ETYKA W PSYCHIATRII

ETYKA W PSYCHIATRII - Przeglądy aktów prawnych

Mental Disorders and Genetics: the ethical context

• „Assumptions about what is standard, and hence about what differs from standard, will vary over time and according to cultural context.” (s. 11)

• „The value of genetic counselling in the common multifactorial mental disorders will depend on two principal criteria: the ability to calculate individual risks and the ability to identify preventive measures to reduce risk in individuals at high risk.” (s. 28)

• „There are already accepted ethical standards which genetic counselling must meet. Those who provide it have responsibilities:

  • to ensure that genetic counselling is voluntarily under taken

  • to provide accessible and accurate information both about patterns of inheritance and about the condition;

  • to ensure confidentiality and to explain to those receiving counselling if there are good reasons for them to share the information with other relatives;

  • to emphasise at each stage of counselling that consent to counselling or to a genetic test (if available) does not constitute consent to take any advice that is offered, to take any reproductive decision or to terminate a pregnancy.” (s. 34)

• „The Working Party recommends that the confidential nature of genetic information should be maintained. It can conceive of exceptional circumstances in which, in the absence of the consent of the individual, disclosure to close family members might be justified, if there are serious implications for them. Such decisions should be judged on a case by case basis.” (s. 51)

• „One US study found that mental illness is one of the most highly rejected conditions, clustering with drug addiction, prostitution and ex-convict status rather than with cancer, diabetes and heart disease. The degree of stigma differs for different mental disorders. Depression evokes considerable sympathy; schizophrenia frequently leads to social isolation.” (s. 54)

• „Most people with mental disorders will be competent to consent on their own behalf to genetic counselling and any further procedures, including genetic tests. Obtaining genuine consent requires health care professionals to do their best to communicate accurately, and in an understandable and appropriate way, the purposes and implications of the procedure as well as its risks. They should respect the limits of individuals’ understanding and capacity to deal with difficult information, and allow time for them to ask questions (…).” (s. 78)