Davis Dena S
Lehigh University, USA.
Health Matrix Clevel. 2013 Spring;23(1):35-54.
This Article focuses on one aspect of prenatal diagnosis: noninvasive prenatal diagnosis, particularly the detection of Trisomy 21 (Down Syndrome) through a simple test of maternal blood. Although I discuss issues salient to this particular test, I place it in the context of "opportunistic" testing generally. It is my view that opportunistic testing presents the most serious challenge to patient autonomy we are facing in the twenty-first century. In this Article, I will explain what I mean by opportunistic testing and consider three different examples of how it threatens informed consent: (1) Prostate-Specific Antigen (PSA) screening, (2) newborn screening, and (3) prenatal diagnosis of maternal blood tests for fetal anomalies.
非侵入性产前诊断，尤其是通过一项简单的孕妇血液检测来检测21三体综合征（唐氏综合征）。尽管我讨论的是这项特定检测的突出问题，但我是将其置于一般意义上的“机会性”检测的背景下来探讨的。我认为，机会性检测是我们在21世纪面临的对患者自主权最严峻的挑战。在本文中，我将解释我所说的机会性检测是什么意思，并思考它威胁知情同意的三种不同情形：（1）前列腺特异性抗原（PSA）筛查，（2）新生儿筛查，以及（3）用于胎儿异常检测的孕妇血液检测的产前诊断。
