To think this is a weird question for a doctor to ask

[ReallyDoc]

Took my DS to A&E today. He had a seizure. Second one he's had. They say nothing to worry about as its febrile seizure and related to him having a high temp and he shluld grow out of them. When DS woke up he was very sleepy I mean he's three and just had a seizure so..he was very quiet.

Anyway the A&E doctor asked a bunch of questions and then discharged us happy DS is fine. One of these questions was "are you and DP (e.g. DS dad) related by blood?". I was like "good god of course not" and he laughed a bit and it was all fine

But now I can't sleep analysing why he asked that. Does he think there looks like there is something genetically off with my kid? What the hell is he suggesting? Or is this a normal question to ask???

This, please don’t refer to “south Asian” communities as one block. The prevalence in the UK, as all the data shows, is within Pakistani Muslim families where cousin marriage has been traditionally very common and actually encouraged

And has been compounded by the belief that a disabled child is a blessing. And another factor, I think, is that although cousin marriage has been traditional the changes both in immigration law and the upbringing of young people means their preference is for a British born and brought up partner.

When people lived in Pakistan there would be a wider gene pool but if you have someone who came to Britain in the 1960s you would probably be a single man (the exception being highly educated people like Drs who may well be women or arrive as a couple) you would marry a woman 'from home' that might be arranged or even forced but successive generations want spouses with similar values and up bringing so the gene pool is small.

I find it interesting to compare with the Jewish community and Tay-Sachs disease. Ashkenazi Jews used to be the people most commonly to have children with Tay-Sachs - if you have not heard of it it is a horrible condition.

Screening before marriage has reduced it so that incidences in the UK are now more common amongst other groups.

The problem with research and trying to reach some communities is that it can feel discriminatory, and it can also bring the shadow of eugenics.

Maybe in the future it will become to have genetic testing before you have children. And yes I realise a lot of babies are not planned.

But this is not the same as consanguinity…

presumably the widow wasn’t related to her husband nor his brother!

2 sisters marrying 2 brothers or a widow marrying her husbands brother is not that unusual and they’re not related!

I can’t believe there are medical professionals, consultants even, who think that this is acceptable. It actually makes me really angry.

It’s a serious problem in my area.
A friend married her cousin and their parents were also cousins, their dc had significant health problems. She later divorced and went on to have 2 healthy children with her new husband
It can be quite sensitive and is best tackled from within the community. There are a couple of initiatives being run by ladies from those communities

It's a weird question but also sadly necessary. There are areas in the UK where consanguineous marriages and offspring are more common. There are specific cultures that actively marry first and second cousins so it's common to see serious physical disabilities in their children. Not to mention the pain some of these children will experience their whole life, the cost that one small life will have on the NHS is massive. And it's all avoidable. I'm sorry that you were asked that, it may be that you live in an area with common consanguinity or that (horrible thought) your physical looks resemble a culture that does this.

I hope your little one is okay, febrile seizures are very very scary but the doctors are right they do grow out of them although it doesn't make it easier right now though.

Why is it a horrible thought that the OP might look like someone from a specific ethnic minority?

I assumed the poster meant it was a horrible thought that OP had been racially profiled based on appearance…

I work in special needs for a government department in an Arab country. Autism is prevalent among the local community and it's believed to be due to consanguineous marriages.

I’m white British and have been asked this multiple times. My child has epilepsy

2 sisters marrying 2 brothers or a widow marrying her husbands brother is not that unusual and they’re not related!

2 Sisters marrying 2 brothers isn't an issue but in some cultures they are already cousins. As is the case with the lady who told me her situation.

Their children are classed as 1st cousins
and can legally marry. Even although genetically they are much closer than normal first cousins as they share two sets of grandparents. Instead of sharing one and having another one each.

2 Sisters marrying 2 brothers isn't an issue but in some cultures they are already cousins. As is the case with the lady who told me her situation.

I used to have a colleague who was marrying his first cousin. Their mothers were sisters, and their fathers were brothers. Pretty sure their grandparents had some consanguinity going on too. I hadn't thought of him in years until this comment. This was about 10 years ago now, so it's likely they've had kids by now. I hope they're all doing ok.

