Table 1

Suggested psychological benefits and dangers from childhood testing (various sources—largely adapted from Michie and Marteau⁷)

Result	Possible danger	Possible benefit
Faulty gene absent	Rejection by family, especially if others affected	Avoid clinical monitoring
	False reassurance about health status	Emotional relief
		Ability to plan life
		Avoids effects of later disclosure
		Avoids “preselection”^1-151
		Relieves anxiety about possible early signs of the disorder

Faulty gene present	Impair child's self esteem	Child has time to adjust—avoids emotional problems of later disclosure
	Impair child's long term adjustment	Enables parents to prepare child psychologically for the future
	Impair relationship with parents (post-test changes in parental attitudes)	Practical preparation for future, e.g. education, career, housing, etc
	Stigmatisation/overprotection	Child can take informed decisions from early age
	Discrimination in education, employment, insurance, mortgage	Allows openness in families
	Impair relationships with future partners	Child doesn't miss opportunity for testing
	Removes autonomy to decline testing	Relieves child's anxiety or uncertainty about the future
	Confirms any “preselection”^1-151	Relieves parents' anxiety or uncertainty
	Could generate anxiety about early symptoms	16 years may not be a good age to be tested
	Parental distress/guilt	?Beneficence^1-150
		?Lessens society^1-150 discrimination

↵1-150 Cohen25 argues that testing respects the principle of beneficence (it is not necessarily unethical for a parent to make choices for a child's welfare) and may lead to possible lessening of discrimination (as society realises that everyone carries “faulty genes”).
↵1-151 Preselection—the concept that in some families persons are singled out for no rational reason as being the ones destined to develop the disorder. This can have adverse effects on the development of the “preselected” child.