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Éthique et anomalies de développement génitosexuel

Ethics and disorders of sexual development

  • Mise Au Point / Update
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Revue de médecine périnatale

Résumé

La prise en charge clinique des anomalies du développement génitosexuel a évolué récemment en relation avec les progrès du suivi médical et les enjeux de nouvelles valeurs sociales. Cet article présente le rôle de plusieurs principes éthiques (neutralité intertemporelle, évitement de malfaisance, rôle du bien de la vie sexuelle, droit à l’avenir ouvert et importance de la justice morale). Il montre que la spécialisation exige un regroupement dans des centres qualifiés adaptés, et l’importance des délibérations participatives et pluridisciplinaires pour appliquer ces principes. Des exemples d’application sont indiqués pour la période anténatale ainsi que pour l’assignation de genre sexe et pour les indications chirurgicales en pédiatrie. Les modalités de décisions en cas d’incertitude complète sont aussi rappelées.

Abstract

The clinical management of children with disorders of sexual development has shown a recent evolution due to the improvement of clinical follow-up and to the pressure of new social values. This paper discusses the role of many ethical principles (intertemporal neutrality, avoidance of maleficence, promotion of future better sexual life, the right to open future and the importance of moral justice). It shows that the treatment of these rare and complex problems must be dealt in a few specialized medical centers and that a shared medical decision must be provided with a multidisciplinary approach. Some examples of application of the ethical principles are provided for three situations: the antenatal period, the attribution of sexual gender and the indications of surgical treatments. The rules of decisions in strict uncertainty are also mentioned.

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  1. Hôpital femme-mère-enfant, 59 boulevard Pinel, F-69677, Lyon cedex, France

    L. Sann

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Sann, L., Et le Conseil d’éthique de l’hôpital Femme-Mère Enfant. Éthique et anomalies de développement génitosexuel. Rev. med. perinat. 7, 179–186 (2015). https://doi.org/10.1007/s12611-015-0328-6

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  • DOI: https://doi.org/10.1007/s12611-015-0328-6

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