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題名:基因干預之公平性探討:從羅爾斯到丹尼爾斯
作者:林耕漢
作者(外文):Kenghan Lin
校院名稱:國立中央大學
系所名稱:哲學研究所
指導教授:李瑞全
學位類別:博士
出版日期:2012
主題關鍵詞:健康照護正義基因增強基因治療丹尼爾斯羅爾斯Norman Danielsgene therapygenetic enhancementhealth carejusticeJohn Rawls
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摘要
本文旨在探討,當基因科技在將來能夠實際應用於醫療層面上,它作為一項醫療的資源應該如何分配才是公平的。這項探討之所以需要,是因為基因科技應用在醫療上,能夠分成以治癒疾病為目的之治療和以提升正常能力為目的之增強二種。基因治療涉及到治癒天生缺陷或是疾病,而基因增強則是一種干預自然天賦的科技。本文主張,個人應該擁有基因治療的權利;並且,在現今,基因增強的權利尚不能被賦予。因此,本文的兩項論證目標在於,為個人擁有基因治療的權利提供證成;以及,個人要求基因干預的權利,尚不能擴展到基因增強上。在論證上,本文試圖說明,從有效地維持社會公平性的觀點來看,公民沒有要求基因增強的權利,不論是從公共資源或是私人財富支出皆然。然而,正義的社會基於公平的考量,亦不會放任自然天賦的差異對個人生活前景所造成的不平等影響。只是在方法上,並非是透過基因增強讓每個人的能力趨近,而是透過差異原則對社會結構進行調整。
而要說明個人所擁有的基因干預的權利僅限於以治療為目的之醫療行為上,本文試圖透過對公民的健康照護權利的相關說明來達成。更為細部的是,說明基因治療的權利應屬於公民的健康照護權利之一;而基因增強則不是國家或是社會有義務提供的健康照護項目,亦即,公民沒有要求基因增強的權利。這項權利擴及二個層面,一是國家沒有義務從公共資源提供基因增強;另一則是個人也不允許從私人財富獲取此項醫療服務,它不應該向自由市場開放,個人不被干預的自由項目不應包含此項。在理論應用上,論述最主要是以羅爾斯的正義原則以及丹尼爾斯關於健康照護權利的相關論點為核心展開。
Abstract
This dissertation project aims to explore, being as a medical resource, how gene technology makes distribution equalably when it becomes a medical application. It is noteworthy that the medical application of gene technology can be categorized as therapy and enhancement. The purpose of the the therapy is to deal with birth defects or diseases. And the enhancement, which aims to improve body function, actually violates human nature. Therefore, this project is going to claimss that individuals have the to gene therapy, but not the right to enhancement. In other words, the right to genetic enhancement still cantnot recognized at present. This project firstly intends to justify that individuals have the right to gene therapy, and then clarifies that the right to gene intervention still can not be applied to the the genetic enhancement. In terms of social equality, this project attempts to argue that citizens have no right to ask for access to enhancement procedures, at the expense of either public resources or private property. However, according to the principle of equality, a just society cannot ignore the influences caused by differential human gift upon the life-prospect. It should be noticed that, a just society has to regulate its basic structure on the basis of the difference pricciple rather than provide equal access through genetic enhancement.
In order to confine the right to gene intervention to medical curing, this project shall scrutinize the health care services for citizens and to make a clear statement that the right to gene therapy should be identified as a part of the health care services. It is not obligate for either a country or a society to make genetic enhancement as one part of health care services. Namely, citizens cannot request the right to genetic enhancement. About the rights of citizens, there are two concerns raised. First, a country has no duty to provide genetic enhancement as a public resource. Second, individuals are not allowed to gain enhancement procedures at the expense of private property. Genetic enhancement should not be opened up for free market, and it also needs not to take account of individual freedom. This disseration project would like to adpot John Rawls’s principles of justice and Norman Daniels’s rights to just health care to be the main argument.
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