博碩士論文 101184005 詳細資訊




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姓名 黃柏青(Po-Ching Huang)  查詢紙本館藏   畢業系所 哲學研究所
論文名稱 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)
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摘要(中) 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。
摘要(英) 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.
關鍵字(中) ★ 唐氏症
★ 人工流產
★ 關懷倫理
★ 關係自主
★ 遺傳諮詢
關鍵字(英) ★ Down syndrome
★ artificial abortion
★ ethics of care
★ relational autonomy
★ genetic counseling
論文目次 中文摘要 i
英文摘要 ii
目錄 iii
導論 1
第一章 面臨的問題 8
第一節 唐氏症簡介 8
第二節 產前胎兒唐氏症篩檢的相關考量 11
第三節 胎兒唐氏症施行人工流產的倫理爭議 14
第二章 西方主流觀點 23
第一節 保守派的觀點 24
第二節 自由派的觀點 31
第三節 非同一問題的困擾 38
第三章 基本倫理學理論的觀點 45
第一節 效益主義的觀點 46
第二節 康德倫理學的觀點 53
第四章 關懷倫理學的觀點 59
第一節 倫理學的另一種聲音 59
第二節 關懷倫理學理論的探討 67
第三節 與本論文主題相關之關懷倫理學觀點 85
第五章 關係自主的決策 95
第一節 對傳統自主概念的重構:關係自主 97
第二節 關係自主決策的實踐:家庭會議 106
第三節 胎兒唐氏症施行人工流產的臨床準則 114
結語 120
參考文獻 127
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三、專書論文
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陳瑤華,2003,〈完美的Baby?──胎兒基因篩檢的女性主義立場〉,輯於李瑞全、蔡篤堅(編),《基因治療與倫理、法律、社會意涵論文選集》(臺北市:唐山),頁93-133。
Beauchamp, T. L., 1997, “Informed consent”, in Medical Ethics, 2nd ed., edited by Robert M. Veatch, Sudbury, MA: Jones and Bartlett Publishers, pp. 185-208.
Brody, B., 1975, “Fetal Humanity and the Theory of Essentialism”, in Philosophy and Sex, edited by Robert Baker, and Frederick Elliston, Buffalo, NY: Prometheus Books, pp. 338-355.
Clarke, A., 1998, “Genetic counseling”, in Encyclopedia of Applied Ethics, edited by Ruth Chadwick, San Diego: Academic Press, pp. 391-405.
Collins, S., 2017, “Care Ethics: Four Key Claims”, in Moral Reasoning: A Text and Reader on Ethics and Contemporary Moral Issues, edited by David R. Morrow, New York: Oxford University Press, pp. 192-204.
Dodds, S., 2000, “Choice and Control in Feminist Bioethics,” in Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self, edited by Catriona Mackenzie, and Natalie Stoljar, New York: Oxford University Press, pp. 213-235.
Feinberg, J., 1980, “Abortion”, in Matters of Life and Death: New Introductory Essays in Moral Philosophy, edited by Tom Regan, Philadelphia: Temple University Press, pp. 183-217.
Lee, P., and George, R. P., 2014, “The Wrong of Abortion”, in Contemporary Debates in Applied Ethics, 2nd ed., edited by Andrew I. Cohen, and Christopher Heath Wellman, Malden, MA: Blackwell Publishing, pp. 37-50.
Little, M. O., 2014, “The Moral Permissibility of Abortion”, in Contemporary Debates in Applied Ethics, 2nd ed., edited by Andrew I. Cohen, and Christopher Heath Wellman, Malden, MA: Blackwell Publishing, pp. 51-62.
Manning, R. C., 2009, “A Care Approach”, in A Companion to Bioethics, 2nd ed., edited by Helga Kuhse, and Peter Singer, Malden, MA: Wiley‐Blackwell, pp. 105-116.
Noonan, J. T., Jr., 1984, “An Almost Absolute Value in History”, in The Problem of Abortion, 2nd ed., edited by Joel Feinberg, Belmont, CA: Wadsworth Publishing Company, pp. 9-14.
Ramsay, P., 1979, “The Morality of Abortion”, in Moral Problems: A Collection of Philosophical Essays, edited by James Rachels, New York: Harper & Row, pp. 11-13.
Regan, T., 2001, “Animal Rights, Human Wrongs”, in Environmental Philosophy: From Animal Rights to Radical Ecology, 3rd ed., edited by Michael E. Zimmerman, J. Baird Callicott, George Sessions, Karen J. Warren, and John Clark, New Jersey: Prentice-Hall, pp. 41-53.
Singer, P., 2001, “All Animals Are Equal”, in Environmental Philosophy: From Animal Rights to Radical Ecology, 3rd ed., edited by Michael E. Zimmerman, J. Baird Callicott, George Sessions, Karen J. Warren, and John Clark, New Jersey: Prentice-Hall, pp. 26-40.
Sumner, L. W., 1994, “A Defense of the Moderate Position”, in The Abortion Controversy: A Reader, edited by Louis P. Pojman, and Francis J. Beckwith, London: Jones and Bartlett Publishers, pp. 279-294.
Williams, B., 1973, “A Critique of Utilitarianism”, in Utilitarianism: For and Against, edited by J. J. C. Smart, and Bernard Williams, Cambridge: Cambridge University Press, pp. 75-150.
Willis, E., 1992, “Abortion: Is a Woman a Person?” in Feminist Philosophies: Problems, Theories, and Applications, edited by Janet A. Kourany, James P. Sterba, and Rosemarie Tong , New Jersey: Prentice-Hall, pp. 83-86.

四、網路資料
Gansberg, M., 1964, “37 Who Saw Murder Didn′t Call the Police”, The New York Times Website, URL=http://www.nytimes.com/1964/03/27/37-who-saw- murder-didnt-call-the-police.html(2018/4/27瀏覽).
Stoljar, N., 2013, “Feminist Perspectives on Autonomy”, Stanford Encyclopedia of Philosophy, URL=https://stanford.library.sydney.edu.au/archives/fall2013/ entries/feminism-autonomy(2018/11/1瀏覽).

五、學位論文
石致華(研撰),李瑞全(指導),2011/06,《諾丁關懷倫理學的道德理論研究》(中壢:國立中央大學文學院哲學研究所博士論文)。
指導教授 李凱恩 審核日期 2019-1-7
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