Doukas D J, Berg J W
University of Pennsylvania, USA.
Am J Bioeth. 2001 Summer;1(3):3-10. doi: 10.1162/152651601750417784.
The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial argument defines the boundaries of autonomy and benefit for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received.
在过去几十年里，医患关系发生了变化，这就需要对患者、医生和家庭相互冲突的需求进行系统的重新评估。在基因检测时代，采用一种名为“家庭契约”的患者护理模式可能会有效地兼顾这些需求。家庭契约明确了基因检测前医生、患者和家庭的角色，这些角色是由参与者协商确定的。初始论点界定了所有参与家庭成员的自主权和利益范围。然后，医生可以在这种关系中充当协调人，与各方共同解决有关基因信息的潜在冲突。家庭契约促进了对收到基因检测结果后可能出现的相互冲突的伦理主张进行更充分的讨论。
