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Cancer Genetics Risk Assessment and Counseling (PDQ®)

  • Updated: 08/11/2014

Table 2. State Case Laws That Apply to Duty to Warn

State Case Law Description Summary 
Tarasoff versus Regents of the University of California [9,10]Establishes moral duty to warn family members of risks unknown to themIn 1976, the California court judged that breach of confidentiality would have been justified in order to warn of a foreseeable and serious harm to an identifiable individual.
Distinct from genetic risk since the mutation is already present (or absent) in family members
Pate versus Threlkel [8,11,12]Duty to warn family members of hereditary risk of cancer is satisfied by telling the patient to tell his or her familyIn 1995, the Florida court judged that a physician had a duty to warn the patient that her children were at risk of developing thyroid cancer because the disease could have been detected and cured at an earlier stage.
Safer versus Estate of Pack [8,13]Physician must take reasonable steps to warn family members of hereditary risk diseaseIn 1996, a New Jersey appellate court defined a physician’s duty to warn immediate family members of risk of colon cancer; however, the court ruled in favor of the doctor because the patient had undergone rectal screening as a child, which indicated that she had been warned of the risk.
Molloy versus Meier [8,14]Physician’s duty regarding genetic testing and diagnosis of foreseeable disease risk extends beyond the patient to biological parentsIn 2004, a Minnesota Supreme Court held that the physician failed to breach confidentiality to warn of hereditary disease risk because he did not inform parents of the diagnosis of fragile X syndrome in their first child. The parents state that this information would have influenced their reproductive decisions.

References

  1. Offit K, Groeger E, Turner S, et al.: The "duty to warn" a patient's family members about hereditary disease risks. JAMA 292 (12): 1469-73, 2004.  [PUBMED Abstract]

  2. Tarasoff v. the Regents of the University of California, 551 P 2d 334 (Cal 1976). 1976. Also available online. Last accessed June 18, 2014. 

  3. Harris M, Winship I, Spriggs M: Controversies and ethical issues in cancer-genetics clinics. Lancet Oncol 6 (5): 301-10, 2005.  [PUBMED Abstract]

  4. Pate v. Threlkel, 661 So. 2d 278 (Florida 1995). 1995. Also available online. Last accessed June 18, 2014. 

  5. Sankar P: Genetic privacy. Annu Rev Med 54: 393-407, 2003.  [PUBMED Abstract]

  6. Safer v. Estate of Pack, 677 A2d 1188 (NJ App), appeal denied, 683 A2d 1163 (NJ 1996). 1996. Also available online. Last accessed June 18, 2014. 

  7. Molloy v. Meier, Nos. C9-02-1821, C2-02-1837 (Minn 2004). 2004. Also available online. Last accessed June 18, 2014.