植入前组织配型孕育"救星同胞"的伦理思考

应用植入前遗传学诊断技术在胚胎植入母体子宫前,对人类白细胞组织相容性抗原配型检测,选择与现存患儿相同HLA配型的胚胎进行受孕,孕育一个组织配型相同的脐带血干细胞供者.在某种意义上说,该项技术的应用是创造人来获得移植组织,由此引发系列伦理争议.讨论孕育"救星同胞"这一医学实践内在需要的伦理规范.     

植入前遗传学诊断中性别选择的伦理辩护

植入前遗传学诊断（PGD）是在胚胎植入子宫前进行遗传学检查的新技术。它可对植入胚胎进行性别选择,从而引发了会增加我国出生人口性别比的担忧。通过对PGD性别选择伦理风险的分析,指出其用于医学需要时不会对性别比造成危害。但在实施过程中需要医生、患者及社会全体人员共同参与,避免该技术用于非医学目的的需要。     

胚胎植入前遗传学诊断（PGD）的伦理思考

针对现在研究者往往关注胚胎的生理质量而忽视伦理选择的现象,用伦理的视角审视实施胚胎植入前遗传学诊断（PGD）的行为,赋予生命科学行为必要的伦理思想。综合各种理论流派的观点,结合临床工作,得出人们在伦理道德上比较容易接受PGD中进行胚胎的优选的结论,用以指导PGD的发展。     

胚胎植入前遗传学诊断(PGD)的伦理思考

针对现在研究者往往关注胚胎的生理质量而忽视伦理选择的现象,用伦理的视角审视实施胚胎植入前遗传学诊断(PGD)的行为,赋予生命科学行为必要的伦理思想.综合各种理论流派的观点,结合临床工作,得出人们在伦理道德上比较容易接受PGD中进行胚胎的优选的结论,用以指导PGD的发展.     

人类胚胎冷冻技术的伦理问题研究及其对策

人类胚胎冷冻技术是保存新鲜胚胎移植周期后剩余优质胚胎的重要手段。从个体伦理、家庭伦理、社会伦理三个层面探讨了人类胚胎冷冻技术引发的伦理问题,认为其具有自身地位的伦理争议、对传统婚姻及亲子关系带来冲击、商业化风险以及剩余冷冻胚胎的应用问题。接着提出了相应的解决对策,认为可以通过强化人类胚胎冷冻技术运用的伦理原则,加强对从业人员和患者的伦理道德教育,加强法律对人类胚胎冷冻技术的伦理监督来有效规约人类胚胎冷冻技术所带来的伦理及其社会问题。     

胚胎干细胞在治疗学研究中的应用

目前有许多研究人员希望能够从事胚胎干细胞的研究。这项研究可能对可移植组织用于对目前认为难以治疗或不能治疗的许多疾病的治疗的发展带来极大的帮助。然而,由于干细胞是源自人体胚胎。这就提出了如下问题：为了治疗学研究,在胚胎植入子宫之前从人类胚胎上获取细胞以从事实验室培养和研究在伦理上能够被接受吗?不同国家的伦理委员会或国家立法机构关于胚胎研究的观点及其采取的解决办法可能存在显著差异。这种差异在多元性世界里是不可避免的。     

人类胚胎干细胞的来源与伦理思考

人类胚胎干细胞研究的伦理问题较多,因此要思考胚胎干细胞的伦理问题。胚胎干细胞来源有四种：选择性流产的人类胚胎组织;治疗不孕症夫妇不需要的由体外受精产生的人类胚胎;由捐献者专门为研究所捐献的配子由体外受精产生的人类胚胎;由体细胞核移植技术将人体细胞核移植入人或动物的卵泡内产生人类胚胎或嵌合体胚胎。用不同胚胎来源研究干细胞产生的伦理问题不同,伦理的思考和结论也不同。     

评《人胚胎干细胞研究伦理指导原则》

据2004年1月14日<健康报>报道,科技部和卫生部联合发布了十二条<人胚胎干细胞研究伦理指导原则>,这是继1998年卫生部颁布<涉及人体的生物医学研究伦理审查办法(试行)>,1999年国家药品监督管理局颁布<药品临床试验管理规范>后,国家有关主管科研部门颁布的一个专项伦理指导原则.该文件首先指出了遵守国际国内的伦理准则与科学研究的顺利发展的一致性,明确禁止人的生殖性克隆,禁止人胚胎的研究超过14天,禁止将研究用胚胎植入人和其他动物生殖系统,禁止人的生殖细胞与其他物种生殖细胞的结合,禁止买卖人类配子、受精卵、胚胎和胎儿组织,强调贯彻知情同意和知情选择原则,保护隐私以及要求成立伦理委员会,这些都是非常重要的,应该加以肯定.     

人类胚胎干细胞研究伦理问题的调查和讨论

此次对各级医生进行关于人类胚胎干细胞研究伦理认知的调查研究,其目的是为制订相关的伦理准则提供认知依据,调查是在我国东西部二个城市的8家三级医院进行,采用随机抽样、自愿无记名填写信息表方法调查.调查结果表明,50%以上医生认为早期胚胎不是道德意义的人,70%以上医生对胚胎干细胞的研究表示支持.海峡两岸的医生由于有相同的文化根源,在对待胚胎干细胞研究的伦理观点及态度上极其接近.     

中国临床遗传学检测的伦理问题

遗传伦理问题是生命科学领域最具争议的问题之一.针对基因诊断的"知情权"、"优劣"胎儿的选择、基于人群的基因筛查、发病前及患病风险的基因检查、全基因组筛查以及植入前遗传诊断中所涉及的伦理前沿问题进行讨论.提出基因检测是否应该重申把伦理考虑放在第一位.     

