DTC基因检测的伦理思考

直接面向消费者提供基因检测服务称为Direct-to-Consumer (DTC)基因检测.随着人类基因组计划测序工作的完成,DTC基因检测服务行业逐渐发展起来,它的出现与人们日益提高的健康需要相适应.但与此同时,一些社会伦理和法律问题也随之产生.对DTC基因检测的现状以及各国对其认可度进行阐述,剖析DTC基因检测存在的伦理问题,如隐私问题,有限的预测价值,检测信息的准确性,检测结果对受试者造成的负面心理影响,以及由此产生的基因歧视和卫生保健资源的浪费等.     

DTC基因检测的伦理思考

直接面向消费者提供基因检测服务称为Direct-to-Consumer(DTC)基因检测。随着人类基因组计划测序工作的完成,DTC基因检测服务行业逐渐发展起来,它的出现与人们日益提高的健康需要相适应。但与此同时,一些社会伦理和法律问题也随之产生。对DTC基因检测的现状以及各国对其认可度进行阐述,剖析DTC基因检测存在的伦理问题,如隐私问题,有限的预测价值,检测信息的准确性,检测结果对受试者造成的负面心理影响,以及由此产生的基因歧视和卫生保健资源的浪费等。     

关于麻醉后监测治疗室的伦理思考

麻醉后监测治疗室(post-anesthesia care unit,PACU)中医学高新技术设备对确保手术后患者的安全发挥极其重大的作用,然而PACU中也产生许多危机与伦理冲突。为了PACU的良性发展,我们认为如下伦理准则必须遵循:科学认定准则、最佳选择准则、精益求精准则、无伤准则、患者自主准则。     

关于麻醉后监测治疗室的伦理思考

麻醉后监测治疗室(post-anesthesia care unit,PACU)中医学高新技术设备对确保手术后患者的安全发挥极其重大的作用,然而PACU中也产生许多危机与伦理冲突.为了PACU的良性发展,我们认为如下伦理准则必须遵循:科学认定准则、最佳选择准则、精益求精准则、无伤准则、患者自主准则.     

关于实验动物运动模型建立的伦理思考

基于目前广泛应用的动物实验伦理3R和5F原则,通过深入分析已有运动干预文献中的动物运动模型构建方法,分别就运动模型建立前实验动物的选取,运动模式、运动剂量的确定,模型建立过程中不同阶段不同运动形式所涉及的伦理问题,以及实验动物安乐死等各个方面进行伦理分析,探讨伦理关怀在动物运动模型建立中的必要性和重要性。运动模型的构建作为研究运动干预的关键环节是极其重要的,此建立过程中涉及到诸多动物实验伦理问题。

     

人类克隆的伦理思考

1997年2月23日,整个世界都知道这个令人惊奇的消息:苏格兰罗斯林研究所的科学家成功地从一只6岁母羊的乳腺细胞中克隆出一只绵羊“多莉”。这个首例成体哺乳动物的克隆目前也被夏威夷大学的研究者所超越:他们用成体克隆的方法从小鼠卵丘细胞中克隆出三代50多只克隆雌性小鼠。迄今,只有从静止休眠期细胞中取出的细胞核才能成功产生克隆动物。但是,如果我们能够克隆哺乳动物,我们能不能克隆人呢?更重要的是,我们会这样做吗?人类克隆可能是在两个极其重要的不同过程中产生变异:在胚胎分裂的过程中,模拟基因相同的双胞胎自然起源的过程,实验性地…     

经济全球化的若干伦理思考

经济全球化已经成为当代社会的客观事实和发展趋势。经济全球化的实质是人类利益实现形式的转换与更新。经济全球化中,不同利益主体需要遵循一定的道德要求,即全球伦理,以实现稳定的经济秩序和自身的利益。但全球伦理的实现是一个漫长而艰苦的过程,需要克服一系列价值观和价值取向的障碍,乃至冲破政治上霸权主义的干扰。     

医疗技术评估的伦理思考

医疗技术的快速发展引发了诸多的社会问题.医疗技术的伦理评估有利于保持技术与社会的和谐.对技术进行伦理评估应是技术评估的重要内容.医疗技术评估中道德因素的强化有利于医疗技术评估机制的健全,确定技术的发展方向和使用范围;对主体与客体的评估有利于充实医疗技术伦理评估的内容;为医疗技术评估进行伦理建制,既要强调制度的道德根基,也要提高制度的执行力;成立医学伦理委员会,对医疗技术进行伦理审查.     

基因专利保护的伦理审视

基因专利与普通专利不同,需要兼顾资源提供者的利益。当前,基因专利保护中出现的诸多问题背离了尊重、公正、有利的普遍伦理原则。基因专利需要接受伦理的考量,道德规范是消解基因专利冲突的理性选择。     

关于非医学目的基因增强技术的伦理思考

非医学目的基因增强技术有违以下伦理原则:首先是不伤害原则,有可能伤害当事人或其后代的健康,改变基因的某一性状可能对另一性状造成不利影响,减少基因的多样性会削弱人类抵御环境危机的能力;其次有违公共卫生资源分配和享用以及体育竞技的公平性原则;再次生殖细胞基因增强技术先天剥夺了后代的自主权.     

