关于基因检测的伦理思考

随着基因组学的发展,在临床医学中出现了基因检测的新方法,它的临床应用带来了一些伦理、法律和社会问题.从伦理学的角度出发,对基因检测中出现或有可能出现的伦理问题进行探讨,提出进行基因检测应遵循的伦理原则.     

哈贝马斯关于基因技术应用的人性论论证

现代生物工程技术的迅猛发展使人类对自身生命过程的干预和控制成为可能,与此同时也对人的尊严和价值构成了极大的挑战和冲击。在新的情势下,怎样利用技术才能避免伤害,体现尊重人的精神?哈贝马斯从人性论的角度出发,认为每个人只有将自己看作是人类当中的一个平等的成员,是人种当中的一个份子,才能避免对其他生命控制和操纵,才能避免对待他人的工具化态度。只有从人类学的广阔视野出发,变人与人之间的主客体关系为主体间性关系,才能深刻理解生命伦理学尊重原则的哲学基础和人文内涵,从而为技术的道德化使用指明了方向。     

方向感的加工机制及影响因素

方向感是一种定位当前位置、确定前往目的地的方向及选择相应路线的能力, 与人们的日常生活和国家航空航天事业的发展有着密切联系。方向感的认知加工包括外部信息输入、内部表征建立和信息整合三个过程, 综合方向感的各加工过程的研究结果形成的方向感认知结构模型将有助于研究者全面认识其加工机制。大脑是实现方向感加工的载体, 当前对方向感神经机制的研究主要有正常人的行为实验、脑成像研究以及脑损伤病人研究三方面, 根据这三方面的研究总结得出的神经网络结构清楚地展示了方向感在大脑中的加工过程。方向感的发生和发展受到了先天遗传和后天环境的影响, 因此了解方向感的遗传基础是了解其加工机制的关键之一。遗传影像学近来取得的重大进展推动了基因、大脑和行为研究的结合, 这将是未来方向感加工机制研究的主要方向之一。     

Beyond Heritability: Twin Studies in Behavioral Research

ABSTRACT— The heritability of human behavioral traits is now well established, due in large measure to classical twin studies. We see little need for further studies of the heritability of individual traits in behavioral science, but the twin study is far from having outlived its usefulness. The existence of pervasive familial influences on behavior means that selection bias is always a concern in any study of the causal effects of environmental circumstances. Twin samples continue to provide new opportunities to identify causal effects with appropriate genetic and shared environmental controls. We discuss environmental studies of discordant twin pairs and twin studies of genetic and environmental transactions in this context.     

Development of an Interactive Decision Aid for Female BRCA1/BRCA2 Carriers

Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer.     

Genetic Counselors' Experiences with Paternal Involvement in Prenatal Genetic Counseling Sessions: An Exploratory Investigation

Limited research exists concerning male partners' participation in prenatal genetic counseling (R. Kenen, A. C. M. Smith, C. Watkins, & C. Zuber-Pitore, J. Genet Corns 9, 33–45, 2000). To further understand paternal participation, we interviewed 17 experienced prenatal genetic counselors to assess their perspectives on this issue. We investigated 6 research questions: 1) How do genetic counselors define paternal involvement, 2) how do they determine and address problematic involvement, 3) what factors influence involvement, 4) was paternal involvement addressed in training, 5) how might training be improved, and 6) how do participant strategies for addressing involvement compare to those of marriage/family therapists? Qualitative analysis revealed that 1) participants regard paternal involvement asimportant; 2) most address problematic involvement with strategies similar to those of marital/family therapists; 3) influential factors include male partner's characteristics, the couple's relationship (including culturalpractices), and pregnancy factors; and 4) participants received little or notraining on paternal involvement and recommended didactic and experientialactivities. Implications and research recommendations are presented.     

When Is Genetic Reasoning Not Fallacious?

Attempts to evaluate a belief or argument on the basis of its cause or origin are usually condemned as committing the genetic fallacy. However, I sketch a number of cases in which causal or historical factors are logically relevant to evaluating a belief, including an interesting abductive form that reasons from the best explanation for the existence of a belief to its likely truth. Such arguments are also susceptible to refutation by genetic reasoning that may come very close to the standard examples given of supposedly fallacious genetic reasoning.     

A Qualitative Investigation of Student and Supervisor Perceptions of Live Supervision in Genetic Counseling

Live supervision of genetic counseling students is critical for ensuring quality client care and student clinical skill development. However, no research has investigated students' and supervisors' experience of this primary supervision method. In this study, separate focus groups of students and supervisors discussed their perceptions of the nature and impact of live supervision. A modified Consensual Qualitative Research method (Hill et al. (1997) Couns Psychol 25:517–572) was used to analyze the data. Results suggest that live supervision is an essential and effective method that promotes student skill development and professional development for both students and supervisors. There is a lack of formal training regarding supervision; most learning is trial and error. Students worry about being evaluated, and supervisors wonder if they are providing supervision effectively. Both samples emphasized that client care should not be compromised. Participant recommendations for improving live supervision are described, and suggestions are made for future research.     

Should we select for genetic moral enhancement? A thought experiment using the MoralKinder (MK+) haplotype

By using preimplantation haplotype diagnosis, prospective parents are able to select embryos to implant through in vitro fertilization. If we knew that the naturally-occurring (but theoretical) MoralKinder (MK+) haplotype would predispose individuals to a higher level of morality than average, is it permissible or obligatory to select for the MK+ haplotype? I.e., is it moral to select for morality? This paper explores the various potential issues that could arise from genetic moral enhancement.     

TNF-α和IL-6基因多态性与妊娠期糖尿病的相关研究

为探讨TNF-α和IL-6基因多态性在妊娠期糖尿病中的分布及其相关性,对照性检测了糖尿病及正常孕妇TNF-α和IL-6的基因型。结果显示：TNF-α的基因多态性与妊娠期糖尿病相关;TNF-α和IL-6基因多态性在妊娠期糖尿病中有协同作用,基因型之间的相互作用可能决定了妊娠期糖尿病的遗传易感性。