产前诊断中的生物伦理和知情同意

IF 0.2 0 RELIGION
D. Serapinas, A. Narbekovas
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引用次数: 0

摘要

产前诊断的创新方法使我们能够看到胎儿的发育,并发现胎儿发育的早期障碍,这可能导致早期诊断和可能的治疗,或使妇女决定终止妊娠。因此,即使在决定进行产前检查之前,准确地告知妇女这一与生命有关的问题的风险和后果是非常重要的;在检查结果出来后,一个错误的诊断可能会导致女性终止妊娠。医生告知患者的义务与获得知情同意的要求是分不开的。这两部分对于任何医疗程序和干预都是强制性的。知情同意的主要要求有:合理性、信息充分明确、自愿、同意形式符合法律行为。然而,知情同意并不是一个绝对的要求,因为患者有权保持不知情。此外,在某些情况下,可能无法通知患者,或无法获得患者或其正式授权代表的同意。产前检查是产前护理的一个组成部分,目的是核实胎儿的正常发育,或在尽可能早的阶段查明潜在的遗传或染色体疾病。根据程序的类型,产前检查可分为非侵入性或侵入性措施。除此之外,根据程序的目的,分为以产前治疗为目的的诊断性产前检查和纯粹的诊断性产前检查。纯诊断性产前检查与选择性流产问题密切相关。这篇文章的一部分涵盖了产前诊断中知情同意的主要问题,概述了这一过程的两个阶段:产前检测前的传输,以及对结果的解释以及可能的选择的介绍。我们考虑的法律影响是基于来自其他欧洲国家的信息:我们列出了法院分析的主要问题,包括“错误出生”和“错误生活”案件;关于流产可能性的不适当信息;妇女有权使用一切可用的诊断方法;以及赔偿给索赔人的分配。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bioethics and Informed Consent in Prenatal Diagnostics
Innovative methods of prenatal diagnosis allow us to see the development of the fetus and to detect early disorders of fetal development, which may lead to an early diagnosis and possible treatment, or to a woman’s decision to terminate the pregnancy. Therefore, it is very important to accurately inform a woman about the risks and consequences of this life-related issue, even before deciding to perform prenatal tests; and after the results, when a misinterpreted diagnosis may lead a woman to terminate her pregnancy. The obligation of doctors to inform patients is inseparable from the requirement to receive informed consent. The two parts are mandatory for any medical procedure and intervention. The main requirements for the informed consent include rationality, sufficient and clear information, free will, and the form of consent conforming to the legal acts. However, informed consent is not an absolute requirement, as the patient has a right to remain uninformed. Additionally, under certain circumstances, it might be impossible to inform patients, or to receive consent from patients or their duly authorized representatives. Prenatal testing is an integral part of ante-natal care that aims to verify the proper development of the fetus, or to identify potential hereditary or chromosomal diseases at the earliest possible stage. Prenatal testing can be classified as non-invasive or invasive measures, according to the types of procedures In addition to this, according to the aim of the procedure, into diagnostic prenatal testing with the aim of prenatal therapy, and purely diagnostic prenatal testing. Purely diagnostic prenatal testing is closely connected with the problem of selective abortion. Part of this article covers the main problems of informed consent in prenatal diagnostics, by outlining two stages of the process: conveyance before prenatal testing, and interpretation of the results alongside presentation of the possible choices. The legal implications we consider are based on information from other European countries: we name the main questions analyzed by courts, including cases of “wrongful birth” and “wrongful life”; inappropriate information regarding possibilities of abortion; the right of a woman to use all available diagnostic methods; and the allocation of damages to the claimants.
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