The Role of PHN in Consanguineous Marriages
Consanguinity is a common practice in some communities across the world, especially in Arab countries. Consanguineous marriages refer to marital unions between two biologically related individuals (Joseph et al., 2016). In clinical genetics, the term refers to marriages between closely related individuals, such as second cousins. Although such unions are practiced in some communities, the exercise evokes ethical and genetic implications that should be addressed in public health.
Genetic Risks of Consanguineous Marriages
Some conditions and genetic disorders are common in families, and the risk is heightened in consanguineous marriages. The unions place individuals at a high risk of inheriting a mutant allele at the identical locus. Genetic inheritance depends on the closeness of a relationship between the individuals, which places children at the danger of being homozygous for a harmful gene (Joseph et al., 2016). They might be affected by various autosomal recessive genetic disorders and a high possibility of infant deaths.
Global Prevalence of Consanguinity
Consanguineous marriages remain commonly practiced in various countries across the world. It is estimated that 20% of world populations reside in such countries that practice such marriages. The highest prevalence is noted in North Africa, the Middle East, and Western Asia. Recent studies show that the highest rates are in Alexandria, Egypt at 68%, Jordan at 51–58%, Kuwait at 54%, Qatar at 52%, Saudi Arabia at 58%, and the United Arab Emirates at 50% (Bener & Mohammad, 2017). Various factors, such as socioeconomic reality, illiteracy, and culture, explain the high prevalence.
Two U.S. Communities that are at Risk
Consanguinity is not common in the United States. However, due to its cultural implications, some communities in the country are at the risk of such marriages. Some of the affected groups are Arabs and Muslims, who reside in the United States (Bener & Mohammad, 2017). They might engage in consanguineous marriages, although such unions are illegal in some parts of the United States.
Three of the Social/Cultural Beliefs That are Predisposing or Perpetuating Factors
Social/cultural factors are implicated with the high rate of consanguinity in some communities. Firstly, some communities believe that family stability is based on such marriages. Secondly, the couple’s compatibility belief is a significant factor behind consanguineous marriages. Thirdly, some believe that marriages eradicate hidden uncertainties in financial and health issues (Saadat, 2015). These factors are evident within the societies that support consanguinity.
Two Factors That Have Reduced Consanguinity
Various factors have caused a decline in the rate of consanguinity in many at-risk populations. Firstly, counseling during the premarital period educates the couples about the danger of such marriages. Secondly, improvement in literacy levels has created knowledge regarding risks such as genetic disorders (Joseph et al., 2015). Counseling and education are creating the necessary awareness and promoting behavior change.
Confidentiality issues in consanguinity relate to the policies regulating the disclosure of genetic information in families. While communication about the information is necessary, the health care provider should be guided by the need to maintain confidentiality (Gallo, Angst, & Knafl, 2009). It also affects independent decision-making, such as whether the couple is willing to discuss or disclose the information even to family members.
Ethical and Privacy Issues
Various moral and privacy issues should be considered before the disclosure of genetic information to a spouse or relatives. Some of the considerations include the need or obligation to the spouse, the risk of a genetic disorder to children born to such a couple, closeness of a relationship to relatives, the need to protect the family from wrong decisions, and need for social support and familial risk (Gallo, Angst, & Knafl, 2009). These factors determine whether and how to disclose information.
Regardless of the need to maintain privacy due to ethical and legal challenges, nurses have a responsibility to individuals when sharing concerns regarding genetic risks of consanguinity. However, they should consider cultural issues and moral obligations when sharing confidential information. They should first disclose the information to the couple and explain the need to share the information with relatives if need be.