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Ethical issues associated with genetic counseling in the context of adolescent psychiatry

机译:青少年精神病学中与遗传咨询相关的伦理问题

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Genetic counseling is a well-established healthcare discipline that provides individuals and families with health information about disorders that have a genetic component in a supportive counseling encounter. It has recently been applied in the context of psychiatric disorders (like schizophrenia, bipolar disorder, schizoaffective disorder, obsessive compulsive disorder, depression and anxiety) that typically appear sometime during later childhood through to early adulthood. Psychiatric genetic counseling is emerging as an important service that fills a growing need to reframe understandings of the causes of mental health disorders. In this review, we will define psychiatric genetic counseling, and address important ethical concerns (we will particularly give attention to the principles of autonomy, beneficence, non-maleficence and justice) that must be considered in the context of its application in adolescent psychiatry, whilst integrating evidence regarding patient outcomes from the literature. We discuss the developing capacity and autonomy of adolescents as an essential and dynamic component of genetic counseling provision in this population and discuss how traditional viewpoints regarding beneficence and non-maleficence should be considered in the unique situation of adolescents with, or at risk for, psychiatric conditions. We argue that thoughtful and tailored counseling in this setting can be done in a manner that addresses the important health needs of this population while respecting the core principles of biomedical ethics, including the ethic of care.
机译:遗传咨询是一门建立完善的保健学科,可为个人和家庭提供有关疾病的健康信息,这些疾病在支持咨询中具有遗传成分。最近已将其应用于精神疾病(例如精神分裂症,双相情感障碍,精神分裂症,强迫症,抑郁症和焦虑症),这些疾病通常在儿童后期到成年初期出现。精神病遗传咨询作为一种重要的服务正在兴起,它满足了对重新构造对精神健康障碍原因的理解的日益增长的需求。在这篇评论中,我们将定义精神病学遗传咨询,并解决在青少年精神病学中的应用时必须考虑的重要伦理问题(我们将特别关注自治,善意,非恶意和正义的原则),同时整合文献中有关患者预后的证据。我们讨论了青少年的发展能力和自治能力,作为这一群体中遗传咨询服务的必要和动态组成部分,并讨论了在患有精神病或有精神病风险的青少年的特殊情况下,应如何考虑传统的关于受益和非虐待的观点条件。我们认为,在这种情况下进行周到且量身定制的咨询可以解决这一人群的重要健康需求,同时尊重生物医学伦理学的核心原则,包括护理伦理学。

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