Campbell Elizabeth, Ross Lainie Friedman
Department of Sociology, University of Chicago, Illinois 60637, USA.
Am J Med Genet A. 2003 Jul 15;120A(2):209-14. doi: 10.1002/ajmg.a.20031.
The ability to perform predictive genetic testing of children raises ethical concerns. Current guidelines support the screening of newborns for conditions in which early treatment reduces morbidity and mortality, and oppose most other predictive genetic screening and testing in childhood. Little is known, however, about parental attitudes. We conducted focus groups to gain information on the attitudes, beliefs, and concerns of parents about newborn screening and testing for both treatable and untreatable conditions that present in childhood. Respondents across racial groups support mandatory newborn screening for treatable conditions like phenylketonuria (PKU), citing lack of parental knowledge, and concerns about immature parental decision-makers. Parents do, however, want more information. Citing a variety of psychosocial concerns, respondents believe that parents should have access to predictive genetic testing for childhood onset conditions, even when there are no proven treatments. Respondents want this information to make reproductive and non-reproductive plans and decisions. Although respondents varied in their personal interest in testing, overwhelmingly they believed that the decisions belong to the parents. Professional guidelines that proscribe predictive testing for untreatable childhood onset conditions should be re-examined in light of consumer attitudes.
对儿童进行预测性基因检测的能力引发了伦理问题。当前指南支持对新生儿进行某些疾病的筛查,这些疾病早期治疗可降低发病率和死亡率,同时反对儿童期的大多数其他预测性基因筛查和检测。然而,对于父母的态度却知之甚少。我们开展了焦点小组讨论,以了解父母对于新生儿筛查以及针对儿童期出现的可治疗和不可治疗疾病进行检测的态度、信念和担忧。不同种族群体的受访者支持对苯丙酮尿症(PKU)等可治疗疾病进行强制性新生儿筛查,理由是父母缺乏相关知识,以及担心父母作为决策者不够成熟。然而,父母确实希望获得更多信息。受访者出于各种心理社会方面的担忧,认为即使没有经过验证的治疗方法,父母也应该能够获得针对儿童期发病疾病的预测性基因检测。受访者希望获取这些信息以制定生育和非生育计划及决策。尽管受访者对检测的个人兴趣各不相同,但绝大多数人认为决定权在父母手中。鉴于消费者的态度,应该重新审视禁止对儿童期发病的不可治疗疾病进行预测性检测的专业指南。