產、兒科醫護人員對遺傳諮詢倫理議題之質性研究

目的：本研究主要在探討基因科技發展對產、兒科醫護人員所產生之倫理衝擊。材料與方法：採質性研究法深度訪談十位在產、兒科工作之醫師、護理師及遺傳諮詢員，以瞭解「產前診斷使用」、「遺傳訊息告知」、「醫療執行過程倫理衝擊」、「遺傳諮詢上的困境」、「諮詢常見的問題」、「如何增進醫護人員的諮詢能力」等議題。結果：在醫護人員工作職場上較常見之倫理衝擊以「墮胎」、「對母親之責怪」較多見；而諮詢上的困境以「支持系統缺乏」、「知識有待增強」、「溝通技巧」為多；諮詢上常見的問題則以「會不會遺傳」、「後續照顧問題」為主；而在如何增進醫護人員的諮詢能力的部分，則以「動機」、「經驗累積」為最主要考量。結論：基因科技發展對產、兒科醫護人員之衝擊，如「生存權」、「家庭內衝突」、「社會支持系統建立」、「醫護人員動機培養」等，都使醫護人員將面臨重大考驗。

關鍵字

基因科技；遺傳諮詢；醫護人員；倫理困境

並列摘要

Objective: The goal of our study was to investigate the ethical impacts of genetic technology development on medical staff of the obstetrics and pediatric departments. Materials and Methods: There were 6 topics in our interviews: 'prenatal diagnostic testing', 'being informed about genetic diseases', 'ethical impacts on medical treatment processes', 'implications of genetic counseling', 'common questions in genetic counseling', and 'ways to improve genetic counseling skills of medical staff'. There were 10 medical staff members of the obstetrics and pediatric departments, including physicians, nurses, and genetic counselors, who participated in these in-depth interviews. Results: There were 4 important findings in this study. First, the common ethical dilemmas were about having an abortion and blaming the mothers. Second, genetic counselors were in need of support systems, knowledge, and communication skills. Third, common questions asked in genetic counseling were centered on heredity and how to take care of a child with a genetic disorder. Finally, the most important skills of genetic counselors were considered to be motivation and experience accumulation. Conclusions: The technology of genetic developments will inevitably force medical staff to think more about human rights, family implications, social support systems, and their own motivations in the future.

並列關鍵字

genetic technology ； genetic counseling ； medical staff ； ethical implications

被引用紀錄

郭淑雅（2008）。台灣結節性硬化症：臨床特徵與照顧者資訊需求〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2008.01750

朱紹盈、翁純瑩（2017）。遺傳／罕見疾病簡介與遺傳諮詢的運用。護理雜誌，64(5)，11-17。https://doi.org/10.6224/JN.000063

延伸閱讀

陳素珍、蘇本華、陳家玉、張靜儀、劉玲娟、汪正青（2008）。產兒科護理人員遺傳學在職教育之成效探討－前趨性研究。中山醫學雜誌，19(1)，85-98。https://doi.org/10.30096/CSMJ.200806.0007
蔣欣欣、喻永生、余玉眉（2005）。剖析產前遺傳檢測之諮詢與倫理議題。中華心理衛生學刊，18(1)，65-86。https://doi.org/10.30074/FJMH.200503_18(1).0003
全聯會國際事務工作小組（2020）。世界醫師會雷克雅維克宣言－醫療照護使用遺傳學的倫理考量。臺灣醫界，63(4)，65-67。https://www.airitilibrary.com/Article/Detail?DocID=17263603-202004-202004160021-202004160021-65-67
McGregor, J., Hager, W., Gibbs, R., Schmidt, L., & Schulkin, J. (1998). Assessment of Office-Based Care of Sexually Transmitted Diseases and Vaginitis and Antibiotic Decision-Making by Obstetrician-Gynecologists. Infectious Diseases in Obstetrics and Gynecology, 1998(), 247-251. https://doi.org/10.1155/S1064744998000519
Dunst, C. J., & Trivette, C. M. (2009). Meta-Analytic Structural Equation Modeling of the Influences of Family-Centered Care on Parent and Child Psychological Health. International Journal of Pediatrics, 2009(), 94-102. https://doi.org/10.1155/2009/576840

國際替代計量

產、兒科醫護人員對遺傳諮詢倫理議題之質性研究

全文下載

主題瀏覽