Many thanks for your comments on my paper. I don’t think that we disagree. Think of meeting the threshold of the probability of harm as a necessary rather than a sufficient condition for there to be a duty to breach confidentiality. On this understanding, even if the threshold were met, you are quite right that other factors such as treatability might also need to be present for it to be sufficient to breach confidentiality. My claim is only that it not even clear that the threshold of the probability of harm (a necessary condition) is met in many cases of familial genetic information.

I enjoyed your article as a response to what seems to be the somewhat one-sided ethical view with regard to confidentiality and genetics.

However, I find it hard to accept your equation of duty to probability. It is true that a threshold must have to be passed for confidentiality to be breached, but I do not think that you have made the argument that this threshold should necessarily be based on the likelihood of expression of the disease. I would suggest other factors, such as treatability of the potential disease are more relevant than the likelihood of its expression.

Yours,
D Peat