Department of Surgery, Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2012 Jul;19(7):2102-7. doi: 10.1245/s10434-012-2235-4. Epub 2012 Feb 10.
Medullary thyroid cancer is a disease with an established genetic inheritance pattern for which evidence-based guidelines recommend genetic testing and subsequent management of affected patients and their family members. The perceived stigma of genetic testing, coupled with issues involving confidentiality and disclosure, create potential conflict and confusion. In some cases, there is a need for genetic testing and prophylactic surgery in children, augmenting the need for a judicious approach that balances respect for individual autonomy and parental rights with the best interest of the child. We provide an overview of the ethical issues facing surgeons caring for patients with familial medullary thyroid carcinoma, and recommend interventions and resources to assist in decision making in these difficult situations.
甲状腺髓样癌是一种具有明确遗传模式的疾病，循证指南建议对患者及其家庭成员进行基因检测和后续管理。基因检测的潜在污名，加上涉及保密性和披露的问题，可能会产生潜在的冲突和困惑。在某些情况下，儿童需要进行基因检测和预防性手术，这增加了需要谨慎处理的必要性，在尊重个人自主权和父母权利与儿童最佳利益之间取得平衡。我们提供了一个概述，介绍了外科医生在照顾家族性甲状腺髓样癌患者时所面临的伦理问题，并建议采取干预措施和资源，以协助在这些困难情况下做出决策。
