Caenazzo Luciana, Tozzo Pamela, Benciolini Paolo, Rodriguez Daniele
Legal Medicine Section, Department of Environmental Medicine and Public Health, University of Padua , Padua, Italy.
Genet Test. 2008 Dec;12(4):507-11. doi: 10.1089/gte.2008.0050.
Paternity testing in Italy is usually performed by private laboratories and universities having direct contacts with the applicants. Recently, the number of paternity tests offered through laboratory websites has increased in Italy and Europe. The execution of genetic tests, including paternity testing based on DNA analysis, represents a complex act, which contains three main steps. Paternity analyses carried out by laboratories via Internet are performed on samples collected by the applicants and then mailed back to the laboratories without any patient-physician relationship. Information is given to the subjects through the laboratory's website or mailed with the test order form. The execution of "household" DNA analysis without technical precautions may provide an incorrect response with severe consequences on the individual who has undergone testing, on the family involved, and on society in general. The problems connected with this kind of analysis are not technical, but ethical and deontological. In this work, we will discuss the problems related to information and consent by way of outlining the relevant Italian laws and codes of medical ethics. The Italian Privacy's Guarantor is assessing the ethical and legal implications, but regulations are not yet in place. We believe that adequate information related to this practice cannot be given via Internet, and, consequently, the validity of the consent expressed during this kind of procedure can be uncertain. Further, we will analyze issues regarding the importance of minors' protection when a paternity test is performed via Internet. In our opinion, the complexity of the situations and expectations linked to paternity investigations require a special sensitivity in dealing with each case, based on a patient-physician relationship in the decision-making process especially referring to the defense of the minors' well-being.
在意大利，亲子鉴定通常由与申请人有直接联系的私人实验室和大学进行。最近，通过实验室网站提供的亲子鉴定数量在意大利和欧洲都有所增加。基因检测的实施，包括基于DNA分析的亲子鉴定，是一个复杂的行为，包含三个主要步骤。实验室通过互联网进行的亲子鉴定是对申请人采集的样本进行检测，然后样本被邮寄回实验室，整个过程不存在医患关系。信息通过实验室网站提供给受测对象，或随测试订单一起邮寄。在没有技术防范措施的情况下进行“家庭式”DNA分析可能会得出错误结果，这会给接受检测的个人、相关家庭以及整个社会带来严重后果。与这种分析相关的问题不是技术问题，而是伦理和道义问题。在本文中，我们将通过概述意大利的相关法律和医学伦理准则来讨论与信息和同意相关的问题。意大利隐私保护机构正在评估其中的伦理和法律影响，但相关规定尚未出台。我们认为，无法通过互联网提供与这种做法相关的充分信息，因此，在此类程序中所表达同意的有效性可能存在不确定性。此外，我们将分析在通过互联网进行亲子鉴定时未成年人保护的重要性问题。我们认为，与亲子鉴定调查相关的情况和期望非常复杂，在处理每个案例时需要特别谨慎，尤其是在决策过程中要基于医患关系，特别要保障未成年人的福祉。
