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Is There a Right Time to Know?: The Right Not to Know and Genetic Testing in Children

Published online by Cambridge University Press:  01 January 2021

Extract

In the last few decades, great progress has been made in both genetic and genomic research. The development of the Human Genome Project has increased our knowledge of the genetic basis of diseases and has given a tremendous momentum to the development of new technologies that make widespread genetic testing possible and has increased the availability of previously inaccessible genetic information. Two examples of this exponential evolution are the increasing implementation of next-generation sequencing technologies in the clinical context and the expanding commercial offer of genetic tests directly-to-consumers.

Firstly, the rapid development of next generation sequencing technologies (i.e., high-throughput and massively parallel DNA sequencing technologies) has substantially reduced both the cost and the time required to sequence an entire human genome. These technologies are increasingly being used in the clinical setting with the goal of diagnosing conditions of presumed genetic origin that cannot be explained by targeted sequencing approaches.

Type
Symposium
Copyright
Copyright © American Society of Law, Medicine and Ethics 2014

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References

Johnston, J. J. Rubinstein, W. S., and Facio, F. M. et al., “Secondary Variants in Individuals Undergoing Exome Sequencing: Screening of 572 Individuals Identifies High-Penetrance Mutations in Cancer-Susceptibility Genes”, American Journal of Human Genetics 91, no. 1 (2012): 97108; Netzer, C. Klein, C. Kohlhase, J., and Kubisch, C., “New Challenges for Informed Consent through Whole Genome Array Testing”, Journal of Medical Genetics 46, no. 7 (2009): 495–496; Ostrer, H., “Changing the Game with Whole Exome Sequencing”, Clinical Genetics 80, no. 2 (2011): 101–103.CrossRefGoogle ScholarPubMed
Id. (Johnston, et al.); Ashley, E. A. Butte, A. J., and Wheeler, M. T. et al., “Clinical Assessment Incorporating a Personal Genome”, The Lancet 375, no. 9725 (2010): 15251535.Google Scholar
Mayer, A. N. Dimmock, D. P., and Arca, M. J. et al., “A Timely Arrival for Genomic Medicine”, Genetics in Medicine 13, no. 3 (2011): 195196 Solomon, B. D. Hadley, D. W., and Pineda-Alvarez, D. E. et al., “Incidental Medical Information in Whole-Exome Sequencing”, Pediatrics 129, no. 6 (2012): e1605–e1611 Worthey, E. A. Mayer, A. N., and Syverson, G. D. et al., “Making a Definitive Diagnosis: Successful Clinical Application of Whole Exome Sequencing in a Child with Intractable Inflammatory Bowel Disease”, Genetics in Medicine 13, no. 3 (2011): 255–262.CrossRefGoogle ScholarPubMed
Saunders, C. J. Miller, N. A., and Soden, S. E. et al., “Rapid Whole-Genome Sequencing for Genetic Disease Diagnosis in Neonatal Intensive Care Units”, Science Translational Medicine 4, no. 154 (2012): 154ra135.CrossRefGoogle ScholarPubMed
Hastings, R. de Wert, G., and Fowler, B. et al., “The Changing Landscape of Genetic Testing and Its Impact on Clinical and Laboratory Services and Research in Europe”, European Journal of Human Genetics 20, no. 9 (2012): 911916 Biesecker, L. G. Burke, W., and Kohane, I. et al., “Next-Generation Sequencing in the Clinic: Are We Ready?” Nature Reviews Genetics 13, no. 11 (2012): 818–824.CrossRefGoogle ScholarPubMed
