ß 2008 Wiley-Liss, Inc. American Journal of Medical Genetics Part A 146A:2447–2448 (2008) Correspondence Reply to Richards: ‘‘Predictive Genetic Testing of Adolescents for Huntington Disease: A Question of Autonomy and Harm’’ Rony E. Duncan, 1,3,5 * Lynn Gillam, 1,2,6 Julian Savulescu, 7 Robert Williamson, 1,3 John G. Rogers, 8 and Martin B. Delatycki 1,3,4,8 1 Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia 2 The Centre for Health and Society, School of Population Health, University of Melbourne, Melbourne, Victoria, Australia 3 Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia 4 Bruce Lefroy Centre for Genetic Health Research, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia 5 Centre for Adolescent Health, Royal Children’s Hospital, Parkville, Victoria, Australia 6 Children’s Bioethics Centre, Royal Children’s Hospital, Parkville, Victoria, Australia 7 Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom 8 Genetic Health Services Victoria, Royal Children’s Hospital, Parkville, Victoria, Australia Received 25 June 2008; Accepted 27 June 2008 How to cite this article: Duncan RE, Gillam L, Savulescu J, Williamson R, Rogers JG, Delatycki MB. 2008. Reply to Richards: ‘‘Predictive Genetic Testing of Adolescents for Huntington Disease: A Question of Autonomy and Harm’’. Am J Med Genet Part A 146A:2447 – 2448. To the Editor: We thank Ms. Richards for commenting again on our research concerning predictive genetic testing in young people. This topic is one that has always raised strong and divergent opinions and we welcome further debate about the theoretical, practical, and empirical issues. The majority of Richards’ concerns are discussed within our manuscript, including those regarding our choice of participants and the response rate we received. We have also addressed several of her comments in previous correspondence, including the value of non-clinical expertise in debates about predictive testing and the justification for conducting empirical research in this field [Duncan, 2005]. Therefore, we respond here only to the arguments that have not previously been discussed in depth. Firstly, Richards believes we are in favor of contravening the international guidelines regarding predictive genetic testing in young people. She states we are ‘‘using the findings of this study to advocate lowering the age for testing in order to identify whether there are negative outcomes that have particular relevance to child and adolescent develop- ment.’’ This is not what we are advocating. The vast majority of guidelines recognize that in some cases, testing young people under the age of 18 years may be appropriate [Borry et al., 2006]. The guidelines published by the International Huntington Asso- ciation and the World Federation of Neurologists in 1994 are in fact an exception in recommending predictive testing should only ever be conducted after the age of majority. The Human Genetics Society of Australasia recently revised their guide- lines concerning predictive testing in children and young people. These guidelines now include an appendix titled ‘‘Criteria for assessing maturity, competence and capacity of young people to consent to predictive testing for adult onset con- ditions where there is no medical benefit.’’ This appendix provides detailed guidance for the assess- ment of young people under the age of 18 years [HGSA, 2008]. Similarly, guidelines published by the American Society of Human Genetics state that ‘‘substantial psychosocial benefits to the competent adolescent also may be a justification for genetic testing’’ [ASHG, 1995]. We know already that pre- dictive genetic tests are being provided to young people under the age of 18 years for adult onset, untreatable conditions in several countries [Duncan et al., 2005]. We therefore advocate for empirical *Correspondence to: Dr. Rony E. Duncan, Centre for Adolescent Health, 2 Gatehouse St, Parkville, Victoria 3052, Australia. E-mail: rony.duncan@mcri.edu.au DOI 10.1002/ajmg.a.32480