Five Points and a Lament About Range and Cotton's "Reports of Assent and Permission in Research With Children: Illustrations and Suggestions"

This comment responds to an article by Range and Cotton (1995) on reporting of parental permission and child assent procedures in published articles for 4 psychology journals. Issue is taken with the assumptions, methodology, interpretations, and implications of listing researchers in the Range and Cotton article. There is no evidence researchers failed in their ethical obligations or that children were put at risk. Reporting permission/assent in publications is not an ethical requirement. Listing researchers as "failing" to do something not part of an ethical code is lamentable. Too many unfortunate implications and problems can be derived from Range and Cotton's analysis and conclusions.     

When Expertise and Ethics Diverge: Lay and Professional Evaluation of Psychotherapists in Israel

This study investigated school psychology doctoral students' beliefs concerning their preparation for, and concern about, dealing with 12 ethical issues based on year in graduate school and whether they had taken an ethics course. Two hundred thirty-three doctoral students from 18 of the 44 American Psychological Association accredited programs in school psychology listed in the December 1996 issue of the American Psychologist completed ethical issues surveys. Results showed that students who had taken an ethics course and those with more years of graduate education said they felt more prepared to deal with ethical issues than students who had not taken an ethics course and who had fewer years of graduate education. Participants believed they were least prepared to deal with ethical issues involving child custody cases, possible ethical violations by colleagues, and potentially violent clients. Participants' concern about dealing with ethical issues was negatively related to their number of internship hours.     

“Before You Formed in the Womb I Knew You”: Sex Selection and Spaces of Ambiguity

The spaces provided by biotechnologies of sex selection are rich with epistemological, ontological, and ethical considerations that speak to broadly held social values and epistemic frameworks. In much of the discourse about sex selection that is not medically indicated, the figure of the “naturally” conceived (future) child is treated as a problem for parents who want to select the sex of their child. As unknown, that child is ambiguous in terms of sex—“it” is both and neither, and might be the “wrong” sex. Drawing on Beauvoirean thinking about ambiguity and desire, I cast part of the desire to select the sex of a child as bound to an ethic and epistemology of disambiguation, and urge that the space of being‐unknown is one to which each person is entitled.     

Five points and a lament about Range and Cotton's "Reports of assent and permission in research with children: illustrations and suggestions

This comment responds to an article by Range and Cotton (1995) on reporting of parental permission and child assent procedures in published articles for 4 psychology journals. Issue is taken with the assumptions, methodology, interpretations, and implications of listing researchers in the Range and Cotton article. There is no evidence researchers failed in their ethical obligations or that children were put at risk. Reporting permission/assent in publications is not an ethical requirement. Listing researchers as "failing" to do something not part of an ethical code is lamentable. Too many unfortunate implications and problems can be derived from Range and Cotton's analysis and conclusions.     

The Well- and Unwell-Being of a Child

The concept of the ‘well-being of the child’ (like the ‘child’s welfare’ and ‘best interests of the child’) has remained underdetermined in legal and ethical texts on the needs and rights of children. As a hypothetical construct that draws attention to the child’s long-term welfare, the well-being of the child is a broader concept than autonomy and happiness. This paper clarifies some conceptual issues of the well-being of the child from a philosophical point of view. The main question is how well-being could in practice acquire a concrete meaning and content for a particular issue or situation. A phenomenological-hermeneutic research perspective will be outlined that allows the child’s well-being to be elucidated and specified as an anthropological and ethical idea. It is based on a contextual understanding of generative relationships, a combination of the theory and practice of making sense, here described as ‘generative insight’, which could provide ethical guidance for decision making in families, legal practice, medicine or biomedical research.     

Two arguments against lying

Kant and Sidgwick are at opposite extremes on whether we may tell paternalistic lies. I trace the extremism to their views about ethical concepts. Sidgwick thinks fundamental ethical concepts must be precise. Common Sense morality says we may tell paternalistic lies to children but not to sane adults. Because the distinction between a child and an adult is imprecise, Sidgwick thinks this principle cannot be fundamental, and must be based on the (precise) principle of utility, which often mandates paternalistic lies to adults. Kant thinks that ethical concepts are ideals of reason, which do not fit the world precisely because the world is imperfect. We lie to children and the insane because they are irrational, but no one is perfectly rational. We must treat all persons with the respect due to rational agents, so the pressure of the theory is toward not lying to anyone. Decisions about where to draw the line must be made pragmatically and to some extent arbitrary. But fear of this is not a good reason to abandon ethical ideals for utilitarianism.     

Ethical Issues in Tissue Banking for Research: The Prospects and Pitfalls of Setting International Standards

Bauer, Taub, and Parsi's review of an international sample of standards on informed consent, confidentiality, commercialization, and quality of research in tissue banking reveals that no clear national or international consensus exists for these issues. The authors' response to the lack of uniformity in the meaning, scope, and ethical significance of the policies they examined is to call for the creation of uniform ethical guidelines. This raises questions about whether harmonization should consist of voluntary international standards or international regulations that include an official oversight mechanism and sanctions for noncompliance, and about who should participate in the harmonization process. Moreover, the normative assumptions and political dynamics that shape global policymaking need to be addressed. This commentary explores the policy implications and normative questions raised by the idea of international ethical guidelines for the use of biotechnologies and biotechnological resources such as stored samples of human tissue.     

Perspectives: The Struggle to Maintain Neutrality in the Treatment of a Patient With Pedophilia

This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored.     

The struggle to maintain neutrality in the treatment of patient with pedophilia

This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored.