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首页> 外文期刊>American journal of bioethics >Psychiatric Genomics and Mental Health Treatment: Setting the Ethical Agenda
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Psychiatric Genomics and Mental Health Treatment: Setting the Ethical Agenda

机译：精神科学基因组学与心理健康治疗：设定道德议程

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摘要

Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health.
机译：意识到将精神科学基因组学研究转化为精神保健的益处并不直。翻译过程引起了伦理挑战，这些挑战与精神科学基因组学研究本身所带来的挑战，或者形成临床精神遗传服务的一部分。本文概述并考虑了三个不同的道德关注，将基因组研究转化为前线精神实践和政策制定。首先，通常与医疗保健中基因组学革命相关的遗传本质主义可能会对精神障碍的人无意中加剧耻辱。其次，基因组医学的承诺推进了个体赋权的叙述。这种叙述可以通过在实践中努力破坏患者的机构和自主权的方式来促进对患者生物学的致命主义，或者可以嵌入到导致心理治疗方法的心理健康服务中提高了最高的主观遗传责任感。临床医生 - 患者治疗联盟受到破坏。最后，采用基因组学致力于公共心理健康风险，从不平等的社会经济，政治和文化结构与负心理健康成果之间的复杂因果关系转移。本文通过概述未来伦理研究的许多潜在途径，强调了检查适当翻译机制的重要性，精神障碍的遗传和心理社会模型之间的互补性，基因组信息对临床医生关系的影响，以及资金优先事项和心理健康的资源分配决策。

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