Lucast Erica K
University of Michigan, Philosophy: 2215 Angell Hall, 435 S. State St., Ann Arbor, MI 48109, USA.
Bioethics. 2007 Jan;21(1):41-50. doi: 10.1111/j.1467-8519.2007.00522.x.
When misattributed paternity is discovered in the course of genetic testing, a genetic counselor is presented with a dilemma concerning whether to reveal this information to the clients. She is committed to treating the clients equally and enabling informed decision making, but disclosing the information may carry consequences for the woman that the counselor cannot judge in advance. A frequent suggestion aimed at avoiding this problem is to include the risk of discovering nonpaternity in the informed consent process for counseling. In this paper I argue that such a move does not resolve the problem, because the conflict hinges on the interpretation of equality on which the counselor operates. Given the principles of genetic counseling, neither construal of equality yields a satisfactory solution to the conflict. In fact, I conclude that including nonpaternity in informed consent is not endorsed by either view, and we are still left with the question of what to do should nonpaternity be discovered. I suggest a compromise position concerning disclosure, involving revealing relevant genetic information but withholding nonpaternity when possible.
当在基因检测过程中发现亲子关系被误认时，基因咨询师会面临一个两难困境，即是否要将这一信息告知客户。她致力于平等对待客户并促使其做出明智的决策，但披露该信息可能会给这位女性带来一些后果，而咨询师无法预先判断。为避免这一问题，人们经常提出的一个建议是，在咨询的知情同意过程中纳入发现非亲生关系的风险。在本文中，我认为这样做并不能解决问题，因为冲突的关键在于咨询师所秉持的平等观念的解读。鉴于基因咨询的原则，平等的任何一种解释都无法为冲突提供令人满意的解决方案。事实上，我得出的结论是，将非亲生关系纳入知情同意并不为任何一种观点所认可，而且如果发现非亲生关系，我们仍然面临该如何应对的问题。我建议在披露方面采取一种折中的立场，即披露相关的基因信息，但尽可能隐瞒非亲生关系。
