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产前诊断作为优生学的一种手段与支撑:当代法国社会中的神话还是现实?

Prenatal diagnosis as a tool and support for eugenics: myth or reality in contemporary French society?

作者信息

Gaille Marie, Viot Géraldine

机构信息

CERSES, Ethics, Meaning and Society Research Center, CNRS-Paris Descartes University, CEC, Hôpital Cochin, 27, rue Fbg. St-Jacques, 75014 Paris, France.

出版信息

Med Health Care Philos. 2013 Feb;16(1):83-91. doi: 10.1007/s11019-012-9429-1.

Abstract

Today, French public debate and bioethics research reflect an ongoing controversy about eugenics. The field of reproductive medicine is often targeted as pre-implantation genetic diagnosis (PGD), prenatal diagnosis, and prenatal detection are accused of drifting towards eugenics or being driven by eugenics considerations. This article aims at understanding why the charge against eugenics came at the forefront of the ethical debate. Above all, it aims at showing that the charge against prenatal diagnosis is groundless. The point of view presented in this article has been elaborated jointly by a geneticist and a philosopher. Besides a survey of the medical, bioethical, philosophical and social sciences literature on the topic, the methodology is founded on a joint analysis of geneticist's various consults. Evidence from office visits demonstrated that prenatal diagnosis leads to case-by-case decisions. As we have suggested, this conclusion does not mean that prenatal diagnosis is devoid of ethical issues, and we have identified at least two. The first is related to the evaluation of a decision to abort. The second line of ethical questions arises from the fact that the claim for "normality" hardly hides normative and ambiguous views about disability. As a conclusion, ethical dilemmas keep being noticeable in the field of reproductive medicine and genetic counselling, but an enquiry about eugenic tendencies probably does not allow us to understand them in the proper way.

摘要

如今,法国的公众辩论和生物伦理学研究反映出一场关于优生学的持续争议。生殖医学领域常常成为众矢之的,因为胚胎植入前基因诊断(PGD)、产前诊断和产前检测被指责有滑向优生学的趋势,或是受优生学考量的驱使。本文旨在理解为何对优生学的指控会成为伦理辩论的焦点。最重要的是,本文旨在表明对产前诊断的指控是毫无根据的。本文所呈现的观点是由一位遗传学家和一位哲学家共同阐述的。除了对该主题的医学、生物伦理学、哲学和社会科学文献进行调查外,该方法还基于对遗传学家各类咨询案例的联合分析。门诊就诊的证据表明,产前诊断会导致逐案决策。正如我们所指出的,这一结论并不意味着产前诊断不存在伦理问题,我们至少已经确定了两个问题。第一个问题与对堕胎决定的评估有关。第二条伦理问题线源于这样一个事实,即对“正常”的追求几乎掩盖了关于残疾的规范性且含混不清的观点。总之,伦理困境在生殖医学和遗传咨询领域依然显著,但对优生学倾向的探究可能无法让我们以恰当的方式理解这些困境。

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