探索遗传测试中未经请求的发现的不确定性.
Vyne van der Schoot1, Eline van der Meer2, Marij A Hillen3
1Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands.
Patient education and counseling
|November 17, 2023
概括
临床遗传学中关于事实和价值的不确定性很大,特别是在未经请求的发现 (UF) 方面. 道德冲突,例如自主与慈善,是这种不确定性的关键驱动力,影响了遗传咨询.
科学领域:
- 临床遗传学 临床遗传学
- 医学伦理 医学伦理
- 基因检测的心理社会方面
背景情况:
- 关于经验事实 (非规范性) 和道德价值观 (规范性) 的不确定性在临床遗传学中很重要.
- 不被要求的发现 (UF) 在遗传咨询中提出了独特的挑战.
- 了解规范性不确定性可以为辅导实践的改进提供信息.
研究的目的:
- 探索非规范性和规范性不确定性对UFs的作用.
- 分析辅导员和辅导员对与UFs相关的不确定性的观点.
- 识别导致遗传咨询不确定性的道德冲突.
主要方法:
- 对20名辅导员和20名辅导员的采访进行了二次定性分析.
- 利用基于汉等人的演方法. 这是一个不确定性框架.
- 在现有的理论框架中纳入了规范性不确定性.
主要成果:
- 辅导员经历了实际和个人非规范性不确定性;辅导员面临着科学不确定性.
- 规范性不确定性是一个普遍的主题,涉及道德冲突.
- 确定了关键的道德冲突:自主性与公益性/非恶性以及自主性与真实性.
结论:
- 需要对UF透率和临床实用性的进一步研究.
- 在临床遗传学中,道德冲突是不确定性的重要来源.
- 解决顾问的规范性不确定性和冲突对于优化遗传咨询至关重要.
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