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公众对成人预测性基因检测相关伦理问题的看法。

Public perceptions of ethical issues regarding adult predictive genetic testing.

机构信息

Department of Health Policy, Management and Evaluation and the Joint Centre for Bioethics, University of Toronto, 88 College St., Toronto, ON, M5G 1L4, Canada.

出版信息

Health Care Anal. 2010 Jun;18(2):103-12. doi: 10.1007/s10728-009-0113-4. Epub 2009 Mar 14.

Abstract

The purpose of this study was to explore the views of members of the general public regarding ethical issues in adult predictive genetic testing. The literature pertaining to ethical issues regarding to adult predictive genetic testing is largely restricted to the views of 'experts' who have emphasized informed consent, patent issues, and insurance discrimination. Occasionally the views of patients who have undergone genetic counselling and testing have been elicited, adding psychosocial and family issues. However, the general public has not had the opportunity to contribute. In order to explore theatre as a health policy research tool, 1,200 audience members attended the play 'Sarah's Daughters' in seven Canadian cities, following which audience discussions were audiotaped. This study performed a secondary qualitative analysis of the data to identify the ethical issues of adult predictive genetic testing important to members of the general public. The identified issues were: (1) need for public education; (2) choice to undergo genetic counselling and testing; (3) access to genetic counselling and testing; and (4) obligations regarding the handling of genetic information. Audience members emphasized public education and access to information regarding potential choices, which was different from the emphasis on informed consent and other ethical issues prominent in the literature. Members of the general public emphasized ethical issues that were different than those identified by experts and patients. It is essential that members of the public be included in complex and controversial public policy decisions.

摘要

本研究旨在探讨普通公众对成人预测性基因检测中伦理问题的看法。有关成人预测性基因检测伦理问题的文献主要局限于“专家”的观点,这些观点强调了知情同意、专利问题和保险歧视。偶尔也会征求接受过基因咨询和检测的患者的意见,增加了心理社会和家庭问题。然而,普通公众没有机会发表意见。为了探索戏剧作为卫生政策研究工具,1200 名观众在加拿大七个城市观看了戏剧《莎拉的女儿们》,随后对观众讨论进行了录音。本研究对数据进行了二次定性分析,以确定普通公众认为重要的成人预测性基因检测的伦理问题。确定的问题有:(1)需要公众教育;(2)进行基因咨询和检测的选择;(3)获得基因咨询和检测的机会;(4)处理遗传信息的义务。观众强调了有关潜在选择的公众教育和信息获取,这与文献中强调的知情同意和其他伦理问题不同。普通公众强调的伦理问题与专家和患者确定的问题不同。在复杂和有争议的公共政策决策中,让公众参与至关重要。

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