Howard, H. C. Borry, P., “Personal Genome Testing: Do You Know What You Are Buying?American Journal of Bioethics 9, nos. 6–7 (2009): 1113.CrossRefGoogle Scholar
Howard, H. C. Borry, P., “Direct-to-Consumer Genetic Testing: More Questions Than Benefits?”, Personalised Medicine 5, no. 4 (2008): 317320.CrossRefGoogle ScholarPubMed
European Society of Human Genetics, “Statement of the ESHG on Direct-to-Consumer Genetic Testing for Health-Related Purposes”, European Journal of Human Genetics 18, no. 12 (2010): 1271–1273; Howard, H. C. Knoppers, B. M., and Borry, P., “Blurring Lines: The Research Activities of Direct-to-Consumer Genetic Testing Companies Raise Questions about Consumers as Research Subjects”, EMBO Reports 11, no. 8 (2010): 579582.CrossRefGoogle ScholarPubMed
Borry, P. Stultiens, L., and Nys, H. et al., “Presymptomatic and Predictive Genetic Testing in Minors: A Systematic Review of Guidelines and Position Papers”, Clinical Genetics 70, no. 5 (2006): 374381.CrossRefGoogle ScholarPubMed
German Society of Human Genetics, Statement on Genetic Diagnosis in Children and Adolescents, 1995, available at <http://www.gfhev.de/en/gfh/> (last visited January 20, 2014).+(last+visited+January+20,+2014).>Google Scholar
Danish Council of Ethics, Genetic Investigation of Healthy Subjects – Report on Presymptomatic Gene Diagnosis, 2001, available at <http://www.etiskraad.dk/sw293.asp> (last visited January 20, 2014).+(last+visited+January+20,+2014).>Google Scholar
Borry, P. Evers-Kiebooms, G., and Cornel, M. C. et al., “Genetic Testing in Asymptomatic Minors: Recommendations of the European Society of Human Genetics Recommendations of the European Society of Human Genetics”, European Journal of Human Genetics 17, no. 6 (2009a): 720721.Google Scholar
Unesco, Universal Declaration on the Human Genome and Human Rights, 1997, Paris.Google Scholar
Andorno, R., “The Right Not to Know: An Autonomy Based Approach”, Journal of Medical Ethics 30, no. 5 (2004): 435439.CrossRefGoogle ScholarPubMed
Feinberg, J., “The Child's Right to an Open Future”, Aiken, W. LaFolette, H., eds., In Whose Child? Children's Rights, Parental Authority, and State Power (Totowa: Adams & Co, 1980): at 124153.Google Scholar
Davis, D. D., “Genetic Dilemmas and the Child's Right to an Open Future”, Hastings Center Report 27, no. 2 (1997): 715.CrossRefGoogle ScholarPubMed
British Society for Human Genetics, “Genetic Testing of Children: Report of a Working Party of the British Society for Human Genetics”, 2010, available at <http://www.publichealth.ox.ac.uk/ethox/ethox-photo-archive/GTOC_2010_BSHG.pdf> (last visisted January 28, 2014). Laurie, G. T., “In Defence of Ignorance: Genetic Information and the Right Not to Know”, European Journal of Health Law 6, no. 2 (1999): 119132.CrossRefGoogle ScholarPubMed
Buchanan, A. E. Brock, D. W., eds., Deciding for Others (Cambridge: University Press, 1989).Google Scholar
Dawson, A., “The Determination of the Best Interests in Relation to Childhood Immunisation”, Bioethics 19, no. 1 (2005): 7289 Downie, R. S. Randall, F., “Parenting and the Best Interests of Minors”, Journal of Medicine & Philosopy 22, no. 3 (1997): 219–231 Ross, L. F., “Genetic testing of Adolescents: Is It in Their Best Interest?” Archives of Pediatrics and Adolescent Medicine 154, no. 8 (2000): 850–852 Spence, K., “The Best Interest Principle as a Standard for Decision Making in the Care of Neonates”, Journal of Advanced Nursing 31, no. 6 (2000): 1286–1292; Trau, J. M. McCartney, J. J., “In the Best Interest of the Patient: Applying This Standard to Healthcare Decision Making Must Be Done in a Community Context”, Health Progress 74, no. 3 (1993): 50–56.CrossRefGoogle ScholarPubMed
