What ethical justification can be found for informing a person that he or she will later develop a lethal disease for which no therapy is available? This question has been discussed during the past twenty years by specialists concerned with the prevention of Huntington's Disease, an incurable late-onset hereditary disorder. Many of them have played an active role in developing experimental testing programmes for at-risk persons. This paper is based on a corpus of 119 articles; it reviews the development of their reflection and includes an outline of the ethical problems identified and the solutions adopted in pre-clinical protocols. Seen in a broader perspective, the experience of presymptomatic testing for Huntington's Disease has given medical geneticists the opportunity to clarify their ethical position in the as yet little explored field of predictive medicine.
Gwen Terrenoire : La evolucion del consejo genético en los E.E.U.U. desde 1940 hasta 1980 : práctica y légitimatión.
Diéronse como misión, las primeras clínicas de consejo genético en los E.E.U.U., difundir acercá del público informes relativos a las enfermedades hereditarias y a su prevención. Eran los consejeros esencialmente investigadores universitarios que definían los objetivos de su práctica según unos principios que marcaban su oposición a la manera de concebir los eugenistas de principios de siglo, las relaciones entre la génetica y la sociedad. Se tradujo la medicalización del consejo genético en los años sesenta por una insistencia de la prevención individual. Pero el descubrimiento, a fines del mismo decenio, de técnicas de diagnóstico prenatal tuvo como consecuencia el pasar de nuevo al sector público de la salud el objetivo de prevención. Dicho objetivo tomaba a cargo una parje importante de las campañas de detección de las enfermedades hereditarias graves y costosas para la colectividad. Para el consejo génetico vuelve a ser planteada de nuevo la cuestión de una vuelta hacia comportamientos y prácticas represivas en materia de procreación humana.
OWEN TERRENOIRE The relationship between the elaboration of a professionnel ethic and the birth of a professional association is studied through the presentation of the creation of the first association of American geneticists. By proclaiming their opposition to the pro- eugenic tendency of earlier research, these scientists were led to elaborate a new ethic and organize their association. The key notion in this ethic was that of responsibility. However, the texts studied reveal how ambiguous this notion was.
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