论家系遗传学研究中的伦理问题

在家系遗传学研究中,尊重个人同意是首要原则,家族同意是个人同意的有益补充.家族成员间的利益冲突导致了基因保密权与知情权的冲突,保护个人基因隐私的同时需兼顾其他成员的利益.利益分配应平等惠及家族所有成员.在当前形势下,立法保护与提高基因技术水平尚需时日,可行方法是建设家系资源库并规范管理.     

Employee Counseling Services: Ethical Dilemmas

Issues surrounding the definition, identification, and handling of emotional problems in the work environment are presented. Strategies for dealing with these dilemmas are provided.     

Commentary: Writing About Clients: Ethical and Professional Issues in Clinical Case Reports

From the standpoint of a former journal editor and long‐time professional, this commentary challenges the direction of the profession as demonstrated in this special section. The ongoing creation of more and more ethical constraints not only harms the profession but also loses sight of fundamental ethical principles.     

The Use of Communication Technology in Private Practice: Ethical Implications and Boundary Dilemmas in Therapy

This study investigates the use of communication technology (CT) by therapists in private practice. CT has exploded in the last decade and therapists have begun to implement this technology in their work. It is important to understand better the types of technology therapists are using and how they decide which devices are most useful for clinical practice. Additionally, the availability of the therapist has long been debated and CT provides media to make therapists readily available. Results show that therapists have boundary concerns and ethical dilemmas regarding CT and often feel unprepared to handle inappropriate out-of-session contacts when they occur.     

Commentary: Critical Reflections on the Ethical and Professional Considerations in Writing About Clients

From the standpoint of a journal editor and researcher, this commentary critically reflects on some of the primary notions addressed in the 4 featured articles of the special section, discussing areas of agreement and divergence. As a way of further exploring these ethical and professional concerns, the contentious issue of using school children as case studies in publications and in graduate counseling courses is briefly examined.     

Gender Differences in Family Communication About Organ Donation

In this study we investigated gender differences in willingness to donate organs and conversations with family members about organ donation. Results from a snowball sample of 353 men and 488 women (average age = 41–50) indicated that men are less willing to donate and less likely to have conversations about organ donation. When such conversations do occur, men are less likely to include within them topics of conversation that are associated with more positive responses from family members. Women are more likely to include a mention of their desire to donate organs, discussion of the need for organs, and an explanation of why they would/would not like to donate their organs. They are also more likely to mention moral/altruistic/religious reasons for donation or to tell/use a narrative in the discussion. Men, however, more commonly discussed whether signing a donation card would affect medical care. Women report higher agreed compliance from family members. Directions are provided for future research and campaign development by taking these differences into consideration.     

Mandatory Reporting and Professional Dilemmas

Summary

Mandatory reporting of suspicions of abuse on minors carries some risk to professional confidence in certain instances. This is of particular importance when a trainee is involved. A clinical case is described to illustrate the issues that an intern may face with respect to therapeutic alliance and professional development when reporting occurs. The issue of countertransference to reported families and its successful resolution is one that would be helpful to address in both graduate and clinical training.     

Marriage and Family Therapy with Low-Income Clients: Professional,Ethical, and Clinical Issues

Economic stress greatly increases the likelihood of mental health issues occurring within a family. Although this is widely known within the mental health profession, there is a lack of literature that assists therapists in working effectively with low-income clients. As a result, marriage and family therapists may be ill equipped to meet the needs of those in poverty, and may even be conducting therapy that is ethically unsound. The authors of this article discuss several ethical and professional issues regarding therapy with families in poverty. A number of suggestions are presented for improving the effectiveness of therapy with low-income clients. Michele E. Grimes and Alyssa D. McElwain are masters students in Marriage and Family Therapy at Purdue University Calumet, Hammond, IN. Michele E. Grimes and Alyssa D. McElwain contributed equally to this article.     

Writing About Clients: An Overview of Ethical and Professional Issues in Clinical Case Reports

This introductory article establishes a context for subsequent articles and commentaries regarding the main ethical and professional issues involved in preparing and publishing clinical case reports. An overview is provided of the 4 articles in the special section along with the 2 commentaries that review and critique these articles.     

Counseling Prisoners: Ethical Issues,Dilemmas, and Cautions

Counseling prisoners involves multiple ethical and therapeutic choices and risks. Prison environments emphasize external control and security. Thus, work in such settings challenges the role of the counselor as a facilitator of client responsibility for independent decision making.     

Extraconjugal Determinants of Spousal Communication About Family Planning in Kenya

Prior researchers have examined the influence of spousal communication on fertility behavior without looking at what causes spouses to start talking about family planning. This study bridges this gap in the literature by examining the extraconjugal (social networks) factors that influence spouses to start talking to each other about family planning. Data from a study conducted in Kenya between 1997 and 1998 show that interspousal communication about family planning is initiated as a result of the operation of the various social network variables. Interacting with others (neighbors, friends, and relatives) appears to encourage the respondents to talk to their spouses about family planning, perhaps because it decreases their fears by giving them adequate background information to introduce the topic to their spouses.     

Ethical Dilemmas at the End of Life: Islamic Perspective

Many Muslim patients and families are often reluctant to accept fatal diagnoses and prognoses. Not infrequently, aggressive therapy is sought by the patient or his/her family, to prolong the life of the patient at all costs. A series of searches were conducted of Medline databases published in English between January 2000 and January 2015 with the following Keywords: End-of-life, Ethics and Islam. Islamic law permits the withdrawal of futile treatment, including all kinds of life support, from terminally ill patients leaving death to take its natural course. However, such decision should only take place when the physicians are confident that death is inevitable. All interventions ensuring patient’s comfort and dignity should be maintained. This topic is quite challenging for the health care providers of Muslim patients in the Western World.     

行政伦理困境与行政行为选择

行政责任的特点之一是其道德性 ,在行政行为选择中伦理动因占据着核心位置。行政伦理困境是行政行为选择中经常遇到的一种特殊情境 ,行政伦理困境与行政行为选择经常相伴而生 ,因此 ,谈及行政伦理困境必然涉及到行政行为选择。     

A Genetic Counseling Intervention to Facilitate Family Communication About Inherited Conditions

This paper describes the development and implementation of the first intervention to facilitate family communication of genetic information based on a genetic counseling model of practice. The intervention is telephone-based and therefore designed to complement face-to-face genetic counseling consultations. It was developed by firstly reviewing the literature and a model of genetic counseling practice, leading to definition of seven core principles underpinning the intervention. A counseling framework based on these principles was developed through iterative role playing and review, tested for consistency with good practice and piloted on ten study participants. It was found to be feasible to implement and consistent with good genetic counseling practice. Implementation included training of the genetic counselors who would deliver the intervention as part of a randomized controlled trial. Noteworthy deviations from good genetic counseling practice were observed, with unexpected additional insights into the ‘black box’ of genetic counseling that may have wider implications and would benefit from further investigation. The intervention is currently being evaluated in a randomized controlled trial, to assess its impact on the number of family members attending genetic services.     

Writing About Clients: Ethical Considerations and Options

Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case material. These considerations are discussed and options are described along with guidelines and a case example illustrating these points.