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从群体健康到“个性化”医学:南北视角下的胚胎植入前遗传学检测所带来的生物伦理挑战。

From collective health to "personalized" medicine: bioethical challenges in preimplantation genetic testing from a North-South perspective.

机构信息

Doctora en Psicología. Investigadora Asistente, Consejo Nacional de Investigaciones Científicas y Técnicas, con sede en Facultad de Psicología, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

Doctora en Ciencias Biológicas. Becaria postdoctoral, Consejo Nacional de Investigaciones Científicas y Técnicas, con sede en Facultad de Filosofía y Letras, Universidad de Buenos Aires. Jefa de Trabajos Prácticos, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Salud Colect. 2023 Sep 12;19:e4481. doi: 10.18294/sc.2023.4481.

Abstract

This article examines the scope and limitations of the precision medicine paradigm and its relationship with the collective health approach. To that end, it takes preimplantation genetic testing (PGT) as a paradigmatic example of technologies aimed at the "individualization" of health processes. In this regard, we review the characteristics and scientific and regulatory foundations of PGT technologies in Argentina, and discuss the next steps for their bioethical analysis. More specifically, we shed light on some of the conditions for their implementation from a north-south perspective. We propose three themes or problematic aspects as a synthesis of our analysis, related to biases in the production of knowledge, the values and interests underlying its uses, and the underlying epistemological assumptions of these technologies. Throughout the article, we review these dilemmas and suggest some issues that should be taken into account in future research.

摘要

本文探讨了精准医学范式的范围和局限性及其与集体健康方法的关系。为此,它以着床前遗传学检测(PGT)为例,说明了旨在“个体化”健康过程的技术。在这方面,我们回顾了阿根廷 PGT 技术的特点和科学及监管基础,并讨论了对其进行生物伦理分析的下一步措施。更具体地说,我们从南北角度出发,探讨了其实施的一些条件。我们提出了三个主题或有问题的方面作为我们分析的综合,这些主题与知识生产中的偏见、其使用所依据的价值观和利益以及这些技术的潜在认识论假设有关。在整篇文章中,我们审查了这些困境,并提出了一些在未来研究中应考虑的问题。

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Preimplantation genetic testing in assisted reproduction.辅助生殖中的植入前基因检测。
Minerva Obstet Gynecol. 2023 Jun;75(3):260-272. doi: 10.23736/S2724-606X.21.04805-3. Epub 2021 Jul 30.

本文引用的文献

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Addressing ethical issues related to prenatal diagnostic procedures.解决与产前诊断程序相关的伦理问题。
Matern Health Neonatol Perinatol. 2023 Feb 3;9(1):1. doi: 10.1186/s40748-023-00146-4.

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