Toward an Ethically Sensitive Implementation of Noninvasive Prenatal Screening in the Global Context.

Toward an Ethically Sensitive Implementation of Noninvasive Prenatal Screening in the Global Context.
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在全球背景下对非侵入性产前筛查的道德敏感实施。

DOI:
10.1002/hast.690
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发表时间:
2017-03
期刊:
The Hastings Center report
影响因子:
--
通讯作者:
Allyse M
Allyse M
中科院分区:
其他
文献类型:
--
作者:
Mozersky J;Ravitsky V;Rapp R;Michie M;Chandrasekharan S;Allyse M

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无细胞DNA(cfDNA)筛查是一种新兴的产前技术,在90个国家可用。尽管其在全球迅速传播,但在北美和欧洲以外,包括中低收入国家,对其执行情况的了解还存在差距。为了解决这个问题,我们组织了一个国际比较研讨会,探讨cfDNA筛查全球扩展的伦理和社会影响。我们描述了讨论中产生的8个关键见解,以说明生物伦理讨论和规范框架,起源和反映北美和欧洲的伦理优先事项可以通过参加当地环境的重要性来丰富。cfDNA筛查的实用性和伦理影响是高度可变的,并取决于当地的医疗保健系统,文化,经济和社会政治背景和需求。我们呼吁对cfDNA筛查的国际传播进行更微妙、动态和背景化的理解,这将在不同的背景下引发不同的挑战。
Cell-free DNA (cfDNA) screening is an emerging prenatal technology available in 90 countries. Despite its rapid global diffusion, there is a gap in knowledge about its implementation outside of North America and Europe including low to middle income countries. To address this, we organized an international comparative workshop to explore the ethical and social implications of the global expansion of cfDNA screening. We describe 8 key insights that arose from discussions to illustrate how bioethical discussions and normative frameworks that originate and reflect North American and European ethical priorities can be enriched by attending to the importance of local context. The utility and ethical implications of cfDNA screening are highly variable and dependent upon local healthcare systems, cultural, economic, and socio-political contexts and needs. We call for a more subtle, dynamic and contextual understanding of the international spread of cfDNA screening, which will evoke diverse challenges across different contexts.
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