DNA親子鑑定的倫理與法律議題

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Graduate Institute of Molecular Medicine College of Medicine

National Taiwan University Master Thesis

DNA

The Ethical and Legal Issues in DNA Parentage Testing

Po-Ching Huang

Li-Hui Tseng

Jehn-Hsiahn Yang Hsuan-Ju Chiu

June, 2011

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1985 Alec Jefferys DNA

DNA

DNA DNA

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Abstract

Parentage testing determines whether two individuals have a biological parent-child relationship. British geneticist Alec Jeffreys developed the technique of DNA fingerprinting used for human identification in 1985. With the advance of techniques in molecular biology, rapid, sensitive, and reliable DNA testing has become available.

The most advanced and accurate method for parentage testing is using polymerase chain reaction (PCR) to analyze short tandem repeats (STRs) polymorphism.

In the human genome, there are some repetitive and short DNA fragments called short tandem repeats (STRs), which have the characteristic of length polymorphism.

Through polymerase chain reaction, a sufficient amount of products can be generated by repeating the specific DNA fragments. By identifying the variations in the number of STRs, the relationships between samples can be confirmed.

This thesis provides a brief review of DNA parentage testing and introduces ethical/

legal issues in clinical practice. DNA parentage testing may have psychosocial impacts on tested individuals and their family members. Therefore, four major topics including respect for autonomy and privacy, substitute decision-making, investigations of parent-child relationship and related legal problems are discussed.

Ethical and legal reflections on the current situation and on future practice are also put forward at the same time.

Key words: parentage testing, polymerase chain reaction (PCR), short tandem repeats (STRs), ethical and legal issues

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(parentage testing)

(paternity testing) (maternity testing)

[1]

(7)

DNA

1935 ABO ABO

[2]1976 (human leukocyte antigen, HLA) HLA

HLA

HLA ^[3]

1985 Alec Jefferys DNA

DNA

DNA (polymorphism) DNA

(point-polymorphism) (single nucleotide

polymorphism, SNP) (length-polymorphism)

(variable number tandem repeat, VNTR)

(short tandem repeat, STR) (polymerase

chain reaction, PCR) DNA STR

[4,5]

DNA deoxyribonucleic acid

1953 James Watson Francis Crick DNA

DNA (nucleotide)

DNA

(adenine) (guanine) (thymine) (cytosine)

A G T C DNA(genomic DNA)

A T G C

30 mRNA DNA(coding DNA) 1~3%

DNA genomic DNA 97%

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DNA(repetitive DNA) 30%

DNA (tandem repetitive DNA) DNA (interspersed repetitive

DNA) DNA (short tandem repeat, STR)

[5-7]

STR DNA

DNA

STR (polymorphism)

STR

PCR

PCR DNA STR ^[5-7]

DNA

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DNA

DNA DNA

[8]

DNA

DNA PCR

DNA

STR

X Y

(paternity index, PI) PI = X/Y

(probability of paternity, PP) PP = X/(X + Y) = PI/(PI +1) STR

(cumulated paternity index, CPI) PI (cumulated probability of paternity, CPP) CPI / (CPI + 1)

99%

99.9% 99.99% ^[9]

(incompatible or mismatch)

DNA

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3~6 ^[10] HLA ^[5]

DNA (sequencing) DNA

(hypervariable region, displacement

loop, D-loop) Y (Y chromosome short

tandem repeat, Y-STR) DNA

DNA

DNA DNA

Y (cross-over)

Y Y DNA

[11,12]

(11)

DNA

DNA ^[13,14]

DNA

12 17

(12)

DNA

60~125

[15]

(13)

DNA

(Taiwan Accreditation Foundation, TAF) ISO 15189 DNA

American Association of Blood Banks (AAAB) “Standards for Relationship Testing Laboratories”

[16-17]

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ethics ethike ethos

(utilitarianism) (deontologism) (virtue theory)

(duty)

(truthfulness) (confidentiality) (informed consent)

[18]

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DNA

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DNA

(17)

(autonomy)

(disclosure) (capacity) (voluntariness)

(force) (coercion)

(manipulation)

[19]

(18)

94 9 28 603

99 5 26 2

DNA DNA

DNA ^[20]

[21]

(19)

DNA

[22,23]

DNA

82 2

184 2

184

2

[24]

DNA

(20)

(21)

63

(22)

7

^[25]

DNA

12~15

(23)

DNA

[26]

12 13

76 77

78

(24)

79

1086

DNA

77 79

DNA

93 12 30 587

1989

12 1

77

[27,28]

(25)

DNA

1086

1094

DNA

(26)

14 1

15

1110 1098

1113

(27)

15 1

14 3

14 4

( )

1113 1 1

15 2 1

(28)

15 2 4

( )

15 2 2

78 83

DNA

(29)

DNA

99%

1061 1062

1063 1

1064 1065

(30)

[29]

1063

(31)

214

80

( )

[30]

DNA

(32)

6

1059

DNA

(33)

DNA 1138

1139

DNA

96 5 23

1067

1065 1

1069

(34)

983

DNA

(35)

8

……

8 2 DNA

DNA

(36)

DNA

96 3 21

15 1

23

24

25

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(02)2314-6871 http://www.moj.gov.tw

(04)2250-2850 http://www.cbi.gov.tw

0800-088-885 http://iff.immigration.gov.tw

(02)6632-8282 http://www.laf.org.tw 0800-889-969 http://www.law885995.com

(02)8911-8595 http://www.goh.org.tw

1999 1999

1999

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[31]

DNA

( )

DNA

(39)

DNA DNA

[32]

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