genetic counseling

Pharmacogenetics testing: where are we today? Kristine Ashcraft, CEO, and founder of YouScript, a translational PGX start-up that Invitae recently acquired, joins us on the Beagle to discuss why it has been so hard to get the ball rolling on PGX testing. Kristine, who was called one of the 25 leading voices in precision medicine by BIS Medicine in 2019, lays out a roadmap to the integration of PGX testing into routine clinical care.

The dismantling of the right to abortion established under Roe v Wade has left many clinicians angry, uncertain, and in dire need of legal advice. If that describes you – speak to a lawyer! Don’t get your legal advice from a podcast, you silly goose. But first: you might want to listen to this conversation with Stanford’s Michelle Mello, a law and health policy professor. Her work examines the intersection of health, law, and ethics; in a recent article in JAMA, Michelle and co-author Kayte Spector-Bagdady suggest that protecting patients and practitioners from legal jeopardy in the post-Dobbs age may require us to rethink what information we put in the medical record.

Allison Kurian is Director of the Stanford Women’s Clinical Cancer Genetics Program, with a practice that centers on women at high risk of breast and gynecologic cancers. Trained in internal medicine, oncology, and epidemiology, Allison has embraced genetics (a fourth specialty!) as a tool for early detection and risk stratification.

Ten years after ACLU v Myriad changed the landscape of genetic testing overnight, how far have we come, and where are we headed next?

Today on The Beagle, one of the rock stars of the genetic counseling field, Jehannine Austin, Professor of Medical Genetics at the University of British Columbia. Jehannine has pioneered the field of psychiatric genetic counseling and, more broadly, they have worked energetically for decades to make psychiatric genetic counseling – and all genetic counseling -- an evidence-based discipline. An impactful figure for both the humanity and the rigor they bring to our field, Jehannine shares their perception of where psychiatric genetic counseling is today, speculates a bit on where it is heading.

Kicker: remember that much-discussed incoming Presidential Address at NSGC 5 years ago? Jehannine has learned a few things since then, and there is something they want us to know about imposter syndrome.

Colleen Caleshu, Senior Director of Research at GeneMatters, received the Jane Engleberg Memorial Foundation Fellowship in 2019 for a randomized controlled trial of meditation to improve genetic counselor professional well-being. She received the best abstract award at the 2021 NSGC Annual Conference for part of this work. Colleen is a Ph.D. candidate at Leiden University and a genetic counselor who specializes in cardio genetics and kindness.

The legal landscape for abortion is changing rapidly, and in ways that will inevitably affect genetic counseling practice in many states. Joining Laura to discuss the new laws and the role that NSGC can play – if the organization decides that protecting reproductive rights is a priority for its membership-- is Jordan Brown, assistant Director at the genetic counseling program at the Ohio State University, vice chair of the NSGC Public Policy Committee, and a member of the newly formed NSGC Task Force looking at the challenges to reproductive rights. Recently, Jordan documented her concern over the response – or lack thereof – to an issue fundamental to GC practice in a blog post on the DNA Exchange.

Today we reach out across closed borders to Australia for a chat with Jodie Ingles, one of the first people anywhere in the world to focus on cardiogenetic counseling. Jodie talks to us about how the field has changed in the last 17 years, and where we are headed next.

Rosemarie Garland Thompson is a professor of English and Bioethics at Emory University. She has been called a “thought leader” in disability studies. She is co-editor of About Us: Essays from the New York Times about Disability by People with Disabilities. She is here today to discuss disability rights in the light of prenatal genetic testing.

Aishwarya Arjunan of Myriad’s Women’s Health and Carrie Haverty of the biotech start-up Miroculus join Laura to discuss dialogues that have cropped up recently on Twitter and in other places against the backdrop of a moment of national reckoning on how racism past and present shapes our society.

Our own accounting includes a look at how exclusion and mistrust have made genetic medicine less effective for some populations than others, how practice can mitigate or perpetuate those inequities, and how to make our field more diverse and welcoming for under-represented groups.

“It’s been a crazy time,” says Gillian Hooker, of the first 5 weeks of her year as President of the National Society of Genetic Counselors. NSGC is attempting to rally support around HR3235, a long-discussed and long-promised federal bill that would permit CMS to recognize genetic counselors as medical caregivers for the purposes of billing, that FINALLY made it to Congress in 2019. A possible wrench in the gears? ACMG announced last month that it cannot support the bill as written.

Why not? Will it matter?

Gillian comes on The Beagle to answer our burning questions (and to tell us to play nice…).