Dr. Sabatello is Associate Professor of Clinical Bioethics, and Co-Director of the Precision Medicine, Ethics, Politics, and Culture Project, Center for Research on Ethical, Legal & Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University, New York, NY. Dr. Insel is a research assistant at Research Foundation for Mental Hygiene, New York, NY. Dr. Link is Distinguished Professor of Sociology and Public Policy, School of Public Policy, University of California, Riverside, CA. Dr. Phelan is Professor Emerita, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY. Dr. Appelbaum is Dollard Professor of Psychiatry, Medicine, and Law, and Director, Center for Research on Ethical, Legal & Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University, New York, NY.
J Am Acad Psychiatry Law. 2021 Jun;49(2):166-178. doi: 10.29158/JAAPL.200066-20. Epub 2021 Feb 12.
The introduction of psychiatric genetic evidence in court proceedings to terminate parental rights raises concerns that such information will result in misconceived assumptions about the child's mental health trajectory and unjust rulings on termination of parental rights. We conducted an online vignette-based survey with a nationally representative sample of adults from the general public ( = 300 respondents) to assess their views on how evidence about a child's psychiatric genetic makeup may affect key decisions in termination proceedings. Our findings indicate that genetic evidence increased the child's labeling as having a psychiatric disorder, regardless of the presence of symptoms, treatment recommendations, evaluation of prescription medication, and beliefs in treatment efficacy. Genetic evidence alone did not affect whether participants would terminate parental rights, but participants who thought that the child did not have a psychiatric disorder were more likely to terminate in the presence of genetic test results. We conclude that psychiatric genetic evidence in termination proceedings may have unintended consequences, and that measures should be taken to ensure that it does not unfairly affect outcomes.
将精神疾病遗传学证据引入法庭程序以终止父母权利引发了人们的担忧，即此类信息将导致对孩子心理健康轨迹的误解假设，并对终止父母权利的判决做出不公正的裁决。我们对来自普通公众的全国代表性成年人样本进行了基于情景的在线调查（=300 名受访者），以评估他们对有关孩子精神疾病遗传学构成的证据如何影响终止程序中的关键决策的看法。我们的研究结果表明，无论是否存在症状、治疗建议、处方药物评估和对治疗效果的信念，遗传证据都会增加孩子被贴上精神疾病标签的可能性。遗传证据本身并不会影响参与者是否终止父母权利，但认为孩子没有精神疾病的参与者更有可能在存在基因检测结果的情况下终止。我们的结论是，终止程序中的精神疾病遗传学证据可能会产生意想不到的后果，应采取措施确保它不会不公平地影响结果。
