RT Journal Article
SR Electronic
T1 Predictive genetic testing for neurodegenerative conditions: how should conflicting interests within families be managed?
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 640
OP 642
DO 10.1136/medethics-2016-103400
VO 42
IS 10
A1 Stark, Zornitza
A1 Wallace, Jane
A1 Gillam, Lynn
A1 Burgess, Matthew
A1 Delatycki, Martin B
YR 2016
UL http://jme.bmj.com/content/42/10/640.abstract
AB Predictive genetic testing for a neurodegenerative condition in one individual in a family may have implications for other family members, in that it can reveal their genetic status. Herein a complex clinical case is explored where the testing wish of one family member was in direct conflict to that of another. The son of a person at 50% risk of an autosomal dominant neurodegenerative condition requested testing to reveal his genetic status. The main reason for the request was if he had the familial mutation, he and his partner planned to utilise preimplantation genetic diagnosis to prevent his offspring having the condition. His at-risk parent was clear that if they found out they had the mutation, they would commit suicide. We assess the potential benefits and harms from acceding to or denying such a request and present an approach to balancing competing rights of individuals within families at risk of late-onset genetic conditions, where family members have irreconcilable differences with respect to predictive testing. We argue that while it may not be possible to completely avoid harm in these situations, it is important to consider the magnitude of risks, and make every effort to limit the potential for adverse outcomes.