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高龄父亲的高度优先伦理问题:来自男性生殖与组建家庭领域专家小组的观点

The high-priority ethical issues of advanced paternal age: perspectives from a panel of experts in the fields of men reproduction and family building.

作者信息

Couture Vincent, Coiteux Émy, Beaulieu Marianne, Bédard Timothey, Lavoie Kévin

机构信息

Université Laval, Québec, Canada.

Université de Sherbrooke, Sherbrooke, Canada.

出版信息

BMC Med Ethics. 2025 Apr 12;26(1):46. doi: 10.1186/s12910-025-01202-8.

DOI:10.1186/s12910-025-01202-8
PMID:40217476
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11992766/
Abstract

BACKGROUND

Research shows that the age of fathers at the time of conception is correlated with detrimental effect for the health of the future offspring. This situation raises ethical questions regarding the priority of the principle of reproductive autonomy of men of advanced age over the well-being of their future offspring. This problem leads to other normative implications such as the value of introducing limits to the use of medically assisted reproduction, and the development of public health interventions. For the moment, this ethical reflection is mostly speculative and calls to open up the discussion. The aim of this research was to survey experts, working in related fields to the topic of advanced paternal age (APA), regarding the top priority ethical issues of this emerging subject.

METHODS

We recruited experts concerned by APA with backgrounds in health sciences, ethics, social work and reproductive medicine. We conducted a modified e-Delphi panel that lasted three rounds to build a consensual list of issues. The last round took the form of structured interviews exploring the results of the previous rounds.

RESULTS

The top four issues according to the panel are: (1) Should APA be included as a criterion for prenatal genetic screening? (2) Should we raise awareness on reproductive health in relation to the age of fathers? (3) How can health-care providers support patients in the context of APA? (4) How can research inform the public without stigmatizing fathers of advanced age?

CONCLUSIONS

These exploratory results suggest that the issues of how to inform various audiences properly on APA are important concerns for experts.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

研究表明,受孕时父亲的年龄与对未来后代健康的有害影响相关。这种情况引发了关于高龄男性生殖自主权原则优先于其未来后代福祉的伦理问题。这个问题导致了其他规范性影响,例如对医学辅助生殖的使用设置限制的价值,以及公共卫生干预措施的发展。目前,这种伦理思考大多是推测性的,需要展开讨论。本研究的目的是调查在高龄父亲(APA)这一主题相关领域工作的专家,了解这一新兴主题的首要伦理问题。

方法

我们招募了具有健康科学、伦理学、社会工作和生殖医学背景且关注APA的专家。我们进行了一个持续三轮的改良电子德尔菲小组讨论,以构建一份共识性的问题清单。最后一轮采取结构化访谈的形式,探讨前几轮的结果。

结果

专家小组认为最重要的四个问题是:(1)APA是否应被纳入产前基因筛查的标准?(2)是否应提高对与父亲年龄相关的生殖健康的认识?(3)在APA的背景下,医疗保健提供者如何支持患者?(4)研究如何在不污名化高龄父亲的情况下向公众提供信息?

结论

这些探索性结果表明,如何向不同受众正确传达APA相关信息的问题是专家们的重要关注点。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d11/11992766/a49f261c1453/12910_2025_1202_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d11/11992766/a49f261c1453/12910_2025_1202_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d11/11992766/a49f261c1453/12910_2025_1202_Fig1_HTML.jpg

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Hum Reprod. 2024 Jun 3;39(6):1161-1166. doi: 10.1093/humrep/deae067.
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The psychosocial outcomes of older parenthood in early to mid-childhood: a mini-review.中老年人生育在儿童早期到中期的心理社会后果:小型综述。
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Deconstructing age(s): an analysis of the different conceptions of age as a legal criterion for access to assisted reproductive technologies.解构年龄:对作为获取辅助生殖技术法律标准的不同年龄概念的分析。
J Law Biosci. 2022 Dec 15;9(2):lsac036. doi: 10.1093/jlb/lsac036. eCollection 2022 Jul-Dec.
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