From ABC versus St George's NHS Trust

Should doctors have a legal duty to warn relatives of their genetic risks?

This commentary piece for The Lancet was published online the last day witness testimony was heard at the ABC v St George's NHS trial at the Royal Courts of Justice, London

Should doctors have a legal duty to warn relatives of their genetic risks?


14th December 2019

Excerpt from article:

On Nov 18–25, 2019, a legal case (QB-2013-009529, ABC vs St George’s Healthcare NHS Trust) was heard in the Royal Courts of Justice in London, UK. The case concerns a man who killed his wife in 2007. He was convicted of manslaughter and while in a forensic psychiatric unit, in 2009, was diagnosed with Huntington’s disease, a progressive neurological condition that confers a 50/50 inherited risk to first- degree relatives.1 His daughter was pregnant at the time and the man told his doctors not to disclose his genetic diagnosis to her as he feared she would terminate her pregnancy. The doctors respected his confidentiality and did not tell the daughter. In 2013, the daughter was diagnosed with Huntington’s disease. The daughter, known as ABC in the legal case, is suing the doctors who cared for her father for neglecting to warn her of her own risks of having Huntington’s disease; she claims that had she been told in time, she would have had an abortion.

The case centres on whether doctors should have a legal duty to warn a patient’s relatives about disease risks from an inherited condition. This case considers the balancing act between a duty to protect patient confidentiality versus a duty to warn, and thus prevent harm, in relatives.2 How much weighting should be given to an individual’s views, when they wish to withhold information that could be important for their relatives? If it is decided that health-care professionals have a legal duty to warn other at-risk relatives, then this case will have wide-ranging implications for how genetic medicine is practised.”

Related Link:


Middleton A, Milne R, Robarts L, Roberts J, Patch C (2019) Should doctors have a legal duty to warn relatives of their genetic risks? The Lancet, vol. 394, issue 10215, pp 2133-2135, December

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