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Question: Hadley, a thirty-five-year-old physician, has worked at Princeton Plainsboro Hospital for six years. She recently received a promotion to the head of oncology and is looking forward to spending the remainder of her medical career at the hospital.

Unfortunately, Hadley has a family history of Huntington's disease, a condition that causes movement, cognitive and psychiatric disorders. Hadley's mother suffered and eventually passed away from the disease, as there is no cure. Huntington's is an autosomal dominant condition, meaning that Hadley has a fifty-percent chance of inheriting the condition from her mother.

For years, she has put the thought of inheriting the condition out of her mind, but she is quickly approaching her thirty-sixth birthday, and that is when her mother began to show symptoms of the disease. Hadley decides that now is the time to go ahead and have the genetic testing done to see if she will inherit the disease from her mother.

Hadley has the testing done at Princeton Plainsboro, and two weeks later receives her results - she is positive for Huntington's. Hadley is devastated, but decides that she will continue with her oncology practice until she is mentally and physically unable to perform her duties.

Additionally, she speaks to her friend, Cameron about a clinical trial for a new medication to treat Huntington's that has recently begun at the hospital. Because she is too late to enter the study and does not want anyone to know she has the condition, Cameron agrees to allow her to take the experimental medication and participate in the trial without signing any documents.

Three weeks later, a lab tech speaks to Hadley's superior regarding her unfortunate diagnosis. Because hospital management knows that Hadley likely only has a few more years to work in oncology, they terminate her employment to hire a new head of oncology that can run the unit for the foreseeable future.

Please read the scenario carefully, and discuss the following:

1) What, if any regulations were violated when Hadley entered into the clinical trial in this manner?

2) Did she commit any ethical violations by entering into the clinical trial this way?

3) Did Cameron commit any ethical or legal violations by allowing Hadley into the clinical trial?

4) What ethical and legal issues arise with the type of genetic testing that Hadley underwent? Do you think this type of testing is beneficial or harmful to the individual being tested?

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