Dickens B M, Pei N, Taylor K M
Faculty of Law, University of Toronto, Ontario.
CMAJ. 1996 Mar 15;154(6):813-8.
The prediction of susceptibility to heritable breast, ovarian and colon cancer raises important legal and ethical concerns. Health care professionals have a duty to disclose sufficient information to enable patients to make informed decisions. They must also safeguard the confidentiality of patient data. These duties may come into conflict if a positive finding in one patient implies that family members are also at risk. A legal distinction is made between a breach of confidentiality and the legitimate sharing of information in a patient's interest or to prevent harm to a third party. Physicians also have a fiduciary duty to warn. Other issues concern the legal liability assumed by genetic counsellors, whose disclosures may influence decisions about childbearing, for example, and the risk of socioeconomic discrimination faced by people with a known genetic susceptibility. Traditional ethical orientations and principals may be applied to these and other questions, but feminist ethics will likely have particular importance in the development of an ethical stance toward testing and counseling for heritable breast and ovarian cancer.
对遗传性乳腺癌、卵巢癌和结肠癌易感性的预测引发了重要的法律和伦理问题。医疗保健专业人员有责任披露足够的信息，使患者能够做出明智的决定。他们还必须保护患者数据的保密性。如果一名患者的阳性检测结果意味着其家庭成员也面临风险，那么这些职责可能会产生冲突。在违反保密规定与为了患者利益或防止对第三方造成伤害而合法共享信息之间，存在法律上的区别。医生还有警示的信托责任。其他问题涉及遗传咨询师承担的法律责任，例如，他们的披露可能会影响生育决策，以及已知具有遗传易感性的人面临社会经济歧视的风险。传统的伦理取向和原则可能适用于这些及其他问题，但在制定针对遗传性乳腺癌和卵巢癌检测与咨询的伦理立场时，女性主义伦理学可能会具有特别重要的意义。
