A mobile DNA testing facility that looks more like a motor home than a medical clinic is raising questions about the ramifications of quick and easy tests to determine paternity and other biological connections.
Once a time-consuming and complicated process, DNA testing has become so accessible that experts worry families and individuals may not be properly prepared for the results.
On the spot tests?
A 28-foot (8.5-meter) recreational vehicle cruising around New York City emblazoned with the question "Who's Your Daddy?" and offering on-the-spot DNA testing services starting at $299 has renewed those concerns.
The clinic, operated by a New York company called Health Street, started in 2010 but was revamped two months ago.
Passersby can hail the conspicuous brown and blue Winnebago to have DNA samples taken by a technician, packaged and sent to a laboratory in Ohio. Results are returned within three to five business days. Mandatory prescriptions for the tests from a customer's physician can be faxed via the Internet to the RV.
While it is common for DNA testing distributors, companies who take the samples and send them to labs for analysis, to offer mobile collection services, Health Street appears to be the first to splash exactly what it does on the vehicle. "DNA TESTING" in bold red lettering is painted on the side.
In demand tests
Jared Rosenthal, who founded Health Street and drives the RV, recounts some of the people affected by his service: Two women who learned they were half-sisters, and a man whose suspicion that he might be the father of a friend's daughter was confirmed.
"It's just such a serious, fundamental question ... who are your children? Who are your parents?" Rosenthal, 42 said.
Experts say there has been a steady increase in demand for such tests in the United States, reaching close to 500 000 a year, according to Michael Baird, director of DNA Diagnostics, a DNA testing laboratory, in part because the rate of births to unmarried women has also been increasing.
In 2010, at least 382 199 relationship tests were conducted in the United States, although the total is likely higher because some labs don't submit data, according to the AABB, formerly known as the American Association of Blood Banks, which accredits relationship testing facilities.
State child-support agencies make up the bulk of this demand, but experts said the number of people simply seeking answers, and the accompanying number of venues and ways to test for family relationships, have increased.
Susan Crockin, a lawyer who teaches at Georgetown Law Center and specialises in reproductive technology, said families should be careful of the reliability of the growing variety of relationship tests around the country, which range from at-home DNA kits that critics say can be subject to contamination, to on-site tests used to prove legal paternity.
"The underlying issues are obviously the quality of testing," Crockin said.
Health Street's DNA tests are analysed in a lab certified by the AABB as well as the New York State Department of Health, Rosenthal said.
Health experts advise customers to only use labs accredited by AABB or distributors who use those labs, but there are no regulations on the outfits themselves. It is also not illegal to run a DNA testing laboratory that is not AABB-certified, Baird said.
Customers at Health Street must have a prescription from a doctor requesting the tests, Rosenthal said. Paternity testing is usually not covered by health insurance unless there is a medical need.
Aside from questions about reliability, experts said wider DNA testing raises concerns of whether families and individuals are psychologically prepared for the results.
"The bigger question is what do we do with this information. Why are we looking for it and what do we think it means?" Crockin said.
Crockin said individuals, especially children, should have the advice of trained genetic counsellors before and at the time of receiving the results of the DNA match.
Others say the promotion and presence of these DNA testing clinics and methods could devalue past family relationships when new biological connections are discovered.
"As this (industry) evolves it will create a social expectation that, despite a past relationship between a social father and a child, DNA is everything," said David Bishai, a professor at Johns Hopkins Bloomberg School of Public Health.
Typical customers at Health Street include men who are engaged and want to confirm offspring from a past relationship, returning soldiers seeking reassurance that they fathered newly-born children, and women inquiring about paternity on behalf of their children, Rosenthal said.
The door, however, is open to heartbreak, especially when men discover that somebody else fathered their children.
"If you're really happy with the children in your life, don't go near these things," Bishai said.
Others are happy to receive the results.
Cornelia Heggs, 40, of Carrollton, Georgia, grew up knowing she had half-siblings from her absent father's other marriages but never met them. She was contacted in 2009 by a half-sister who promised their mutual grandmother that she would find Heggs. The two women confirmed their relationship in June through a test at Health Street.
"We found each other and now we have the proof. There's no more guessing. I'm just happy to know," she said.
For others the information opens an uncertain chapter.
A 44-year-old married father of two in New York City confirmed in July through a DNA test at Health Street's mobile clinic that the adult daughter of a woman he dated some 20 years ago was his.
The man, who declined to give his name for reasons of privacy, said he is slowly and cautiously building a relationship with his 20-year-old daughter, a student in Ohio.
"This issue is still raw and very sensitive," he said.
"I will get to know my daughter; this is something I'm taking one day at a time."
(Reuters Health, August 2012)
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