Skip to main content
Log in

Moral reasoning among medical geneticists in eighteen nations

  • Published:
Theoretical Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fletcher JC, Berg K, Tranøy KE. Ethical aspects of medical genetics. Clin Genet 1985;27:199–205.

    Google Scholar 

  2. Wertz DC, Fletcher JC. Ethics and medical genetics in the United States: a national survey. Am J Med Genet 1988;29:815–27.

    Google Scholar 

  3. Wertz DC, Fletcher JC. Attitudes of genetic counselors: a multi-national survey. Am J Hum Genet 1988;42:592–600.

    Google Scholar 

  4. 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.

    Google Scholar 

  5. 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.

    Google Scholar 

  6. Wertz DC, Fletcher JC. Fatal knowledge? Prenatal diagnosis for sex selection. Hastings Cent Rep (in press).

  7. Wertz DC, Fletcher JC. Ethics and Human Genetics: A Cross-cultural Perspective. Heidelberg: Springer-Verlag, 1989.

    Google Scholar 

  8. 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.

    Google Scholar 

  9. Wertz DC, Fletcher JC. Communicating genetic risks. Science, Technology, and Human Values. 1987;12(3/4):60–6.

    Google Scholar 

  10. 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.

    Google Scholar 

  11. 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.

    Google Scholar 

  12. 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.

    Google Scholar 

  13. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 3rd ed. New York: Oxford University Press, 1989.

    Google Scholar 

  14. Engelhardt HT Jr. The Foundations of Bioethics. New York: Oxford University Press, 1986.

    Google Scholar 

  15. Gilligan C. In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press, 1982.

    Google Scholar 

  16. Czeizel A, Metriki J, Osztrovics M. Evaluation of information-guidance counseling. J Med Genet 1981;8:91–8.

    Google Scholar 

  17. Heitlinger A. Reproduction, Medicine, and the Socialist State. New York: St. Martin's Press, 1987.

    Google Scholar 

  18. Light DW, Schuller O. Political Values and Health Care: The German Experience. Cambridge, MA: MIT Press, 1986.

    Google Scholar 

  19. Overall C. Ethics and Human Reproduction: A Feminist Analysis. Boston: Allen and Unwin, 1987.

    Google Scholar 

  20. Sherwin S. A feminist approach to ethics. Dalhousie Review 1987;64:704–13.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00539878

Key words

Navigation