How Should Clinicians Counsel a Woman with a Strong Family History of Early-Onset Alzheimer's Disease about Her Pregnancy?
作者信息
Mapes Marianna V, O'Brien Barbara M, King Louise P
机构信息
An ethics intern at Beth Israel Deaconess Medical Center in Boston.
Associate professor of obstetrics and gynecology in the Division of Maternal Fetal Medicine at Harvard Medical School and the associate director for the Obstetrics and Gynecology Clerkship at Brigham and Women's Hospital in Boston, and the director of the Maternal Fetal Medicine Fellowship at Beth Israel Deaconess Medical Center (BIDMC).
出版信息
AMA J Ethics. 2017 Jul 1;19(7):663-674. doi: 10.1001/journalofethics.2017.19.7.ecas4-1707.
Counseling patients regarding the benefits, harms, and dilemmas of genetic testing is one of the greatest ethical challenges facing reproductive medicine today. With or without test results, clinicians grapple with how to communicate potential genetic risks as patients weigh their reproductive options. Here, we consider a case of a woman with a strong family history of early-onset Alzheimer's disease (EOAD). She is early in her pregnancy and unsure about learning her own genetic status. We address the ethical ramifications of each of her options, which include genetic testing, genetic counseling, and termination versus continuation of the pregnancy. Our analysis foregrounds clinicians' role in helping to ensure autonomous decision making as the patient reflects on these clinical options in light of her goals and values.
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