de Wert G
Institute for Bioethics, University of Maastricht, The Netherlands.
Patient Educ Couns. 1998 Sep;35(1):43-52. doi: 10.1016/s0738-3991(98)00082-2.
The recent identification of gene mutations involved in hereditary cancers increasingly allows for predictive DNA-testing. There is an urgent need to analyse the ethical issues involved. This article concentrates on the ethics of predictive testing for mutations in the breast (and ovarian) cancer genes BRCA1 and -2. Using international guidelines for presymptomatic DNA-testing for Huntington disease and the Li-Fraumeni syndrome as a model, a provisional protocol, which entails four parts is presented: (i) inclusion and exclusion criteria; (ii) preparing for the test; (iii) informing about the results of the test; (iv) post-test counselling and evaluation. The importance of an integral education of both doctors and the public is stressed.
近期对遗传性癌症相关基因突变的鉴定越来越使得预测性DNA检测成为可能。迫切需要分析其中涉及的伦理问题。本文着重探讨乳腺癌（及卵巢癌）基因BRCA1和BRCA2突变的预测性检测的伦理问题。以针对亨廷顿病和李-佛美尼综合征的症状前DNA检测的国际准则为模型，提出了一个包含四个部分的暂行方案：（i）纳入和排除标准；（ii）检测准备；（iii）检测结果告知；（iv）检测后咨询与评估。强调了对医生和公众进行全面教育的重要性。
