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題名：剖析產前遺傳檢測之諮詢與倫理議題
書刊名：中華心理衛生學刊
作者：蔣欣欣／喻永生／余玉眉
作者(外文)：Chiang, Hsien-hsien／Yuh, Yeong-seng／Chao Yu, Yu-mei
出版日期：2005
卷期：18:1
頁次：頁65-85
主題關鍵詞：基因科技；產前遺傳諮詢；產前母血唐氏症篩檢；專業關係；互為主體性；Genetic technology；Prenatal genetic counseling；Maternal serum screening；Professional relationships；Intersujectivity
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:85
  • 點閱點閱:42
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.
期刊論文
1.蔣欣欣(20020800)。由護理實踐建構倫理進路。護理雜誌，49(4)，20-24。new window  延伸查詢new window
2.蔣欣欣、喻永生(19970200)。唐氏症嬰幼兒父母認知真相後之調適過程。護理研究，5(1)，19-29。new window  延伸查詢new window
3.蔣欣欣、陳美碧、蔡欣玲(20030600)。建構照顧情境中的專業自我--自身與他者之間。本土心理學研究，19，201-226。new window  延伸查詢new window
4.蔣欣欣、余玉眉(20010600)。護病間的互為主體性。國立政治大學哲學學報，7，307-321。new window  延伸查詢new window
5.陳淑齡、余玉眉(20000400)。懷有唐氏症胎兒的初孕婦接受終止妊娠過程的生活處境。護理研究，8(2)，177-189。new window  延伸查詢new window
6.汪文聖(20011100)。醫護倫理之存有論基礎初探--從海德格走向優納斯。哲學雜誌，37，4-34。  延伸查詢new window
7.Chao, A. S.、Chung, C. L.、Wu, C. D.、Chang, S. D.、Cheng, P. J.、Lin, Y. T.、Soong, Y. K.(1999)。Second Trimester Maternal Serum Screening Using Alpha Fetoprotein, Free Beta Human Chorionic Gonadotropin and Maternal Age Specific Risk: Result of Down Syndrome in an Asian Population。Acta Obstetricia et Gynecologica Scandinavica，78(5)，393-397。  new window
8.Gekas, J.、Gondry, J.、Mazur, S.、Cesbron, P.、Thepot, F.(1999)。Informed Consent to Serum Screening for Down Syndrome: Are Women Given Adequate Information?。Prenatal Diagnosis，19(1)，1-7。  new window
9.Abuelo, Dianne N.(1991)。Anxiety in Women with Low Maternal Serum Alpha-fetoprotein Screening Results。Prenatal Diagnosis，11(6)，381-385。  new window
10.Adler, Bernard、Kushnick, Theodore(1982)。Genetic Counseling in Prenatally Diagnosed Trisomy 18 and 21: Psychosocial Aspects。Pediatrics，69(1)，94-99。  new window
11.Al Jader, Layla N.、Parry-Langdon, Nina、Smith, R. J. William(2000)。Survey of Attitudes of Pregnant Women towards Down Syndrome Screening。Prenatal Diagnosis，20(1)，23-29。  new window
12.Anderson, G. W.(1999)。Nondirectiveness in Prenatal Genetics: Patients Read between the Line。Nursing Ethics，6(2)，126-136。  new window
13.Bartels, Dianne M.、LeRoy, Bonnie S.、McCarthy, Patricia、Caplan, Arthur L.(1997)。Nondirectiveness in Genetic Counseling: A Survey of Practitioners。American Journal of Medical Genetics，72(2)，172-179。  new window
14.Bernhardt, Barbara A.、Biesecker, Barbara B.、Mastromarino, Carrie L.(2000)。Goals, Benefits, and Outcomes of Genetic Counseling: Client and Genetic Counselor Assessment。American Journal of Medical Genetics，94(3)，187-197。  new window
15.Biesecker, Barbara Bowles(2003)。Back to the Future of Genetic Counseling: Commentary on "Psychosocial Genetic Counseling in the Post-nondirective Era"。Journal of Genetic Counseling，12(3)，213-217。  new window
16.Bosco, Amy Foster(2000)。Caring for the Care-giver: The Benefit of a Peer Supervision Group。Journal of Genetic Counseling，9(5)，425-430。  new window
17.Earley, Kenna J.、Blanco, Jorge D.、Prien, Sam、Willis, Donald(1991)。Patient Attitudes toward Testing for Maternal Serum Alphafetoprotein Values When Results Are False-positive or True-negative。Southern Medical Journal，84(4)，439-442。  new window
18.Edwards, Steven(2002)。Philosophy of Disablement。Nursing Philosophy，3(2)，182-183。  new window
