Genome-wide association studies (GWAS) provide valuable information in research contexts regarding genomic changes that contribute to risks for complex psychiatric conditions like major depressive disorder. GWAS results can be used to calculate polygenic risk scores (PRS) for psychiatric conditions, such as bipolar disorder or schizophrenia, as well as for other traits, such as obesity or hypertension. Private companies that provide direct-to-consumer (DTC) genetic testing sometimes report PRS for a variety of traits. Recently, the first well-powered GWAS study for suicide death was published. PRS reports that claim to assess suicide risk are therefore likely to appear soon in the DTC setting. We describe ethical concerns regarding the commercial use of GWAS results related to suicide. We identify several issues that must be addressed before PRS for suicide risk is made available to the public through DTC: (a) the potential for misinterpretation of results, (b) consumers' perceptions about determinism and behavior change, (c) potential contributions to stigma, discrimination, and health disparities; and (d) ethical problems regarding the testing of children and vulnerable adults. Tests for genetic prediction of suicidality may eventually have clinical significance, but until then, the potential for individual and public harm significantly outweighs any potential benefit. Even if genetic prediction of suicidality improves significantly, information about genetic risk scores must be distributed cautiously, with genetic counseling, and with adequate safeguards.

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与自杀遗传风险评分相关的伦理问题


全基因组关联研究 (GWAS) 在研究背景下提供了有关基因组变化的宝贵信息，这些变化会导致严重抑郁症等复杂精神疾病的风险。 GWAS 结果可用于计算双相情感障碍或精神分裂症等精神疾病以及肥胖或高血压等其他特征的多基因风险评分 (PRS)。提供直接面向消费者 (DTC) 基因检测的私营公司有时会报告各种性状的 PRS。最近，第一个针对自杀死亡的强有力的 GWAS 研究发表了。因此，声称评估自杀风险的 PRS 报告可能很快就会出现在 DTC 环境中。我们描述了与自杀相关的 GWAS 结果的商业用途的伦理问题。我们确定了在通过 DTC 向公众提供针对自杀风险的 PRS 之前必须解决的几个问题：(a) 结果可能被误解，(b) 消费者对决定论和行为改变的看法，(c) 对自杀风险的潜在贡献耻辱、歧视和健康差异； (d) 有关儿童和弱势成年人检测的道德问题。对自杀倾向进行基因预测的测试最终可能具有临床意义，但在此之前，对个人和公共造成的潜在伤害远远超过任何潜在的益处。即使自杀倾向的基因预测显着改善，有关遗传风险评分的信息也必须在遗传咨询和充分的保障措施下谨慎分发。