RESUMEN
Here we discuss the opinion on disclosure issues (respect for confidentiality) of Mexican professionals working in clinical genetics. The information was obtained from a comprehensive survey on genetics, ethics and society organized by Wertz and Fletcher in 1993, in which geneticists from 37 nations participated. The responses to 18 questions from 64 of 89 (72%) geneticists invited to participate were analyzed for this paper. The questions were directed to investigate: a) disclosure of clinically relevant information in several situations such as testicular feminization syndrome, mosaic de novo balanced translocation in a fetus, or accidental discovery of non-paternity; b) the protection of patient's privacy from the spouse or blood relatives; and c) confidentiality in cases with high genetic risk to relatives. The results reveal significant disparity between general responses related to disclosure of all clinically relevant information and specific responses in particular cases. In addition, professionals appear to give higher priority to protecting the spouse, blood relatives or public safety, rather than the patient's confidentiality.
Asunto(s)
Actitud del Personal de Salud , Confidencialidad , Asesoramiento Genético , Revelación de la Verdad , Humanos , México , Encuestas y CuestionariosRESUMEN
A survey of 2901 genetics professionals in 36 nations suggests that eugenic thought underlies their perceptions of the goals of genetics and that directiveness in counseling after prenatal diagnosis leads to individual decisions based on pessimistically biased information, especially in developing nations of Asia and Eastern Europe. The "non-directive counseling" found in English-speaking nations is an aberration from the rest of the world. Most geneticists, except in China, rejected government involvement in premarital testing or sterilization, but most also held a pessimistic view of persons with genetic disabilities. Individual, but not state-coerced, eugenics survives in much modern genetic practice.
Asunto(s)
Actitud del Personal de Salud , Consejo Dirigido , Eugenesia , Asesoramiento Genético/psicología , Internacionalidad , Aborto Eugénico/psicología , Asia , Australia , Cuba , Recolección de Datos , Personas con Discapacidad/psicología , Europa (Continente) , Enfermedades Genéticas Congénitas/prevención & control , Regulación Gubernamental , Humanos , Recién Nacido , Programas Obligatorios , Tamizaje Neonatal/psicología , América del Norte , Exámenes Prenupciales/psicología , Diagnóstico Prenatal/psicología , Sudáfrica , América del Sur , Esterilización Reproductiva/psicologíaRESUMEN
We surveyed the approaches of 661 geneticists in 18 nations to 14 clinical cases and asked them to give their ethical reasons for choosing these approaches. Patient autonomy was the dominant value in clinical decision-making, with 59% of responses, followed by non-maleficence (20%), beneficence (11%) and justice (5%). In all, 39% described the consequences of their actions, 26% mentioned conflicts of interest between different parties and 72% placed patient welfare above the welfare of others. The U.S., Canada, Sweden, and U.K. led in responses favoring autonomy. There were substantial international differences in moral reasoning. Gender differences in responses reflected women's greater attention to relationships and supported feminist ethical theories.