I understand this is an issue in Pakistani families but it’s not uncommon around our local council estate either. Not married but lots of children, teens and adults who are all related to each other.

My daughter went to the local school and within her class there were at least 7/8 kids who were cousins/brothers/sisters at the same time.

One mother had a girl by her partner and then literally got pregnant a few months later by his father. So two sisters but also one was the auntie of her sister. Plus numerous first cousins of the same age

@BeanieTeen I'm not sure if there's a lack of awareness. I've never really thought about it because it's not considered anything unusual. I must admit that I myself was under the impression that problems only occur when it goes on for multiple generations. My cousin turned out fine by the way. Got an engineering degree and everything.

I agree it's more of an issue when you have multiple generations who are all interrelated.
We all carry dodgy genes but often you need two copies of dodgy genes to be affected the odds of two copies coming together are much higher when the gene pool is very small.

The lady I spoke to has two very bright kids and one with severe autism and learning disabilities. Who can't be left alone with no sense of danger.

I was just agreeing with PP that things where done differently in the past.

We never mentioned it as inbreeding just morally wierd leading to a fucked up 'loopy' family tree branch.

Again that isn’t an issue unless the offspring all start having kids with each other

Again that isn’t an issue unless the offspring all start having kids with each other

But within just a few generations, in places where people don’t tend to move away, it naturally becomes an issue. People don’t and can’t keep track of who is related to who.

Oh I can. I know a few actually. 2 doctors who are 1st cousins, as are the wife's parents. Another went 'home' to get married and came back with his young cousin as his wife. They now have 3 DC, two of which have medical conditions.

And aghast we all should be. Regardless of cultural sensitivities the risks on the health and wellness of many is too high to accept it as ok.

My husband is Pakistani and in truth you can count on one hand the amount of extended family members (he and I included) that aren’t married to a direct relative.

from my understanding, for marriage to be legal in the UK, you need to be 3 degrees removed from them, so your first cousin is ok, as it’s 3 lines away from you (your parents- their sibling- their child) and as long as your parents aren’t related then it’s ok, and the reasoning behind this is genetic variation, however it gets more murky when parents are cousin and then you marry a cousin, this marriage is illegal as it’s considered the same as marrying your brother / sister. However crucially in the Muslim community (and I’ve known this happen in Bangladeshi, Pakistani and Indian Muslim community) the marriages aren’t civilly registered so there’s no proof that the marriages have occurred.

whilst I’d never marry my cousin, I think we should be sensitive that there might be some scenario where first cousins (crucially who’s parents aren’t also cousins) that may want to marry, so I don’t think banning these marriages is the answer. Although from my in laws, this only accounts for 1 of the dozens of couples. I do think these couples need to be offered genetic counselling. However where I do think the law needs to Improve is to mandate that all ‘minority religions’ marriages are civilly registered too to stop these deeply incestuous marriages that I referenced above from occurring. It will also give the opportunity for some to get help getting out of the marriage, in my experience whilst not exactly gun to the head forced, most are presented as, this is what you will do, you owe the family etc.

Most neurological disorders go hand in hand with epilepsy and having parents who related puts you at higher risk of neurological disorders. He’s just establishing the risk factors.

It's a normal question. On a lot of my special needs support groups on facebook there will be people going to their first appointment and asking for advice. Someone will always reply saying don't be alarmed if the dr asks if you are related to their other parent. I hope your little one feels better soon.

I’m a teacher and did a long term placement in a school where it was probably about half South Asian, many Pakistani, the rest of various other backgrounds. A very diverse area. They had a high proportion on SEND and a complex needs resource base and looking back, it’s not something I really thought about at the time, but actually a vast majority on the children with needs and certainly in the resource base were of South East Asian decent. It was not proportional in terms of the school population at all. It could be coincidence of course, but having read this I think maybe not. I do find this problematic and as a PP said regardless of cultural sensitivity this is not ok really.

And has been compounded by the belief that a disabled child is a blessing.

Its only one experience but I know of a family with a child with significant needs where culturally it was seen as some sort of curse and the family were cut off from their extended family.

So I was surprised by this comment.

You will be surprised how many people are related. Normally it’s quite distantly - one of my friends from uni ended up marrying a distant cousin (they’re originally from India).