非法药物的产前筛查。助产士面临的困境。

Prenatal screening for illegal drugs. Dilemma for the nurse-midwife.

作者信息

Moseley R, Bell C

机构信息

College of Medicine, University of Florida, Gainesville 32610.

出版信息

J Nurse Midwifery. 1991 Jul-Aug;36(4):245-8. doi: 10.1016/0091-2182(91)90086-5.

DOI:10.1016/0091-2182(91)90086-5

PMID:1895174

Abstract

Prenatal screening for illegal drugs poses very complex ethical problems for the nurse-midwife who must make the decision whether to screen for illegal drugs and whether to report positive results to state child abuse investigators. We argue that the results of prenatal screening for illegal drug use should not be used for determination of child abuse and that the nurse-midwife should not be required to report the results of these screens for illegal drugs to state child protection agencies. It is far from clear that required reporting offers any benefit to the fetus or future child, and there are serious ramifications of reporting for the fetus, the pregnant woman, and the nurse-midwifery profession. However, we do argue that prenatal screening for both illegal and legal drug use should be encouraged and should be done as early as possible in the pregnancy. Prenatal screening for drugs should only be used by the nurse-midwife as a diagnostic procedure wherein standard informed consent and confidentiality restraints are maintained.

摘要

对非法药物进行产前筛查，给助产士带来了非常复杂的伦理问题，她们必须决定是否进行非法药物筛查，以及是否向州儿童虐待调查人员报告阳性结果。我们认为，非法药物使用的产前筛查结果不应被用于判定儿童虐待，并且不应要求助产士向州儿童保护机构报告这些非法药物筛查的结果。要求报告是否能给胎儿或未来的孩子带来任何益处，这一点远不明确，而且报告对胎儿、孕妇和助产行业都有严重的影响。然而，我们确实认为，应该鼓励对非法和合法药物使用进行产前筛查，并且应该在孕期尽早进行。药物的产前筛查仅应用于诊断程序，助产士应保持标准的知情同意和保密限制。