Take family ca history in pregnancy or risk lawsuit. (New Frontier of Medical Litigation).

CANCUN, MEXICO -- Cancers of genetic origin are the next frontier of medical litigation, Dr. Aubrey Milunsky said at a conference on obstetrics. gynecology perinatal medicine, neonatology, and the law.

"Juries increasingly believe that physicians are expected to take a complete family history, and then use this information to alert the patient about the possibilities of cancer," said Dr. Milunsky, director of the Center for Human Genetics at Boston University.

In particular, it's now expected that obstetric record keeping expand into the realm of family history of cancer and the outcomes of patients' prior children. An obstetrician needs to compile a family history chart and pedigree for every woman seen and then update the chart annually, Dr. Milunsky advised at the conference, sponsored by Boston University and the Center for Human Genetics.

He cited a case in which a doctor was sued for failing to advise a woman who had had retinoblastoma that the condition might be passed to her children. When the woman gave birth to a child who developed the condition. she sued the doctor for not informing her of this risk.

To help sidestep such an occurrence, ob.gyns. should take a careful personal and family history of all women who are pregnant or want to become pregnant. A patient should be counseled about the risks her history suggests, and she should be informed about tests that exist for genetic mutations that she might pass to her children.

A major factor driving this trend is the recent advances in cancer genetics. "Tracking genes through DNA linkage analysis or directly analyzing genes for mutations has become, for a selected group of different cancers, the standard of expected care. DNA analysis has facilitated our ability to make specific diagnoses, to predict the likelihood of specific cancers, and to anticipate via prenatal diagnosis those who might be destined to develop a specific cancer later."

Physicians must pay particular attention to: