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接受收养的不确定性:收养前基因检测的有限伦理

Accepting adoption's uncertainty: the limited ethics of pre-adoption genetic testing.

作者信息

Leighton Kimberly J

机构信息

Department of Philosophy, American University, Washington, DC, USA,

出版信息

J Bioeth Inq. 2014 Jun;11(2):245-60. doi: 10.1007/s11673-014-9519-2. Epub 2014 Jun 10.

Abstract

An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best "match," and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the "genetics" of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain.

摘要

在美国,越来越多的儿童是从医疗保健和环境条件都极其恶劣的国家收养的。出于对病史准确性的担忧,准养父母在收养前越来越多地要求对儿童进行基因检测。尽管关于收养前基因检测(PAGT)的伦理问题存在普遍共识,反对对可供收养的儿童进行基因检测,而这种检测一般情况下对儿童并不允许,但一种越来越有影响力的观点主张扩大允许进行的检测范围。这一观点背后的理由是,国家有责任为孩子提供最匹配的父母,因此应该获取所有有助于实现这一目标的信息。虽然匹配论旨在促进儿童的最大利益,但我将说明它是基于这样一种主张,即可供收养儿童的最大利益在于让准养父母的基因偏好得到满足,以便他们最终收养的孩子的“基因”能准确反映这些偏好。我得出的结论是,PAGT非但没有保护弱势群体,反而增加了这类儿童面临的伤害风险,因为它鼓励有强烈基因偏好的人收养基因背景始终不确定的儿童。

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