Unearthing bones can also unearth family secrets

WASHINGTON - It started off as a routine DNA test to help two parents from a wealthy Southern family decide whether to have children. But the saga that unfolded as a genetic counselor investigated the family's biological roots became a tale of long-concealed secrets worthy of a Faulkner novel.

The counselor discovered that the husband, who was in his 40s, was not the biological son of the man who had raised him from birth. His real father was the man he had grown up calling uncle. The lab results posed a dilemma, the counselor recalled, forcing her to decide whether to break the news to the unsuspecting husband about the true identity of his biological father. In the end, she decided not to.

"You just can't be prepared for each and every case like this," says counselor Debbie Pencarinha.

Now, as the military develops new technologies that could identify fallen soldiers using similar kinds of DNA tests, it is facing the real possibility that bones unearthed from distant battlefields may also end up exposing family secrets from World War II. The tests could well uncover cases of false paternity that have been kept secret for decades.

"You could really do a lot of damage to a family," says Johnie E. Webb Jr., the deputy director of the Joint POW/MIA Accounting Command, the military unit responsible for identifying the remains of American soldiers, which has imposed a moratorium on the most powerful tests while drafting ethical guidelines. "We haven't totally come to grips with how we're going to handle it. We're going to make sure we don't do anything that's going to be embarrassing to anyone."

Genetic counselors say such ethical quandaries are emerging more often with the increasingly widespread use of DNA tests. By providing irrefutable evidence of biological paternity, the tests have created dilemmas for physicians who are sometimes forced to reveal decades-old cases of infidelity.

Counselors and medical ethicists say that in the rapidly evolving field there are no firm guidelines for how to handle such inadvertently discovered information. In many cases, physicians simply withhold potentially traumatizing information unless disclosing it is medically necessary.

In all, about 25 percent of the roughly 400,000 familial DNA tests conducted every year result in an "exclusion," said Mary K. Mount, an official at the American Association of Blood Banks. That figure includes situations where the negative result was expected, such as a man who sought a test to prove he did not father a child. But it also includes thousands of cases where the results came as a complete shock, most often to men who are surprised to learn they are not the biological father of their children.

There are no statistics of how many cases of misattributed paternity are discovered by DNA tests. Overall, the number of misattributed fathers in the general population is between 1 and 3 percent, said Lyn Turney, a researcher at Swinburne University in Australia.

The number is thought to be higher for older generations, before legalized abortion and when the social stigmas around illegitimacy and adultery caused some couples to keep it a secret if children were born as a result of infidelity.

And in the case of the war generation, the number may be higher still, making it more likely the military would uncover misattributed paternity cases in the identification of war dead if they seek DNA samples from their children. With many men overseas, some researchers theorize that illegitimacy rose during the World War II era. According to a wartime study by the military, up to 75 percent of married soldiers cheated on their wives while in uniform, said Karen Anderson, a history professor at the University of Arizona and author of "Wartime Women: Sex Roles, Family Relations, and the Status of Women During World War II," and there is no reason to believe that many women weren't unfaithful too.

"Marriages were under strain," Anderson said. "None of this should surprise anyone."

Misattributed parentage is not the only secret that can be accidentally unmasked by testing. Angela Trepanier, president of the National Society for Genetic Counselors, said in one of her cases a World War II veteran who had covered up his Jewish ancestry when he joined the Army had been forced to reveal his background to his family after tests showed that his children carried a genetic disorder found in Jews.

"You sometimes get more than you bargain for," Trepanier said.

Although counselors often decide to withhold such findings, some ethicists argue that patients have an inherent right to their genetic information, since knowledge of inherited genetic risks can lead to improved medical care. A 2001 article by Anneke Lucassen and Michael Parker in Lancet, a British medical journal, argued that patients should always be informed about their paternity, no matter how embarrassing or awkward the revelation may be.

So far, the military has avoided such dilemmas because it has not been able to use the same kind of DNA, known as nuclear DNA, that is used by genetic counselors and forensic labs. Until recently it was too difficult to extract samples from skeletons that may have been buried for decades, military officials said.

Instead, the military has relied on mitochondrial DNA, a type of DNA that contains less identifying information but is more plentiful in the body and is much easier to recover from remains. Mitochondrial DNA tests, first deployed by the Joint POW/MIA Accounting Command in 1992, are now used in between 75 and 80 percent of missing soldier cases, according to the military, and have helped identify the remains of 531 missing service members.

However, mitochondrial DNA isn't unique to an individual and doesn't contain enough information to make a conclusive match. The more complex nuclear DNA is inherited from both parents and is far more fragile than mitochondrial DNA. Only now, with the availability of better methods to extract nuclear DNA samples, has the military been confronted with the same ethical dilemmas familiar to genetic counselors.

For instance, if two children of a missing soldier independently volunteered DNA samples, and they did not match, the military would know they did not share the same father.

For now, Webb says, nuclear DNA testing is on hold while the Joint POW/MIA Accounting Command develops a protocol for collecting samples from family and handling the results. But he emphasizes that the military remains committed to eventually using the technology.

"We'll come up with a way to approach this to obtain the samples and deal with it," he says. "It's just something that we have to do."