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To test or not to test: genetic cancer predisposition testing in paediatric patients with cancer
  1. Sapna Mehta1,
  2. Dennis John Kuo2
  1. 1Global Health, Biology, University of California San Diego, La Jolla, California, USA
  2. 2Pediatric Hematology–Oncology, University of California San Diego School of Medicine, La Jolla, California, USA
  1. Correspondence to Dr Dennis John Kuo, Pediatric Hematology–Oncology, University of California San Diego School of Medicine, La Jolla CA 92093, USA; dekuo{at}


Genetic cancer predisposition testing in the paediatric population poses unique ethical dilemmas. Using the hypothetical example of a teenager with cancer with a high probability of having an underlying cancer predisposition syndrome, we discuss the ethical considerations that affect the decision-making process. Because legally these decisions are made by parents, genetic testing in paediatrics can remove a child’s autonomy to preserve his or her own ‘open future’. However, knowledge of results confirming a predisposition syndrome can potentially be beneficial in modifying treatment and surveillance plans and enabling at-risk family members to obtain cascade testing for themselves. Considering virtue ethics to envision the best characters of the patient, parents and healthcare providers can guide them to the better choice to test or not to test, with the ultimate goal of achieving the best outcome for survival and eudaimonia, human flourishing reliably sought out.

  • genetic screening/testing
  • genethics
  • clinical ethics
  • paediatrics

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  • Contributors Authors SM and DJK both contributed equally to the research, writing and editing of this manuscript.

  • Funding Summer URS Ledell Family Research Scholarship for Science and Engineering: UCSD.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement There are no data in this work.

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