Wouters Roel H P, Cornelis Candice, Newson Ainsley J, Bunnik Eline M, Bredenoord Annelien L
Bioethics. 2017 Nov;31(9):648-656. doi: 10.1111/bioe.12375. Epub 2017 Oct 4.
The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between "scanning the body" and "sequencing the genome" from an ethical perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate.
在基因组学和放射学等临床领域引入新型诊断技术，引发了一场关于如何处理这些创新所带来的意外发现的丰富伦理辩论。然而，虽然意外发现在基因组学和放射学中都会出现，但迄今为止，大多数相关文献往往只关注其中一个领域。在本文中，我们从伦理角度综合并批判性地评估“扫描身体”和“对基因组进行测序”之间的异同。在简要描述导致意外发现的新型诊断背景后，我们综合并思考了与这两个专业相关的六个核心伦理问题：术语；益处和风险；自主性；向儿童披露意外发现；不确定性；以及筛选和常规筛查。我们确定了与这两个领域都相关的伦理依据，这些依据可能有助于制定更符合伦理的政策。维护公众信任以及确保人们认为医疗保健政策是公平的考量，也支持进行联合辩论的必要性。
