The arrogance of some doctors can be scary. I used to be a clinical genetic counselor, a job specifically designed to focus on working with doctors as a genetics specialist so that they don't need to know all the intricacies of that on top of everything else. Most doctors I worked with hated me, and saw me as a distraction from work they could handle on their own.
One time a doctor went over my head to order a genetic test for a patient who had a very strong family history of breast cancer. He didn't refer her for a genetic counseling session, which was the protocol so that we could explain to her her own risk and the potential positive result, and give her the option to make an informed choice about whether or not she wanted testing at all. He just offered her the test out of the blue and, not really knowing what it meant, she just accepted by default. Not only did she test positive for a BRCA1 mutation, increasing her lifetime risk of developing breast cancer to over 90%, but the doctor incorrectly interpreted the results of the test, and believed she tested positive for breast cancer itself.
I only learned about the patient because the doctor mentioned her nonchalantly during a review meeting, and I had to correct him about the results of the test and convince him to refer her to me. I think the only reason he agreed was because he was put on the spot in front of the whole oncology department. I was lucky that the doctor hadn't yet incorrectly reported to the patient that she had breast cancer, but I still had to inform this woman, who barely understood why she was here, that she'll likely want to start scheduling yearly mammograms right now, or even consider a mastectomy, while she was still in college. That was the most difficult day of my short time in the field, and a big reason for why I ultimately left.
Oh, no, the diagnosis isn't the bad thing, the process by which the patient received it is the bad thing. Genetic testing is a big decision, since it not only affects the patient's entire life, but also the lives of their family members. It's not something you want the patent to suddenly be informed of out of the blue without even fully understanding that they were being tested in the first place. This patient had no time to prepare for the possibility that she could have a high lifetime cancer risk, and didn't even know what that would mean until she already had the result.
This woman went from a normal college student with normal worries to someone who now has to worry about whether or not she wants to risk keeping her breast tissue to maybe one day breastfeed a baby, or simply feel like herself when she looks in the mirror. She has to think about whether she wants to have kids at all because they'd have a 50% chance of inheriting the same mutation. Every time she touches her own breasts for the rest of her life she's going to be scared that she feels a lump.
It's good that she got a diagnosis, but a lot of people choose not to, or at least choose to have it at a time when they're ready to focus on it, and this woman was denied that. She could have simply gotten more mammograms without testing right now, for example, because her family history put her in higher risk in its own. She wasn't even given a heads up that she might be thrust into this reality - the doctor was thinking about her physical well-being, but ignored her mental well-being. That's what the genetic counselors are supposed to be there for, but he ignored us, and the patent suffered for it. A woman walked into my office thinking everything was fine, and walked out with a world of worries on her shoulders.