产前性别选择:医学、伦理和心理方面

O. Kovalyova, D. Mykytenko
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引用次数: 0

摘要

本文致力于产前性别选择的方法及其实施的伦理方面。在对科学出版物进行分析的基础上,介绍了胚胎和胎儿着床前性别确定的主要技术。侵入性和非侵入性的产前诊断程序进行了描述。侵入性检查包括对羊膜穿刺术获得的细胞进行绒毛膜绒毛取样核型检查。非侵入性技术相关的孕妇血液生化,超声标记唐氏综合征给出。胎儿血液DNA检测是一个更敏感的诊断参数,减少了侵入性手术的适应症。精子分离筛查是目前最新最有效的着床前性别确定方法。产前性别确定的医疗和非医疗原因,如预防儿童的x连锁遗传疾病、夫妇为平衡家庭中儿童性别而作出的选择、社会性别偏好。预防x连锁疾病的性别选择是合理的。讨论了有关家庭子女平衡、在先进诊断技术的帮助下优先选择某一性别以及选择性堕胎的伦理问题。建立了预防因性别原因导致的选择性流产的生物伦理原则。审议了国际文件——《在生物学和医学应用方面保护人权和人的尊严公约》、《世界医学协会关于防止性别歧视的宣言》
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Prenatal gender selection: medical, ethical and psychological aspects
The article is devoted to the methodology of prenatal gender selection and ethical aspects of its implementation. Based on the analysis of scientific publications, the principal techniques to determine sex in pre-implantation period, in the embryo and fetus, are presented. Invasive and non-invasive procedures of prenatal diagnosis are descreibed. Invasive procedures include examination of the fetus by chorionic villus sampling karyotyping of cells obtained by amniocentesis. Non-invasive techniques related to pregnant women's blood biochemistry, ultrasound markers of the Down syndrome are given. Fetal blood DNA testing is a more sensitive diagnostic parameter that reduces the indication for invasive procedures. The newest most effective method of sex determination in pre-implantation period is sperm separation screening. Medical and non-medical reasons for prenatal gender determination such as prevention of X-linked genetic disorders in a child, a couple’s choice in order to balance sex of children in the family, social gender preferences are shown. Gender selection for the prevention of the X-linked disorders is justified. Ethical issues regarding to the balance of children in the family, giving preference to a certain sex with the help of advanced diagnostic techniques, and selective abortion are discussed. The bioethical principles for the prevention selective abortion resulted from the gender reasons are established. International documents – the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine, the Declaration of the World Medical Association regulating protection against sexual discrimination are considered
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审稿时长
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