Brothers Kyle B, Knapp Esther E
A primary care pediatrician and bioethicist at the University of Louisville School of Medicine in Louisville, Kentucky.
A pediatric hematologist-oncologist at the University of Louisville School of Medicine in Louisville, Kentucky.
AMA J Ethics. 2018 Sep 1;20(9):E812-818. doi: 10.1001/amajethics.2018.812.
In this case, a primary care physician is presented with direct-to-consumer genetic test results and asked to provide counseling and order follow-up diagnostics. In order to deal effectively with this situation, we suggest physicians need look no further than the practice principles that guide more routine clinical encounters. We examine the rationale behind 2 major clinical ethical considerations: (1) physicians have obligations to help their patients achieve reasonable health goals but are not obligated to perform procedures that are not medically indicated; and (2) primary care physicians do not need to know everything; they just need to know how to get their patients appropriate care.
在这种情况下，一名初级保健医生收到了直接面向消费者的基因检测结果，并被要求提供咨询服务并安排后续诊断。为了有效应对这种情况，我们建议医生只需遵循指导更常规临床诊疗的实践原则即可。我们审视了两大主要临床伦理考量背后的基本原理：（1）医生有义务帮助患者实现合理的健康目标，但没有义务实施无医学指征的程序；（2）初级保健医生无需知晓一切；他们只需知道如何为患者提供恰当的治疗。
