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    题名: 胎兒唐氏症施行人工流產的倫理反省;Ethical Reflection in Aborting the Fetus with Down syndrome
    作者: 黃柏青;Huang, Po-Ching
    贡献者: 哲學研究所
    关键词: 唐氏症;人工流產;關懷倫理;關係自主;遺傳諮詢;Down syndrome;artificial abortion;ethics of care;relational autonomy;genetic counseling
    日期: 2019-01-07
    上传时间: 2019-04-02 14:35:13 (UTC+8)
    出版者: 國立中央大學
    摘要: 產前唐氏症篩檢可能涉及複雜的後續處置決定,特別是人工流產的爭議,西方當代倫理學界大致上可分成保守派與自由派兩大立場,兩者都是從「胎兒的生命權」與「孕婦的身體自主權」相互衝突的角度來分析人工流產的問題,而忽略了需考慮實際的情境及孕婦與胎兒之間的關係;因此最終還是落入孕婦與胎兒雙方權利義務的協調分配,而無法妥善處理「胎兒唐氏症施行人工流產」的倫理爭議。此外,繼續或終止懷孕的選擇還可能陷入Derek Parfit所提出之「非同一問題」的困擾,使得原本已成僵局的爭議更形複雜難解。
    由於保守派、自由派及Parfit的觀點對「胎兒唐氏症施行人工流產」的問題可能產生不同的道德判斷與道德衝突,為求對此複雜困難的議題作一更根本的消解,我們有必要回歸到最根源的基本倫理學理論:效益主義與康德倫理學進行探討。然而,無論是效益主義或康德倫理學,其思維仍是從傳統的權利觀點分析胎兒生命權與孕婦身體自主權的衝突,忽略了母胎之間具有密不可分的關係,並非兩獨立不相干的個體。女性的經驗與關懷倫理學的立場可提供我們一種新的方式去看待、理解「人工流產」這個問題,轉向以孕婦與胎兒的親密關係來看待人工流產的爭議,對「胎兒唐氏症施行人工流產」的問題或許能指出一條不同於西方主流觀點的思考方向。本論文將闡明關懷倫理學回應此倫理爭議的優勢,最後再藉由對此問題的倫理反省,提出一組以「關係自主」概念為基礎的臨床準則,協助我們做出適當的生育決策。;When the fetus has Down syndrome, the pregnant woman would face the problem of artificial abortion. However, artificial abortion is a difficult moral issue in bioethics. There are two traditional approaches which both analyze the controversy from rights in this topic, namely the conservative and the liberal position. In addition, “non-identity problem” also disturbs our common belief and threatens the genetic health policy. These approaches all take the mother and the fetus as separate individuals, and thus neglect the intimate relationship between them. This essay indicates principlism cannot provide a satisfying solution to the moral dilemma of artificial abortion, even would produce different moral judgments and conflicts; therefore, we have to investigate the issue from basic moral theories such as utilitarianism, Kantism, and ethics of care. Ethics of care is a different voice from the traditional main moral theories and tries to take a new approach which focuses on the relationship between the mother and the fetus instead of the rights approach in the reflection of the issue. This essay will clarify the advantage of care ethics in responding the issue, and try to offer a clinical guideline based on “relational autonomy”. It is hoped that the guideline can help us make an appropriate decision and provide an important reference for the clinical practice.
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