European Parliament, Charter of Fundamental Rights of the European Union, 2000, available at <http://www.europarl.europa.eu/charter/pdf/text_en.pdf> (last visited January 21, 2014).+(last+visited+January+21,+2014).>Google Scholar
See Unesco, supra note 13.Google Scholar
United Nations, Convention on the Rights of the Child, 1989, available at <http://www.unhchr.ch/html/menu3/b/k2crc.htm>..>Google Scholar
Borry, P. Goffin, T. Nys, H., and Dierickx, K., “Predictive Genetic Testing in Minors for Adult-Onset Genetic Diseases”, Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 75, no. 3 (2008): 287296.CrossRefGoogle ScholarPubMed
Borry, P. Howard, H. C. Séenéecal, K., and Avard, D., “Direct-to-Consumer Genome Scanning Services: Also for Children?”, Nature Reviews Genetics 10, no. 1 (2009c): 8.CrossRefGoogle Scholar
Borry, P. Howard, H. C. Séenéecal, K. and Avard, D., “Health-Related Direct-to-Consumer Genetic Testing: A Review of Companies’ Policies with Regard to Genetic Testing in Minors”, Famillial Cancer 9, no. 1 (2010): 5159.CrossRefGoogle ScholarPubMed
Howard, H. C. Avard, D., and Borry, P., “Are the Kids Really All Right? Direct-to-Consumer Genetic Testing in Children: Are Company Policies Clashing with Professional Norms?”, European Journal of Human Genetics 19, no. 11 (2011): 11221126.CrossRefGoogle ScholarPubMed
See Howard, et al., supra note 29.Google Scholar
See Borry, et al., supra note 28.Google Scholar
Tabor, H. K. Stock, J., and Brazg, T. et al., “Informed Consent for Whole Genome Sequencing: A Qualitative Analysis of Participant Expectations and Perceptions of Risks, Benefits, and Harms”, American Journal of Medical Genetics 158A, no. 6 (2012): 13101319.CrossRefGoogle ScholarPubMed
Biesecker, B. B., “Future Directions in Genetic Counseling: Practical and Ethical Considerations”, Kennedy Insitute of Ethics Journal 8, no. 2 (1998): 145160 Mahowald, M. B. Verp, M. S., and Anderson, R. R., “Genetic Counseling: Clinical and Ethical Challenges”, Annual Review of Genetics 32 (1998): 547–559.CrossRefGoogle ScholarPubMed
Allan, D., “Ethical Boundaries in Genetic Testing”, Canadian Medical Association Journal 154, no. 2 (1996): 241244.Google ScholarPubMed
Tarini, B. A. Tercyak, K. P., and Wilfond, B. S., “Commentary: Children and Predictive Genomic Testing: Disease Prevention, Research Protection, and Our Future”, Journal of Pediatric Psychology 36, no. 10 (2011): 11131121.CrossRefGoogle ScholarPubMed
Van, C. G. El and Cornel, M. C., “Genetic Testing and Common Disorders in a Public Health Framework”, European Journal of Human Genetics 19, no. 4 (2011): 377381.CrossRefGoogle Scholar
Janssens, A. C. van Duijn, C. M., “Genome-Based Prediction of Common Diseases: Advances and Prospects”, Human Molecular Genetics 17, no. R2 (2008): R166R173.CrossRefGoogle ScholarPubMed
Janssens, A. C. van Duijn, C. M., “An Epidemiological Perspective on the Future of Direct-to-Consumer Personal Genome Testing”, Investigative Genetics 1, no. 1 (2010): 15.CrossRefGoogle ScholarPubMed
See Tarini, et al., supra note 36.Google Scholar
