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胚胎和胎儿标本档案库继续使用的伦理原理和准则。

Ethical Rationales and Guidelines for the Continued Use of Archival Collections of Embryonic and Fetal Specimens.

机构信息

Louisiana State University School of Medicine, New Orleans, Louisiana.

Department of Cell Biology and Anatomy, Louisiana State University School of Medicine, Health Sciences Center, New Orleans, Louisiana.

出版信息

Anat Sci Educ. 2019 Jul;12(4):407-416. doi: 10.1002/ase.1897. Epub 2019 Jun 12.

Abstract

Benefits from the use of cadavers in anatomical education are well described. Historically, human embryos and fetal cadavers were used in anatomy education to understand development and congenital malformations. Recently, three-dimensional printed models produced from archival fetal specimens, and online repositories of images from archival collections of embryos and fetuses, have been used as an educational tool in human development courses. Given that the archival specimens were likely obtained prior to the era of informed consent, this raises questions about their appropriate and ethical use. Because some institutions in the United States retain archival collections of embryonic and fetal specimens that were once used as educational tools, their existence and utility require frequent reexamination against contemporary ethical frameworks to guide appropriate use or utilization. Four ethical rationales for uses of these collections are examined, including destruction, indefinite storage, use in research, and use in health professions education. Guidelines for the use of archival collections of human embryos and fetuses are presented. Indefinite storage and use in health professions education are supported, while use in research is also permitted, however, such use is limited and dependent on circumstance and purpose. The development of current digital repositories and three-dimensionally printed models based on archival collections that were collected without informed consent, or those promoting commercial opportunity, are not supported. New embryonic and fetal donations obtained with informed consent should include reference to potential uses with new technology and virtual, genetic, or imaging applications.

摘要

使用尸体进行解剖教学的好处已有充分描述。从历史上看,人类胚胎和胎儿尸体曾被用于解剖教学,以了解发育和先天性畸形。最近,利用存档胎儿标本制作的三维打印模型,以及胚胎和胎儿存档标本图像的在线数据库,已被用作人体发育课程的教学工具。鉴于存档标本很可能是在知情同意时代之前获得的,这就引发了关于其适当性和伦理使用的问题。由于美国的一些机构保留了曾经用作教学工具的胚胎和胎儿存档标本,因此需要根据当代伦理框架对其存在和用途进行频繁重新评估,以指导适当的使用或利用。本文探讨了使用这些存档标本的四个伦理理由,包括销毁、无限期储存、用于研究以及用于医疗保健专业教育。本文提出了使用人类胚胎和胎儿存档标本的指南。支持无限期储存和在医疗保健专业教育中使用,但也允许在研究中使用,然而,这种使用是有限的,并取决于具体情况和目的。不支持使用未经知情同意或利用商业机会而开发的现有数字数据库和基于存档标本的三维打印模型,这些模型的建立并未考虑新技术和虚拟、遗传或成像应用的潜在用途。

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