Robertson S, Savulescu J
Victorian Clinical Genetics Service, Melbourne, Australia.
Bioethics. 2001 Feb;15(1):26-49. doi: 10.1111/1467-8519.00210.
Genetic testing has brought the ability to predict the onset of diseases many years before symptoms appear and the use of such predictive testing is now widespread. The medical fraternity has met the application of this practice to children with caution. The justification for their predominantly prohibitive stance has revolved around the lack of a readily identifiable medical benefit in the face of potential psychological harms to the child. We argue that predictive testing can have important psychosocial benefits and that the interests of the child have been construed too narrowly. Proponents of a prohibitive stance also argue that testing in childhood breaches the child's future right to make the same decision as an autonomous adult and to maintain this information as confidential. We argue that predictive genetic testing of children is not necessarily a violation of the child's future autonomy. Indeed, in some cases, such testing may facilitate the development of autonomy in the maturing child. We argue that parents are generally best placed to judge what is in their own child's overall interests, and that parental request for testing after appropriate genetic counselling should be respected unless there is clear evidence that the child will be harmed in an overall sense as a result of testing.
基因检测已具备在症状出现多年前预测疾病发作的能力，且这种预测性检测的应用如今已很普遍。医学界对将这种做法应用于儿童持谨慎态度。他们主要采取禁止立场的理由围绕着这样一点：面对对儿童潜在的心理伤害，缺乏易于确定的医学益处。我们认为，预测性检测可带来重要的心理社会益处，而且对儿童利益的理解过于狭隘。采取禁止立场的支持者还认为，儿童期检测侵犯了儿童未来作为自主成年人做出相同决定并对该信息保密的权利。我们认为，对儿童进行预测性基因检测不一定侵犯儿童未来的自主权。事实上，在某些情况下，这种检测可能有助于成长中的儿童发展自主性。我们认为，父母通常最有资格判断什么符合自己孩子的整体利益，并且在进行适当的遗传咨询后，父母要求检测应得到尊重，除非有明确证据表明检测会对孩子造成整体伤害。
