Prenatal genetic counselling: conceptual and ethical issues

Author(s):  
Anders Nordgren
2016 ◽  
Vol 22 (1) ◽  
pp. 6 ◽  
Author(s):  
Johannes L. Roos

<p><strong>Background:</strong> Recent genetic findings have led to profound changes in genetic and family counselling for schizophrenia patients and their families.</p><p><strong>Objectives:</strong> The article gives an overview of the present knowledge regarding the genetic and family counselling for schizophrenia.</p><p><strong>Method:</strong> Literature searches were performed on the MEDLINE database (2011–2015) and African Healthline. A current alert service which provides the most recent literature on the topic on a monthly basis was also used in the study. A clinical case example is presented as is experienced in daily psychiatric practice.</p><p><strong>Results:</strong> Genetic risk communication has become the responsibility of the multiprofessional treatment team, moving away from specialists in the field. The treatment team provides information on a daily basis regarding risk predictors in the management of schizophrenia, including risk of relapse, suicide and comorbid substance use. Although genetic information is unique and has implications for blood relatives, genetic risk factors only rarely provide information that is inherently different from that provided by other risk predictors commonly used in healthcare. The common variant common disease and rare variant common disease models as contrasting hypothesis of the genetics of schizophrenia are discussed and debated. An example of a family counselled is given and the place of commercial companies that offer directly to the consumer affordable personal DNA testing for psychiatric illness is discussed. Ethical issues without resolution regarding genetic counselling of schizophrenia are debated.</p><p><strong>Conclusions:</strong> Recent genetic findings must lead to profound changes in genetic and family counselling in schizophrenia. Exposed attributable risk has immediate effects on genetic counselling of schizophrenia. Psychiatric risk counselling has thus changed from risk estimates based on family history to estimates based on test results in specific individuals.</p><p><strong><br /></strong></p>


2012 ◽  
Vol 32 (4) ◽  
pp. 389-395 ◽  
Author(s):  
George McGillivray ◽  
Jill A Rosenfeld ◽  
R. J. McKinlay Gardner ◽  
Lynn H. Gillam

Genes ◽  
2020 ◽  
Vol 11 (12) ◽  
pp. 1454
Author(s):  
Thomas Eggermann

Prenatal detection of uniparental disomy (UPD) is a methodological challenge, and a positive testing result requires comprehensive considerations on the clinical consequences as well as ethical issues. Whereas prenatal testing for UPD in families which are prone to UPD formation (e.g., in case of chromosomal variants, imprinting disorders) is often embedded in genetic counselling, the incidental identification of UPD is often more difficult to manage. With the increasing application of high-resolution test systems enabling the identification of UPD, an increase in pregnancies with incidental detection of UPD can be expected. This paper will cover the current knowledge on uniparental disomies, their clinical consequences with focus on prenatal testing, genetic aspects and predispositions, genetic counselling, as well as methods (conventional tests and high-throughput assays).


2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.


Author(s):  
Christine Evans ◽  
Peter Harper
Keyword(s):  

Pflege ◽  
2001 ◽  
Vol 14 (1) ◽  
pp. 13-16
Author(s):  
Monika Bobbert

Pflegeethik als relativ neuer Bereich der angewandten Ethik hat unter anderem die Aufgabe, auf ethische Probleme in der pflegerischen Praxis aufmerksam zu machen und diese zu reflektieren. An einem Fallbeispiel wird gezeigt, dass das pflegerische Vorgehen bei der Ernährung von Frühgeborenen ethische Konflikte bergen kann. Am konkreten Fall werden Fragen der Patientenautonomie und Fürsorge diskutiert, die auch für andere pflegerische Situationen relevant sind. Der Artikel leistet einen Beitrag zur Klärung der spezifischen Inhalte einer auf den Handlungsbereich der professionellen Pflege bezogenen Ethik.


Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 238-246 ◽  
Author(s):  
Paul W. C. Wong ◽  
Wincy S. C. Chan ◽  
Philip S. L. Beh ◽  
Fiona W. S. Yau ◽  
Paul S. F. Yip ◽  
...  

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.


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