基因检测与治疗中若干问题的伦理学思考

随着基因组学的发展,临床医学中出现了基因检测与基因治疗的新方法,伴随着基因技术的临床应用出现了一些伦理、法律和社会新问题,迫使人们从理论和观念层次加以考察并探讨解决问题的可能性途径,对基因检测和基因治疗中出现或可能出现的伦理学问题进行了初步探讨,结合国际人类基因组计划的有关规范,探索了解决问题的可能性途径。     

Genetic Testing Considerations in Breast Cancer Patients

Genetic testing is now feasible for a growing number of cancers. Although the implications for unaffected relatives have been widely described, the impact of the tests on affected individuals are often not recognized. We present and discuss four cases that highlight some of the issues—for example, feelings of guilt and anxiety, intrafamilial conflict, and support needs—that may arise in testing affected individuals. We offer some suggestions to aid in the approach to such testing.     

A Patient's Perspective on Genetic Counseling and Predictive Testing for Alzheimer's Disease

The availability of genetic testing for Alzheimer's disease is anticipated to be widespread in the future. As an individual at risk with a family history of Alzheimer's disease, I discuss why I sought predictive tests and how I would use the information from such tests. I relay what I learned in my genetic counseling session, my response to the counseling process, and steps I have since taken. I discuss life planning, psychological and fear of discrimination issues from a patient's perspective.     

A Systemic Approach to Fetal Loss Following Genetic Testing

Advances in genetic technology challenge couples to make complex life and death decisions about their fetus that have far-reaching practical and emotional consequences. When genetic defects lead to fetal loss, whether by miscarriage, elective interruption, or still birth, it can be a devastating experience with ripple effects on couple and family development. This paper presents a systemic approach to coping and adaptation to fetal loss in the wake of genetic testing. Clinical vignettes illustrate common experiences and present interventions designed to help the individual grieving partners as well as the marriage. thereby strengthening the family fabric at a vulnerable transitional stage.     

Antenatal Genetic Testing and the Right to Remain in Ignorance

As knowledge increases about the human genome,prenatal genetic testing will become cheaper,safer and more comprehensive. It is likelythat there will be a great deal of support formaking prenatal testing for a wide range ofgenetic disorders a routine part of antenatalcare. Such routine testing is necessarilycoercive in nature and does not involve thesame standard of consent as is required inother health care settings. This paper askswhether this level of coercion is ethicallyjustifiable in this case, or whether pregnantwomen have a right to remain in ignorance ofthe genetic make-up of the fetus they arecarrying. While information gained by genetictesting may be useful for pregnant women whenmaking decisions about their pregnancy, it doesnot prevent harm to future children. It isargued that as this kind of testing providesinformation in the interests of the pregnantwomen and not in the interests of any futurechild, the same standards of consent that arenormally required for genetic testing should berequired in this instance.     

The Psychological Dimension of Informed Consent: Dissonance Processes in Genetic Testing

This paper discusses the issue of the psychological dimension of informed consent. In this paper, the author proposes that informed consent is a continuous variable rather than a dichotomous one. When clients better understand their motives and actual, rather than just perceived degree of choice in pursuing a particular option in a medical setting, their level of informed consent is greater. Findings from existing literature in the field of genetic testing are examined in terms of dissonance theory. These findings suggest that testing candidates sometimes overestimate their coping skills and minimize the threat to psychological integrity that a particular genetic result may pose. Counseling directed towards realistic appraisal of degree of choice in pursuing testing is examined as an aspect of supporting informed consent and possibly reducing the potential for adverse psychological outcome in the longer term.     

抗体工程研究中几点思维启示和策略

本文以近几年非常活跃的抗体基因工程研究的几个方面为素材,回顾性地阐述了人们在对深邃的自然界认识过程中认识的逐步深化以及科学的创造性思维对研究工作的设计和结局的重大影响,并地未来抗体工程研究方面几个战略性问题提出了商榷性看法和建议。     

The Complexity and Challenges of Genetic Counseling and Testing for Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term referring to two chronic idiopathic intestinal diseases: ulcerative colitis (UC) and Crohn’s disease (CD). Both UC and CD are characterized by immune activation that leads to symptoms, but the location, severity and behavior of the inflammation varies among individuals and in characteristic ways between UC and CD. A majority of patients with IBD are diagnosed in young adulthood, but the response to therapy is variable and difficult to predict, with some patients demonstrating a prompt and effective remission while others have continuous symptoms that do not respond to existing medical options. Surgery remains a frequent and necessary occurrence among patients with IBD, but in UC it is considered curative, while in CD only temporizing. Clinical observations, epidemiological studies, and molecular genetics have provided strong evidence that both genetic and environmental factors are important determinants for disease susceptibility. In recent years, a number of genes have been identified that associate with CD and UC, although the clinical utility of these discoveries in patients or in susceptible family members has not been determined. Nonetheless, it is hoped that these fundamental advances in our understanding of IBD will lead to better therapies for patients and prevention strategies for those who are susceptible. Effective incorporation of clinical genetic testing for IBD into practice will require appropriate education and counseling.