19.Evans, M. I.、Bottoms, S. F.、Carlucci, T.、Grant, J.、Belsky, R. L.、Solyom, A. E.、Quigg, M. H.、Laferla, J. J(1988)。Determinants of Altered Anxiety after Abnormal Maternal Serum Alpha-fetoprotein Screening。American Journal of Obstetrics & Gynecology，159(6)，1501-1504。  new window
20.Giarelli, Ellen(2003)。Safeguarding Being: A Bioethical Principle for Genetic Nursing Care。Nursing Ethics，10(3)，255-325。  new window
21.Green, D.、Malin, J.(1988)。Prenatal Diagnosis: When Reality Shatters Parents' Dreams。Nursing，18(2)，61-64。  new window
22.Butler, William J.、Keenan, Kathy L.、Basso, Deborah、Goldkrand, John(1991)。Low Level of Maternal Serum Alpha-fetoprotein: Its Associated Anxiety and the Effects of Genetic Counseling。American Journal of Obstetrics and Gynecology，164(1)，54-56。  new window
23.Marteau, Theresa M.、Cook, Rachel、Kidd, Jane、Michie, Susan、Johnston, Marie、Slack, Joan、Shaw, Robert W.(1992)。The Psychological Effects of False-positive Results in Prenatal Screening for Fetal Abnormality: A Prospective Study。Prenatal Diagnosis，12(3)，205-214。  new window
24.McAllister, Marion(2001)。Grounded Theory in Genetic Counseling Research。Journal of Genetic Counseling，10(3)，233-250。  new window
25.McConkie-Rosell, A.、Sullivan, J. A.(1999)。Genetic Counseling-stress, Coping, and the Empowerment Perspective。Journal of Genetic Counseling，8，345-357。  new window
26.Newell, Christopher(2000)。Biomedicine, Genetics and Disability: Reflections on Nursing and a Philosophy of Holism。Nursing Ethics，7(3)，227-237。  new window
27.Petersen, Alan(1999)。Counselling the Genetically "at Risk": The Poetics and Politics of "Nondirectiveness"。Health, Risk & Society，1(3)，253-265。  new window
28.Plunkett, Katie S.、Simpson, Joe Leigh(2002)。A General Approach to Genetic Counseling。Obstetric Gynecology Clinic North America，29(2)，265-276。  new window
29.Pueschel, S. M.(1987)。Maternal Alpha-Fetoprotein Screening for Down's Syndrome。New England Journal of Medicine，317(6)，376-378。  new window
30.Smith, Deana K.、Shaw, Robert W.、Marteau, Theresa M.(1994)。Informed Consent to Undergo Serum Screening for Down's Syndrome: The Gap between Policy and Practice。British Medical Journal，309，776-776。  new window
31.Becker, H. S.、Nield, M.、Tak, S. H.(1999)。Use of a Computer Software Program for Qualitative Analysis-part I: Introduction to Nudist。Western Journal of Nursing Research，21，111-117。  new window
32.Tercyak, Kenneth P.、Johnson, Suzanne Bennett、Roberts, Shearon F.、Cruz, Amelia C.(2001)。Psychological Response to Prenatal Genetic Counseling and Amniocentesis。Patient Education and Counseling，43(1)，73-84。  new window
33.Weil, Jon(2003)。Psychosocial Genetic Counseling in the Post-nondirective Era: A Point of View。Journal of Genetic Counseling，12(3)，199-211。  new window
34.Weinans, M. J. N.、Huijssoon, A. M. G.、Tijmstra, T.、Gerrits, M. C. F.、Beekhuis, J. R.、Mantingh, A.(2000)。How Women Deal with the Results of Serum Screening for Down Syndrome in the Second Trimester of Pregnancy。Prenatal Diagnosis，20(9)，705-708。  new window
35.Wertz, Dorothy C.、Fletcher, John C.、Mulvihill, John J.(1990)。Medical Geneticists Confront Ethical Dilemmas: Cross-cultural Comparisons Among 18 Nations。American Journal of Human Genetics，46(6)，1200-1213。  new window
