The article by Elger and Harding1 was a welcome treat: a discussion of the ethical issues raised by gene testing adolescents for BRCA1. Although they clarify that the gene test is supposed to be done at a research center as part of a study,1(p114) their analysis fails to address the issue of consent in research and whether that differs from consent in routine health care.2 Instead, they assume that because adolescents have been given the right to make decisions and have information held confidentially with respect to sexually transmitted diseases,1(p117) the same arguments apply to gene testing. In fact, the strongest argument to support adolescent autonomy in the area of sexually transmitted diseases is a public health argument. Namely, we want at-risk individuals to seek health care early. The arguments rarely focus on whether the adolescent has the competency to make such decisions.3 In contrast, one would hope that there would be a higher threshold to enroll adolescents in research precisely because it is research and the risks and benefits are unclear, particularly the long-term consequences.
Ross LF. Genetic Testing of Adolescents: Is It in Their Best Interest?. Arch Pediatr Adolesc Med. 2000;154(8):850-851. doi: