Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice.

Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice.
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DOI:
10.1080/15265161.2015.1039721
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发表时间:
2015
期刊:
The American journal of bioethics : AJOB
影响因子:
--
通讯作者:
Juengst ET
Juengst ET
中科院分区:
其他
文献类型:
--
作者:
Lázaro-Muñoz G;Conley JM;Davis AM;Van Riper M;Walker RL;Juengst ET

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基因组学的进步导致人们呼吁开发基于人群的预防性基因组测序(PGS)计划,其目标是在没有已知风险因素的情况下识别成人的遗传健康风险。最大限度地减少PGS的危害和最大限度地提高其益处的一个关键问题是确定个体对其基因组信息的产生、使用和处理应该拥有的控制类型和程度。在本文中,我们研究了PGS项目是否应该为个人提供选择性选择退出特定基因组条件测序或分析的机会(菜单方法),或者PGS是否应该使用全有或全无的面板方法来实施。我们的结论是,任何负责任的PGS规模的扩大都需要一种菜单式的方法,这种方法对一些人来说可能是不切实际的,但它从规范、法律和实际考虑的丰富组合中得出了理由。
Advances in genomics have led to calls for developing population-based preventive genomic sequencing (PGS) programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt-out of the sequencing or analysis of specific genomic conditions (the menu approach) or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale up of PGS will require a menu approach that may seem impractical to some, but which draws its justification from a rich mix of normative, legal, and practical considerations.
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