Botkin J R
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio.
Obstet Gynecol. 1990 May;75(5):875-80.
Medicine has a strong tradition of respect for parental autonomy in reproductive decisions. As prenatal diagnostic technology develops, the physician's obligation to the prospective parents with respect to prenatal screening must be determined, and standards for disclosure of diagnostic capabilities and results must be developed. This article explores potential justifications for limits on parental choice in prenatal screening. Information about screening capabilities can be limited appropriately when resources do not exist to ensure accurate testing and counseling. Other policy limits to parental information and choice based on risk levels, cost-benefit analyses, or harms to the parent-child relationship cannot be established without broad consensus on complex ethical issues. Limits to parental choice may be more appropriately applied through the moral values of individual physicians in their provision of diagnostic services.
医学在生殖决策方面有着尊重父母自主权的悠久传统。随着产前诊断技术的发展,必须确定医生在产前筛查方面对准父母的义务,并且必须制定关于诊断能力和结果披露的标准。本文探讨了限制父母在产前筛查中选择的潜在理由。当没有资源确保准确检测和咨询时,关于筛查能力的信息可以适当地加以限制。基于风险水平、成本效益分析或对亲子关系的损害而对父母信息和选择进行的其他政策限制,如果没有就复杂的伦理问题达成广泛共识,就无法确立。对父母选择的限制可能更适合通过个体医生在提供诊断服务时的道德价值观来实施。