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Informed consent and the misattributed paternity problem in genetic counseling

机译：遗传咨询中的知情同意和不正确的亲子关系问题

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When misattributed paternity is discovered in the course of genetic testing, a genetic counselor is presented with a dilemma concerning whether to reveal this information to the clients. She is committed to treating the clients equally and enabling informed decision making, but disclosing the information may carry consequences for the woman that the counselor cannot judge in advance. A frequent suggestion aimed at avoiding this problem is to include the risk of discovering nonpaternity in the informed consent process for counseling. In this paper I argue that such a move does not resolve the problem, because the conflict hinges on the interpretation of equality on which the counselor operates. Given the principles of genetic counseling, neither construal of equality yields a satisfactory solution to the conflict. In fact, I conclude that including nonpaternity in informed consent is not endorsed by either view, and we are still left with the question of what to do should nonpaternity be discovered. I suggest a compromise position concerning disclosure, involving revealing relevant genetic information but withholding nonpaternity when possible.
机译：当在基因测试过程中发现父母身份不正确时，遗传顾问会面临两难选择，即是否向客户透露此信息。她致力于平等对待客户并做出明智的决策，但披露信息可能会对辅导员无法提前判断的女性产生后果。旨在避免此问题的常见建议是在进行知情同意的过程中包括发现不陪伴的风险。在本文中，我认为这样的举动并不能解决问题，因为冲突取决于顾问对工作机会平等的解释。根据遗传咨询的原则，平等的解释都不能为冲突带来令人满意的解决方案。实际上，我得出的结论是，无论哪种观点都没有认可将非父亲身份包括在知情同意书中，而且我们仍然面临应该如何发现非父亲身份的问题。我建议在披露方面采取妥协立场，包括披露相关的遗传信息，但在可能的情况下保留非亲权。

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