Skip to main content
Log in

Disclosing Huntington’s Genetic Testing Results in the Context of Intellectual Disability and Guardianship: Using the Family Illness Narrative to Guide the Flow of Information

  • Case Study
  • Published:
Journal of Genetic Counseling

Abstract

A diagnosis of Huntington’s disease has broad social, vocational, reproductive and psychological implications. The ability to accurately diagnose the illness via genetic testing is not new. However, given a persistent lack of robustly effective interventions, it remains an area of ethical concern. The difficulty is compounded in cases of intellectual disability. This paper presents a case of genetic testing for Huntington’s disease conducted on a patient with intellectual disability with guardian consent, but without the patient’s direct knowledge and how the family illness narrative and psychiatric care were employed in the eventual disclosure of the patient’s diagnosis and subsequent management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ahmed T, Raza SH, Maryam A, Setzer W, Braidy N, Nabavi SF, et al. (2016, Epub ahead of print). Ginsenoside Rb1 as neuroprotective agent: a review. Brain Research Bulletin.

  • Committee on Bioethics, Committee on Genetics, and, The American College of Medical Genetics and, Genomics Social, Ethical, and Legal Issues Committee (2013). Ethical and Policy Issues in Genetic Testing and Screening of Children. Pediatrics, 131, 620–622.

    Article  Google Scholar 

  • Dobson, L., Träger, U., Farmer, R., Hayardeny, L., Loupe, P., Hayden, M. R., et al. (2016). Laquinimod dampens hyperactive cytokine production in Huntington’s disease patient myeloid cells. Journal of Neurochemistry, 137, 782–794.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jia, H., Wang, Y., Morris, C. D., Jacques, V., Gottesfeld, J. M., Rusche, J. R., et al. (2016). The effects of pharmacological inhibition of histone deacetylase 3 (HDAC3) in Huntington’s disease mice. PloS One, 11, e0152498.

    Article  PubMed  PubMed Central  Google Scholar 

  • Killoran, A., & Biglan, K. M. (2014). Current therapeutic options for Huntington’s disease: good clinical practice versus evidence-based approaches? Movement Disorders, 29, 1404–1413.

    Article  PubMed  Google Scholar 

  • Rhodes, R. (2006). Why test children for adult-onset genetic diseases? Mount Sinai Journal of Medicine, 73, 609–616.

    PubMed  Google Scholar 

  • Ross, L. F., Saal, H. M., David, K. L., & Anderson, R. R. (2013). Technical report: ethical and policy issues in genetic testing and screening of children. Genetics in Medicine, 15, 234–245.

    Article  PubMed  Google Scholar 

  • Ross, C. A., Aylward, E. H., Wild, E. J., Langbehn, D. R., Long, J. D., Warner, J. H., et al. (2014). Huntington disease: natural history, biomarkers and prospects for therapeutics. Nature Reviews Neurology, 10, 204–216.

    Article  CAS  PubMed  Google Scholar 

  • Scully, J. L., Porz, R., & Rehmann-Sutter, C. (2007). You don’t make genetic test decisions from one day to the next’--using time to preserve moral space. Bioethics, 21, 208–217.

    Article  PubMed  Google Scholar 

  • The Huntington’s Disease Collaborative Research Group. (1993). A novel gene containing a trinucleotide repeat that is expanded and unstable on Huntington’s disease chromosomes. Cell, 72, 971–983.

    Article  Google Scholar 

  • Walker, F. O. (2007). Huntington’s disease. Lancet, 369, 218–228.

    Article  CAS  PubMed  Google Scholar 

  • Werner-Lin, A., & Gardner, D. S. (2009). Family illness narratives of inherited cancer risk: continuity and transformation. Families, Systems and Health, 27, 201–212.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark B. Warren.

Ethics declarations

Disclosures

Some details of this case have been changed to protect the patient’s identity.

Conflict of Interest

Mark B. Warren and Kathryn M. Schak declare that they have no conflict of interest.

Ethical Approval

For this type of study formal consent is not required.

Animal Studies

No animal studies were carried out by the authors for this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Warren, M.B., Schak, K.M. Disclosing Huntington’s Genetic Testing Results in the Context of Intellectual Disability and Guardianship: Using the Family Illness Narrative to Guide the Flow of Information. J Genet Counsel 26, 272–275 (2017). https://doi.org/10.1007/s10897-016-0007-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10897-016-0007-1

Keywords

Navigation