Abstract:
An inherited predisposition to cancer may result from constitutional mutations in a number of tumour suppressor genes. Knowledge of the specific mutations with a family which render the individuals susceptible to bowel, breast or stomach cancer facilitates genetic testing. Genetic testing is a relatively new technology, and New Zealand society is still coming to terms with its ethical implications and informational potential.
Maori people are the indigenous people of Aotearoa New Zealand. As a consequence of a colonial history that has had a major impact on Maori health, New Zealand is struggling to reduce significant disparities in the health status of Maori. With the exception of one high profile case, Maori people have not readily engaged in genetic testing or genetic counselling services. This thesis set out to examine Maori perspectives about this state. Drawing on a Kaupapa Maori approach to research, a group of Maori cultural commentators (Pukenga), Maori families (whanau), and health professionals who work with families (Interfacers) were interviewed for this study.
The thesis discusses the different world views that Maori have in regards to health, wellbeing and human society. These world views help explain Maori cultural perspectives about predictive/presymptomatic DNA testing. The thesis draws on the notion of two worlds which may stand apart in terms of world view, but which have the potential to come together at the level of individual and family health and well-being. The thesis draws on the interviews and suggests pathways forwards in the area of genetic counselling and other services. While these pathways are relevant to Maori and the New Zealand context the study shows how other cultural groups with alternative world views may seek their own solutions and responses to the technologies available through predictive/presymptomatic DNA testing.