剖析產前遺傳檢測之諮詢與倫理議題

Explore the Ethical Issues in Counseling for Prenatal Genetic Test

產前遺傳檢測有利於提升唐氏症胎兒的診斷率，但也帶給一些孕婦及其家庭衝擊與兩難的抉擇。本論文旨在探究產前檢測遺傳的諮詢關係與倫理議題。採用參與觀察的方式訪談接受檢測為陽性反應的孕婦、唐氏症兒父母以及產科醫護人員，研究結果指出專業制度與知識體系（知己）、孕婦的生活世界（知彼）、以及互為主體的諮詢關係為三項重要議題。並且進一步討論遺傳檢測帶來生命價值的反省、產前檢測的告知、人本導向的產前遺傳諮詢。

The aim of prenatal testing is to enhance the detection rate for Down’s syndrome; however there is a tension between the goals of reproductive choice and the prevention of the birth within a family of a child who would has a disability. The aim of this study was to explore the way of informing clients of prenatal testing and the ethical issues associated with genetic counseling. Using participant observation and in-depth interviews, this study examined the experiences of women who had received positive results for maternal serum screening and who followed this up with amniocentesis, of women who had given birth to a child with Down’s syndrome and of obstetricians, nurses, and genetic counselors. This study identified three positions associated with the professional roles involved in the process of prenatal genetic counseling. These included, first, the professional status constructed by health system and knowledge of genetics, second, the lived experiences of pregnant women in genomic era, and third, the intersubjectivity in prenatal genetic counseling. In conclusion, this study offers insights into the effects of prenatal screening on disability, informed consent for prenatal testing, and person-centered prenatal counseling.