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Predictive genetic testing in minors for late-onset conditions: a chronological and analytical review of the ethical arguments
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  1. Cara Mand1,2,
  2. Lynn Gillam3,4,
  3. Martin B Delatycki1,
  4. Rony E Duncan5,6,7
  1. 1Bruce Lefroy Centre for Genetic Health Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
  2. 2Monash University, Clayton, Victoria, Australia
  3. 3Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Victoria, Australia
  4. 4School of Population Health, The University of Melbourne, Victoria, Austraila
  5. 5The Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
  6. 6Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
  7. 7Department of Paediatrics, The University of Melbourne, Victoria, Australia
  1. Correspondence to Dr Rony Duncan, The Centre for Adolescent Health, Royal Children's Hospital, 3052, Melbourne, Victoria, Australia; rony.duncan{at}mcri.edu.au

Abstract

Predictive genetic testing is now routinely offered to asymptomatic adults at risk for genetic disease. However, testing of minors at risk for adult-onset conditions, where no treatment or preventive intervention exists, has evoked greater controversy and inspired a debate spanning two decades. This review aims to provide a detailed longitudinal analysis and concludes by examining the debate's current status and prospects for the future. Fifty-three relevant theoretical papers published between 1990 and December 2010 were identified, and interpretative content analysis was employed to catalogue discrete arguments within these papers. Novel conclusions were drawn from this review. While the debate's first voices were raised in opposition of testing and their arguments have retained currency over many years, arguments in favour of testing, which appeared sporadically at first, have gained momentum more recently. Most arguments on both sides are testable empirical claims, so far untested, rather than abstract ethical or philosophical positions. The dispute, therein, lies not so much in whether minors should be permitted to access predictive genetic testing but whether these empirical claims on the relative benefits or harms of testing should be assessed.

  • Genethics
  • genetic screening/testing
  • predictive genetic testing
  • children
  • newborns and minors
  • genetic counselling/prenatal diagnosis
  • ethics committees/consultation
  • research ethics
  • minors/parental consent
  • paediatrics
  • genetic information
  • scientific research
  • applied and professional ethics
  • availability of contraceptives to minors

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Footnotes

  • Linked article YES.

  • Contributors All the authors have contributed substantially to the manuscript.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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