Mihaescu, R. Meigs, J. Sijbrands, E., and Janssens, A. C., “Genetic Risk Profiling for Prediction of Type 2 Diabetes”, PLoS Currents 3 (2011): RRN1208; Mihaescu, R. Van Zitteren, M., and van Hoek, M. et al., “Improvement of Risk Prediction by Genomic Profiling: Reclassification Measures Versus the Area under the Receiver Operating Characteristic Curve”, American Journal of Epidemiology 172, no. 3 (2010): 353–361.CrossRefGoogle ScholarPubMed
Paulweber, B. Valensi, P., and Lindströom, J. et al., “A European Evidence-Based Guideline for the Prevention of Type 2 Diabetes”, Hormone and Metabolic Research 42, no. SO1 (2010): S3S36.CrossRefGoogle ScholarPubMed
McBride, C. M. Koehly, L. M. Sanderson, S. C., and Kaphingst, K. A., “The Behavioral Response to Personalized Genetic Information: Will Genetic Risk Profiles Motivate Individuals and Families to Choose More Healthful Behaviors?”, Annual Review of Public Health 31 (2010): 89103.CrossRefGoogle ScholarPubMed
Clarke, A., “The Genetic Testing of Children: Working Party of the Clinical Genetics Society (UK)”, Journal of Medical Genetics 31, no. 10 (1994): 785797.CrossRefGoogle Scholar
Dunca, R. E. Delatycki, M. B., “Predictive Genetic Testing in Young people for Adult-Onset Conditions: Where Is the Empirical Evidence?”, Clinical Genetics 69, no. 1 (2006): 816.CrossRefGoogle Scholar
James, K. M. Cowl, C. T., and Tilburt, J. C. et al., “Impact of Direct-to-Consumer Predictive Genomic Testing on Risk Perception and Worry among Patients Receiving Routine Care in a Preventive Health Clinic”, Mayo Clinic Proceedings 86, no. 10 (2011): 933940.CrossRefGoogle Scholar
Nordgren, A., “Neither as Harmful as Feared by Critics Nor as Empowering as Promised by Providers: Risk Information Offered Direct to Consumer by Personal Genomics Companies”, Journal of Community Genetics 5, no. 1 (2012): 5968.CrossRefGoogle ScholarPubMed
Wade, C. H. Wilfond, B. S., and McBride, C. M., “Effects of Genetic Risk Information on Children's Psychosocial Wellbeing: A Systematic Review of the Literature”, Genetics in Medicine 12, no. 6 (2010): 317326.CrossRefGoogle ScholarPubMed
Patenaude, A. F., “Commentary: Save the Children: Direct-to-Consumer Testing of Children Is Premature, Even for Research”, Journal of Pediatric Psychology 36, no. 10 (2010): 11221127.CrossRefGoogle Scholar
European Academies Science Advisory Council, Direct-to-Consumer Genetic Testing for Health-Related Purposes in the European Union, 2012, available at <http://www.easac.eu/fileadmin/Reports/EASAC_Genetic_Testing_Web_complete.pdf> (last visited January 21, 2014); see European Society of Human Genetics, supra note 8.+(last+visited+January+21,+2014);+see+European+Society+of+Human+Genetics,+supra+note+8.>Google Scholar
Su, Y. Howard, H. C., and Borry, P., ““Users’ Motivations to Purchase Direct-to-Consumer Genome-Wide Testing: An Exploratory Study of Personal Stories”, Journal of Community Genetics 2, no. 3 (2011): 135146.CrossRefGoogle Scholar
See Borry, et al., supra note 27.Google Scholar
Tercyak, K. P. Alford, Hensley S., and Emmons, K. M. et al., “Parents Attitudes toward Pediatric Genetic Testing for Common Disease Risk”, Pediatrics 127, no. 5 (2011): e12881295 see Hu, et al., supra note 53.CrossRefGoogle ScholarPubMed
23andMe website, available at <https://www.23andme.com> (last visited January 21, 2014).+(last+visited+January+21,+2014).>Google Scholar
See Solomon, et al., supra note 3.Google Scholar
Green, R. C. Berg, J. S., and Grody, W. W. et al., “ACMG Recommendations for Reporting of Incidental Findings in Clinical Exome and Genome Sequencing”, Genetics in Medicine 15, no. 7 (2013): 565574.CrossRefGoogle ScholarPubMed