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.     

Ethical Issues in Gerocounseling

Recently, there has been a tremendous increase in the attention paid to counseling older adults and the importance of maintaining sound ethical practices in professional counseling. Unfortunately, to date there has been little movement to combine the two areas and examine the unique ethical issues faced in gerocounseling practice. To address this void, the authors enumerate some ethical dilemmas they have encountered in gerocounseling, examine the American Association for Counseling and Development (formerly American Personnel and Guidance Association) Ethical Standards (1981) that are pertinent, and suggest options for handling the conflicts raised.     

Genetic Counseling and the Ethical Issues Around Direct to Consumer Genetic Testing

Over the last several years, direct to consumer(DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism,particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely,promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethic allens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately,when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions,but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic based healthcare system.     

Ethical Issues Raised by Epigenetic Testing for Alcohol,Tobacco, and Cannabis

Epigenetic testing is one of the most significant new technologies to provide insight into the behavioral and environmental factors that influence the development and reconfiguration of the human genetic code. This technology allows us to identify structural changes in the genome that occur due to exposure to a wide variety of substances including alcohol, tobacco, and cannabis. The information gained can be used to promote health but it also raises a variety of ethical, legal, and social issues. As society progresses in understanding the epigenetic mechanisms of substance use and addiction, there is an opportunity to use these use this knowledge to enable medical, behavioral, and environmental interventions to alleviate the burden of addiction. This article describes the ethical issues associated with use of epigenetic testing for alcohol, tobacco, and cannabis and the implications of this technology. A further review of the scientific basis for the relevance of epigenetics is found in the accompanying article by Philibert and Erwin in this issue. Copyright © 2015 John Wiley & Sons, Ltd.     

Ethical Issues in Private Practice

Abstract

A psychoanalytic experience with Herb Strean is described as facilitating the author's personal evolution of competencies required for a successful marriage. Rather than focusing on the familiar difficulties that often beset marriage, eight core competencies (capacity for commitment, emotional maturity, tolerance for imperfections, unconscious wisdom, mature dependence, capacity for oedipal success, capacity to face existential realities, and capacity for humor and playfulness) are delineated. Many people develop these competencies from fortunate internalizations of effectively loving parental couples. Others are able to do this via supplemental mentoring experiences. The author's mentoring was received during the course of two psychoanalyses with Herb Strean.     

高新生命技术的伦理问题

高技术的推广应用引起人们对人体客体化的忧虑,以及对维护人的价值和尊严的关注。高新生命技术的伦理问题的特点是它对社会或人类的影响深远,以及在利用高新技术干预人体过程中涉及未知的、不确定的因素太多。因此必须开发新的战略调控这些高新技术的发展和应用。本文集中讨论异种移植和基因治疗中的伦理问题,认为对这些高新生命技术应该采取“有罪推定”的政策,在提供证据证明它不会给人类带来严重危害前,应该暂停在人体上试验     

Ethical Issues in Gestational Surrogacy

The introduction of contraceptive technologies hasresulted in the separation of sex and procreation. Theintroduction of new reproductive technologies (mainlyIVF and embryo transfer) has led not only to theseparation of procreation and sex, but also to there-definition of the terms mother and family.For the purpose of this essay, I will distinguishbetween:1. the genetic mother – the donor of the egg;2. the gestational mother – she who bears and gives birth to the baby;3. the social mother – the woman who raises the child.This essay will deal only with the form of gestationalsurrogacy in which the genetic parents intend to bethe social parents, and the surrogate mother has nogenetic relationship to the child she bears anddelivers. I will raise questions regarding medicalethical aspects of surrogacy and the obligation(s) ofthe physician(s) to the parties involved. I will arguethat the gestational surrogate is “a womb to rent,”that there is great similarity between gestationalcommercial surrogacy and organ transplant marketing.Furthermore, despite claims to freedom of choice andfree marketing, I will claim that gestationalsurrogacy is a form of prostitution and slavery,exploitation of the poor and needy by those who arebetter off. The right to be a parent, although notconstitutional, is intuitive and deeply rooted.However, the issue remains whether this rightoverrules all other rights, and at what price to theparties involved. I will finally raise the followingprovocative question to society: In the interim periodbetween today's limited technology and tomorrow'sextra-corporeal gestation technology (ectogenesis),should utilizing females in PVS (persistent vehetativestate) for gestational surrogacy be sociallyacceptable/permissible – provided they have leftpermission in writing?     

Ethical Issues in Intergenerational Equity

ABSTRACT

Family systems theory illumines the way in which family interactions influence the spirituality of each member of an aging family. Five spiritual tasks of the aging family are: facing mortality, defining the shape and limits of love and fidelity, struggling with the meaning of evil and suffering, seeking forgiveness and reconciliation, and giving and receiving a spiritual legacy. Professionals who work with families are encouraged to help families explore their spiritual concerns, work toward small and immediate changes with families as they address spiritual issues, listen for and affirm the family's spiritual resources, and support the enactment of family rituals and ceremonies.     

Ethical Issues in Counselling in Education

It is suggested that there are two quite distinct Systems of ethics and practice in use by counsellors in education: the integrated model, which emphasises viewing the counsellor-institution relationship as theprimary ethical perspective; and the differentiated model, which emphasises the counsellor-client relationship as the starting point for an ethical understanding of the counsellor's role. The implications of these two perspectives for ethical issues relating to sources of referrai, issues of confidentiality, accountability for resources, the implications of role diffusion, and the outcomes of counselling, are examined. The ethical consequences of viewing the two Systems as reconcilable or incompatible are explored.     

Ethical Issues in Observational Family Research

Ethical issues raised by the increasing reliance on observational technology in family research are discussed. The tensions between scientific advancement and participant welfare are highlighted by delineating the process of observational research and the nature of the relationship between family scientists and the families they study. Guidelines are proposed for ethical decision making regarding potential child abuse, suicidality, informed consent, confidentiality, and debriefing.     

β受体阻滞剂治疗慢性心力衰竭作用机制规律的探讨

β受体阻滞剂作为一种负性肌力药物,其在慢性心力衰竭治疗中的地位于近几十年中发生了戏剧性的改变,由禁忌药转变为指南推荐的重要药.β受体阻滞剂引发了人们对慢性心力衰竭发病机制的重新思考,使人们对疾病及其治疗有了更新更全面的认识,这其中体现了哲学与自然科学间的紧密联系,提示我们运用哲学原理可以指导自然科学的发展.     

医学科学数据共享的伦理问题研究

医学科学数据既是医学科学研究的成果,又是一种重要研究资源.针对医学科学数据共享所面临的伦理学问题,如医学科学数据的所有权、医学科学数据共享与知识产权保护等,提出相应的举措,对促进和规范医学科学数据的共享、最大化科学数据的价值具有现实和长远的意义.     

Ethical Issues in Family-Centered Primary Care

In 1969 a new primary care medical specialty, family practice, was formally created. One element in the development of this specialty from the roots of general practice was an understanding of the importance of family process in health and health care. Family physicians are now trained to work with families in the provision of primary medical care, and many provide some formal family counseling and therapy. The family physician who works with families faces many of the same ethical conflicts with which family therapists are confronted. The primary relationship of the family physician to his or her patients, however, as the provider of continuing health care, modifies these conflicts and creates new and vexing problems.     

Ethical Issues in Research on Psychotherapy

A number of ethical issues that researchers in the area of psychotherapy have to consider are reviewed and some possible solutions considered.