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基因化与生物伦理学:推动辩论与研究

Geneticization and bioethics: advancing debate and research.

作者信息

Arnason Vilhjálmur, Hjörleifsson Stefán

机构信息

Department of Philosophy & Centre for Ethics, University of Iceland, Reykjavik, Iceland.

出版信息

Med Health Care Philos. 2007 Dec;10(4):417-31. doi: 10.1007/s11019-007-9088-9. Epub 2007 Aug 18.

Abstract

In the present paper, we focus on the role that the concept of geneticization has played in the discussion about health care, bioethics and society. The concept is discussed and examples from the evolving discourse about geneticization are critically analyzed. The relationship between geneticization, medicalization and biomedicalization is described, emphasizing how debates about the latter concepts can inspire future research on geneticization. It is shown how recurrent themes from the media coverage of genetics portray typical traits of geneticization and thus contribute to the process. We look at examples of small-scale studies from the literature where geneticization of medical practice has been demonstrated. Methodological disputes about the relevance of empirical evidence for the geneticization thesis and the normative status of the concept are discussed. We consider arguments to the effect that ideas from mainstream bioethics have facilitated geneticization by emphasizing individualistic notions of autonomy and responsibility while ignoring the role of genetics in the wider social context. It is shown how a concept like geneticization, which can be used to draw the attention of philosophers, social scientists and others to challenges that tend to be neglected by mainstream bioethics, also has the potential to move people's attention away from other pertinent issues. This may happen if researchers become preoccupied with the transformative effects of genetics, and we argue that a wider reading of geneticization should inspire critical analysis of the sociocultural preconditions under which genetics is currently evolving.

摘要

在本文中,我们聚焦于基因化概念在有关医疗保健、生物伦理学及社会的讨论中所扮演的角色。我们对这一概念进行了探讨,并对基因化相关论述演进过程中的实例进行了批判性分析。我们描述了基因化、医学化和生物医学化之间的关系,强调了关于后两个概念的争论如何能够启发未来关于基因化的研究。我们展示了媒体对遗传学报道中的反复出现的主题如何描绘基因化的典型特征,从而推动了这一过程。我们审视了文献中一些小规模研究的实例,这些实例证明了医疗实践中的基因化现象。我们讨论了关于基因化论点的经验证据的相关性以及该概念的规范地位的方法论争议。我们考虑了这样的观点,即主流生物伦理学的观念通过强调个人主义的自主性和责任观念,同时忽视遗传学在更广泛社会背景中的作用,从而促进了基因化。我们展示了像基因化这样一个概念,它既能用于引起哲学家、社会科学家及其他人士对那些往往被主流生物伦理学忽视的挑战的关注,同时也有可能使人们的注意力从其他相关问题上转移开。如果研究人员专注于遗传学的变革性影响,这种情况就可能发生,并且我们认为对基因化进行更广泛的解读应该激发对遗传学当前发展所处的社会文化前提条件的批判性分析。

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