Ethical Discourse about the Modification of Food for Therapeutic Purposes: How Patients with Gastrointestinal Diseases View the Good, the Bad, and the Healthy.
Ethical Discourse about the Modification of Food for Therapeutic Purposes: How Patients with Gastrointestinal Diseases View the Good, the Bad, and the Healthy.
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DOI：
10.1080/21507716.2012.662574
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发表时间：
2012-07-01
期刊：
影响因子：
--
通讯作者：
Sharp RR
中科院分区：
文献类型：
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作者：
Harrison KL;Geller G;Marshall P;Tilburt J;Mercer M;Brinich MA;Highland J;Farrell RM;Sharp RR
研究人员有潜力利用基因改造（GM）技术创造“食品”和“药物”的混合体，这可能会挑战对“自然”的传统理解。道德和伦理问题可能会出现在任何讨论这些治疗食品，并会影响产品融入临床护理和日常生活。这项研究探讨了慢性胃肠道（GI）疾病患者如何将益生菌视为未来的生物工程治疗食品。在克利夫兰诊所、马约诊所和约翰霍普金斯大学进行了一项由慢性胃肠道疾病焦点组组成的多中心定性研究。我们在2009年3月至8月期间对136例重大胃肠道疾病患者进行了22个焦点组。GI患者将“自然”一词与降低风险和道德“好”的概念相关联;相反，患者将“非自然”一词与“危险”，“外国”和道德“坏”的事物相关联。容易获得的未经修饰的益生菌更常被描述为“天然”，而转基因益生菌更常被标记为“非天然”和“危险”。然而，患者承认，并非所有的天然产品都是安全的，非天然产品也不总是有害的。如果GI患者的观点表明公众对治疗性食品的看法，我们的研究结果表明，采用治疗性食品的临床和公共卫生举措的潜在利益和风险将被理解为道德方面。生物伦理学家和其他人应该对隐含的规范性呼吁保持敏感，这些呼吁往往隐含在“自然”和“非自然”的语言中。
Researchers have the potential to utilize genetic modification (GM) technologies to create a hybrid of “food” and “medicine” that may challenge traditional understandings of what is “natural”. Moral and ethical concerns are likely to arise in any discussion of these therapeutic foods and will affect the integration of products into clinical care and daily life. This study examined how patients with chronic gastrointestinal (GI) diseases view probiotics as future bioengineered therapeutic foods. A multi-site qualitative study consisting of focus groups with chronic GI diseases was conducted at Cleveland Clinic, Mayo Clinic, and Johns Hopkins University We conducted twenty-two focus groups with 136 patients with major GI diseases between March and August 2009. GI patients associated the term “natural” with concepts of diminished risk and morally “good”; conversely, patients associated the term “unnatural” with things that are “risky,” “foreign”, and morally “bad”. Readily available unmodified probiotics were more commonly described as “natural” while genetically modified probiotics were more commonly labeled as “unnatural” and “risky”. However, patients acknowledged that not all natural products are safe, nor are unnatural products always harmful. If GI patient perspectives are indicative of public perceptions of therapeutic foods, our findings suggest that the potential benefits and risks of clinical and public health initiatives employing therapeutic foods will be understood in moralistic terms. Bioethicists and others should be sensitive to the implicit normative appeals that are often embedded in the language of what is “natural” and “unnatural”.