Rectifying or Reinforcing? The (In)Equity Implications of Recontacting Practices in Genomic Medicine

Abstract

The practice of recontact in genomic medicine has the power to help rectify long-standing inequities in genetic testing. However, if not delivered systematically, recontacting practices also have the potential to reinforce these same inequities. Recontact, which occurs when contact between a clinician and patient is reinitiated after a relationship has ended, is often in search of or in response to updated interpretation or results. Currently, recontact is happening in a patient-driven and ad hoc manner, undermining its potential to benefit all patients. In this paper, the authors position justice as an additional argument in favor of systematic recontact and an argument against the predominantly patient-initiated model. They argue that patients from equity-deserving groups should be early beneficiaries of an emerging responsibility to recontact patients. The authors share illustrative clinical vignettes and propose role-specific and systems-level solutions to rightfully position recontact as a tool to promote a more equitable clinical genomics future.