Case and Commentary
Jan 2005
A. Contacting Mandy's parents to inform them of her intention to get tested for Huntington's should be avoided; it likely violates the Code in Opinion 5.055, "Confidential Care for Minors": "Where the law does not require otherwise, physicians should permit a competent minor to consent to medical care and should not notify parents without the patient's consent...For minors who are mature enough to be unaccompanied by their parents for their examination, confidentiality of information disclosed...should be maintained."
B. Beginning the process of testing Mandy for Huntington's disease is premature and should be avoided; it is not supported by the Code and may violate Opinion 2.12, "Genetic Counseling": "Counseling should include reasons for and against testing as well as discussion of inappropriate uses of genetic testing." Simply beginning the process of Mandy's genetic testing, without any counseling on the implications and significance of a test, does not provide Mandy with the necessary basis for informed decision making about the implications for her or her pregnancy.
C. Referring Mandy to a genetic counselor and/or adolescent psychologist is preferable and supported by the Code. Opinion 5.055, "Confidential Care for Minors" states: "Physicians should permit a competent minor to consent to medical care and should not notify parents without the patient's consent. Depending on the seriousness of the decision, competence may be evaluated by physicians for most minors. When necessary, experts in adolescent medicine or child psychological development should be consulted."
