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Predictive testing – HD in child – not recommended — RACP Paediatrics MCQ

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HardGeneticsPredictive testing – HD in child – not recommendedRACP Paediatrics

An asymptomatic 8-year-old has a parent with molecularly confirmed Huntington disease. The parent requests predictive testing now “so the child can get used to the result”. No childhood intervention would change according to carrier status. What is the best approach?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Defer predictive testing and preserve the child’s future autonomous decision-making

Explanation lettering: B = shown as A · C = shown as B · A = shown as C · E = shown as D · D = shown as E

A is correct because predictive testing for an adult-onset disorder with no childhood intervention is generally deferred, preserving the child’s future autonomous choice while supporting the family through genetics services. B overstates parental authority and neglects the child’s future interests. C breaches consent and confidentiality. D cannot predict Huntington status or remove the ethical issue. E delegates a clinical and family decision to an inappropriate third party. The conclusion would differ if a result changed childhood surveillance or treatment, which is why paediatric cancer-predisposition testing can be appropriate.

Reference: NSW Centre for Genetics Education, ethical issues in human genetics and genomics: https://www.genetics.edu.au/SitePages/Ethical-issues-in-human-genetics-and-genomics.aspx