are the controversies of cloning, "designer genes" and stem cell research.

The field of genetics has arrived, but the profession of social work is not adequately prepared for it. If you have been thinking that genetics does not affect you and your practice, think again. Every area of social work — clinical practice, community development, education, research and policy — has a significant contribution to make in meeting the challenges and in ensuring that the advances in genetics are used for the benefit and well-being of society.

To comment to Elizabeth J. Clark: NewsColumn@naswdc.org