研究報告
1.陳麗美(1997)。臺灣地區嬰兒死亡率、新生兒死亡率、週產期死亡率之流行病學調查研究。臺北。  延伸查詢new window
學位論文
1.郭義興(2003)。台灣母血唐氏症篩檢對唐氏症出生趨勢之影響(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.BUCHANAN, ALLEN, BROCK, DAN W., DANIELS, NORMAN、WIKLER, DANIEL(2000)。From Chance to Choice: Genetics and Justice。Cambridge, UK：Cambridge University Press。  new window
2.Richards, Lyn(1999)。Using NVivo in Qualitative Research。California：Sage Publications, Inc.。  new window
3.Rogers, C.(1983)。Freedom to Learn: A View of What Education Might Become。Columbus：Charles Merrill publishing。  new window
4.Rogers, Carl Ransom、宋文里(1990)。成為一個人：一個治療者對心理治療的觀點。臺北：桂冠。  延伸查詢new window
5.臺北市婦幼綜合醫院、臺北市政府衛生局(2002)。幸福婚姻智典：新婚優生保健手冊。幸福婚姻智典：新婚優生保健手冊。臺北市。  延伸查詢new window
6.Angrosino, M. V.、De Perez, Kimberly A. Mays(2000)。Rethinking Observation: From Method to Contex。Handbook of Qualitative Research。London, UK。  new window
7.Benkendorf, J. L.、Peshkin, B. N.、Lerman, C.(2000)。Impact of Genetic Information and Genetic Counseling on Public Health。Genetics and Public Health in the 21st Century。New York, NY。  new window
8.Dodds, S.(2002)。Choice and Control in Feminist Bioethics。Relational Autonomy。New York, NY。  new window
9.Jennings, Bruce(2000)。Technology and the Genetic Imaginary: Prenatal Testing and the Construction of Disability。Prenatal Testing and Disability Rights。Washington, DC。  new window
10.Kessler, Seymour(2000)。Psyche and Helix: Psychological Aspects of Genetic Counseling。Psyche and Helix: Psychological Aspects of Genetic Counseling。Toronto, Canada。  new window
11.McKinlay, John B.(1982)。From "Promisimg Report" to "Standard Procedure": Seven Stages in the Career of a Medical Innovation。Technology and the Future of Health Care, Vols. 8。Cambridge, MA。  new window
12.Meyers, Diana Tietjens(2000)。Intersectional Identity and the Authentic Self: Opposites Attract!。Relational Autonomy : Feminist Perspectives on Automony, Agency, and the Social Self。New York, NY。  new window
13.Parens, Erik、Asch, Adrienne(2000)。The Disability Rights Critique of Prenatal Genetic Testing: Reflections and Recommendations。Prenatal Testing and Disability Rights。Washington, DC。  new window
14.Press, Nancy、Clayton, Ellen Wright(2000)。Genetics and Public Health: Informed Consent Beyond the Clinical Encounter。Genetics and Public Health in the 21st Century。New York, NY。  new window
15.Ruddick, William(2000)。Ways to Limit Prenatal Testing。Prenatal Testing and Disability Rights。Washington, DC。  new window
16.Zaner, Richard M.(2003)。Ethics and the Clinical Encounter。Ethics and the Clinical Encounter。Ohio。  new window
圖書論文
1.顧忠華(200712)。風險、社會與倫理。第二現代--風險社會的出路？。台北：巨流。new window  延伸查詢new window
2.孫治本(2001)。風險抉擇與形而上倫理學。第二現代：風險社會的出路？。臺北：巨流。new window  延伸查詢new window
3.Ryan, Gery W.、Bernard, H. Russell(2000)。Data Management and Analysis Methods。Handbook of Qualitative Research。Sage Publications。  new window
4.Weitzman, E. A.(2000)。Software and qualitative research。Handbook of qualitative research。Sage。  new window
5.周桂田(2001)。科學風險 : 多元共識之風險建構。第二現代 : 風險社會的出路?。臺北：巨流。new window  延伸查詢new window
6.Charmaz, Kathy(2000)。Grounded theory: Objectivist and constructivist methods。Handbook of qualitative research。Sage。  new window
 
 
 
 
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