When a Gene Echoes Through a Family

A single genetic diagnosis can ripple through generations and reshape medical care for an entire family. Cascade genetic testing, the offering of targeted genetic testing to biological relatives of a person in whom a disease-causing variant has already been identified, can find at‑risk relatives, improve outcomes, and save costs through early treatment and prevention. We spoke with Rajani Aatre, senior genetic counselor at Michigan Medicine’s Frankel Cardiovascular Center, about the importance of cascade genetic testing, the ethical tension between honoring a patient’s privacy and protecting relatives from preventable harm; and the question of whether, when, and how to share life‑changing genetic information with relatives.