Abstract
We surveyed the approaches of 661 geneticists in 18 nations to 14 clinical cases and asked them to give their ethical reasons for choosing these approaches. Patient autonomy was the dominant value in clinical decision-making, with 59% of responses, followed by non-maleficence (20%), beneficence (11%) and justice (5%). In all, 39% described the consequences of their actions, 26% mentioned conflicts of interest between different parties and 72% placed patient welfare above the welfare of others. The U.S., Canada, Sweden, and U.K. led in responses favoring autonomy. There were substantial international differences in moral reasoning. Gender differences in responses reflected women's greater attention to relationships and supported feminist ethical theories.
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Fletcher JC, Berg K, Tranøy KE. Ethical aspects of medical genetics. Clin Genet 1985;27:199–205.
Wertz DC, Fletcher JC. Ethics and medical genetics in the United States: a national survey. Am J Med Genet 1988;29:815–27.
Wertz DC, Fletcher JC. Attitudes of genetic counselors: a multi-national survey. Am J Hum Genet 1988;42:592–600.
Wertz DC, Fletcher JC. Ethical problems in prenatal diagnosis: a cross-cultural survey of medical geneticists in 18 nations. Prenat Diagn 1989;9:145–57.
Wertz DC, Fletcher JC. An international survey of attitudes of medical geneticists toward mass screening and access to results. Publ Health Rep 1989;104:35–44.
Wertz DC, Fletcher JC. Fatal knowledge? Prenatal diagnosis for sex selection. Hastings Cent Rep (in press).
Wertz DC, Fletcher JC. Ethics and Human Genetics: A Cross-cultural Perspective. Heidelberg: Springer-Verlag, 1989.
Fletcher JC, Wertz DC, Sorenson JR, Berg K. Ethics and human genetics: a cross-cultural study in 17 nations. In: Vogel F, Sperling K, eds. Human Genetics. Heidelberg: Springer-Verlag, 1987:655–72.
Wertz DC, Fletcher JC. Communicating genetic risks. Science, Technology, and Human Values. 1987;12(3/4):60–6.
Fletcher JC, Wertz DC. Ethical aspects of prenatal diagnosis: views of U.S. medical geneticists. In: Silber TF, ed. Clinics in Perinatology, Vol 14, No 2. Philadelphia: WB Saunders, 1987:293–312.
Fletcher JC, Wertz DC. Ethics and human genetics: a cross-cultural perspective. In: Subramanian S, McCullough LB, eds. Seminars in Perinatology, Vol 11, No 3. Emerging Problems in Perinatal and Neonatal Ethics. Orlando, FL: Grune & Stratton, 1987:224–8.
Fletcher JC, van Eyes J, Dorn LD. Ethical considerations in pediatric oncology. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology, Philadelphia: JB Lippincott, 1989:309–20.
Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 3rd ed. New York: Oxford University Press, 1989.
Engelhardt HT Jr. The Foundations of Bioethics. New York: Oxford University Press, 1986.
Gilligan C. In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press, 1982.
Czeizel A, Metriki J, Osztrovics M. Evaluation of information-guidance counseling. J Med Genet 1981;8:91–8.
Heitlinger A. Reproduction, Medicine, and the Socialist State. New York: St. Martin's Press, 1987.
Light DW, Schuller O. Political Values and Health Care: The German Experience. Cambridge, MA: MIT Press, 1986.
Overall C. Ethics and Human Reproduction: A Feminist Analysis. Boston: Allen and Unwin, 1987.
Sherwin S. A feminist approach to ethics. Dalhousie Review 1987;64:704–13.
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Wertz, D.C., Fletcher, J.C. Moral reasoning among medical geneticists in eighteen nations. Theor Med Bioeth 10, 123–138 (1989). https://doi.org/10.1007/BF00539878
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DOI: https://doi.org/10.1007/BF00539878