Advances in psychiatric genetics are likely to offer major diagnostic and therapeutic benefits, but also legal and social-related risks, to individuals who were diagnosed with, or have a proclivity for, psychiatric disorders. In response, courts and policy-makers will have to ensure that psychiatric genetic data are used to promote, and not to obstruct, equality, justice, and social inclusion. However, few studies have queried how such data might impact judicial decision-making; none have explored this question in civil proceedings about parental rights, children's education, and responsibility for behavior in tort. This K01 proposes to study the impact of psychiatric genetic data on these 3 prominent areas of litigation and its relationship to stigma to better understand the implications of new discoveries in psychiatric genetics for law, society, and individual rights, and to inform policy-makers about this knowledge as they devise responses to these advances. The study's aims are: 1) To survey appellate court decisions in family law, education, and torts to determine the extent to which courts are considering psychiatric genetic data, and how they use such data in their decisions; 2) To investigate judicial views about the use of psychiatric genetic data and how such data may affect judges' and public perceptions of parental capacity, educational decisions, and civil responsibility for behavior in tort cases; and 3) To assess the association between psychiatric genetic data and stigma by studying if such data affect judges' and public perception of broader civil legal incapacity and treatment options, and the relationship to judicial bias against persons with psychiatric conditions.
For Aim 1, I will use a mix of qualitative legal analysis and empirica methods.
For Aim 2, I will use a vignette methodology, administered in 3 waves, with samples, respectively, of family court judges, parents, and state trial court judges and the jury-eligible general population.
For Aim 3, I will use existing legal and sociological literature on psychiatric related stigma to develop measures of explicit stigma, and a computer-based measure designed to detect implicit bias, administered as part of the vignettes, to assess the relationships among psychiatric genetic data, judicial decisions, and stigma. Findings will be published in peer-reviewed medical, psychological and policy journals. Complementing these studies will be an intensive training program comprised of didactic courses, tailored training, clinical exposure at the NY State Psychiatric Institute, and mentored experience. My primary mentor Dr. Appelbaum, co-mentors Drs. Link and Ottman, collaborator, Dr. Phelan, biostatistician, Dr. Goldsmith, and consultant, Dr. Parens will train and monitor my progress as I attain my training goals to: 1) develop the skills necessary for conducting empirical research; 2) learn about the clinical aspects of psychiatric disorders; and 3) build and expand national and international professional collaborations with scholars in psychiatry, genetics, social sciences, bioethics, and law. This training will culminate in R01 grant submission to further study the intended and unintended consequences of psychiatric genetic data on law, equality, and social inclusion.

Public Health Relevance

This Mentored Research Scientist Development Award (K01) will prepare the candidate to develop an independent mixed-methods research program to study the intended and unintended consequences of psychiatric genetic data for law, equality, and social inclusion. This study advances NHGRI research priorities relating to the ethical, legal, and social implications of genomic research. It will explore legal, regulatory and public policy issues by studying the effects of current and prospective use of psychiatric genetic data on civil judicia decision-making, and inform the development of new policies for the introduction of such data in non- medical settings (civil courts and schools). It also addresses broader societal issues by querying the implications of psychiatric genomic data for the conceptualization and understanding of mental disability, rights and treatment options for persons with, or proclivity fo, psychiatric disorders, and concepts of free will, responsibility, and justice in the genomic era.

National Institute of Health (NIH)
National Human Genome Research Institute (NHGRI)
Research Scientist Development Award - Research & Training (K01)
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Study Section
Societal and Ethical Issues in Research Study Section (SEIR)
Program Officer
Mcewen, Jean
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New York State Psychiatric Institute
New York
United States
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Sabatello, Maya (2018) Precision medicine, health disparities, and ethics: the case for disability inclusion. Genet Med 20:397-399
Sabatello, Maya; Chen, Ying; Sanderson, Saskia C et al. (2018) Increasing genomic literacy among adolescents. Genet Med :
Sabatello, Maya; Callier, Shawneequa; Garrison, Nanibaa' A et al. (2018) Trust, Precision Medicine Research, and Equitable Participation of Underserved Populations. Am J Bioeth 18:34-36
Bester, Johan; Sabatello, Maya; van Karnebeek, Clara D M et al. (2018) Please Test My Child for a Cancer Gene, but Don't Tell Her. Pediatrics 141:
Sabatello, Maya (2018) A Genomically Informed Education System? Challenges for Behavioral Genetics. J Law Med Ethics 46:130-144
Sabatello, Maya; Janvier, Annie; Verhagen, Eduard et al. (2018) Pediatric Participation in Medical Decision Making: Optimized or Personalized? Am J Bioeth 18:1-3
Sabatello, Maya; Appelbaum, Paul S (2017) Behavioral Genetics in Criminal and Civil Courts. Harv Rev Psychiatry 25:289-301
Sabatello, Maya (2017) Psychiatric Genomics and Public Mental Health in the Young Mind. Am J Bioeth 17:27-29
Sabatello, Maya; Appelbaum, Paul S (2017) The Precision Medicine Nation. Hastings Cent Rep 47:19-29
Sabatello, Maya; Appelbaum, Paul S (2016) Raising Genomic Citizens: Adolescents and the Return of Secondary Genomic Findings. J Law Med Ethics 44:292-308

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