為何我們應該摒棄知情同意器官勸募政策？--「弱家屬參與式強制抉擇」的道德優先性_

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題名：	為何我們應該摒棄知情同意器官勸募政策？--「弱家屬參與式強制抉擇」的道德優先性
書刊名：	政治與社會哲學評論
作者：	陳振業／蔡甫昌
作者(外文)：	Chan, Chan-ip／Tsai, Daniel Fu-chang
出版日期：	2010
卷期：	32
頁次：	頁145-202
主題關鍵詞：	醫學倫理；器官移植倫理；器官捐贈；器官勸募政策；知情同意；推定同意；強制抉擇；Medical ethics；Organ transplantation ethics；Organ donation；Organ procurement policy；Informed consent；Presumed consent；Mandated choice
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:3 共同引用:0 點閱:72

移植器官短缺是世界各國共同面臨的難題，為了增加器官來源，許多國家檢討知情同意器官勸募政策，並改採推定同意或強制抉擇等政策。透過對不同器官勸募政策之研究，發展進而制訂能有效減少移植器官短缺之策略，乃是當前我國重要之醫療政策議題。本文介紹現今最重要的三類器官勸募政策，分別為知情同意、推定同意及強制抉擇，並以此三類政策為橫軸、以家屬參與決策的程度為縱軸，發展出九種政策選項，進而論證為何在同時考慮個體、家屬及國家三方之利益、並平衡效益和自主價值後，「弱家屬參與式強制抉擇」比起台灣目前採用之知情同意，更合乎倫理之要求，適合作為我國政策改進之選項。

以文找文

Many countries have suffered from severe transplant organ shortage, including Taiwan. Different organ procurement policies may result in different outcomes in harvesting transplantable organs. However, the effectiveness and moral justifiability of different organ procurement policies need to be examined carefully. This paper compares three policies including informed consent, presumed consent, and mandated choice by constructing an analytical framework with nine policy options. It is argued that after considering the interests of the three stakeholders (individual, family, and the state) and balancing the value of utility and respect for autonomy, weak mandated choice is the most ethically justifiable among the different options. It is also better than the current informed consent policy practiced in Taiwan.

以文找文

期刊論文
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4.	Klassen, A. C.、Klassen, D. K.(1996)。Who Are the Donors in Organ Donation? The Family’s Perspective in Mandated Choice。Annals of Internal Medicine，125(1)，70-73。
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6.	Shih, Fu-Jin Ming-Kuen Lai and Min-Heuy Lin et al.(2001)。“Impact of Cadaveric Organ Donation on Taiwanese Donor Families during the First 6 Months after Donation。Psychosomatic Medicine，63;1，69-78。
7.	Shih, Fu-Jin Ming-Kuen Lai and Min-Heuy Lin et al.(2001)。“The Dilemma of ‘To-Be or Not-to-Be’: Needs and Expectations of the Taiwanese Cadaveric Organ Donor Families during the Pre-Donation Transition。Social Science and Medicine，53;6，693-706。
8.	Siminoff, Laura A. and Mary B. Mercer(2001)。“Public Policy, Public Opinion, and Consent for Organ Donation,”。Cambridge Quarterly of Healthcare Ethics，10;4，377-386。
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10.	Spellman, Denise(2006)。“Encouragement is Not Enough: The Benefits of Instituting a Mandated Choice Organ Procurement System,”。Syracuse Law Review，56;2，353-381。
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36.	Cohen, Carl(1992)。“The Case for Presumed Consent to Transplant Human Organs after Death,”。Transplantation Proceedings，24;5，2168-2172。
37.	Downie, Jocelyn, Alison Shea and Chantelle Rajotte(2008)。“Family Override of Valid Donor Consent to Postmortem Donation: Issues in Law and Practice,”。Transplantation Proceedings，40;5，1255-1263。
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研究報告
1.	Fevrier, Philippe and Sebastien Gay(2004)。“Informed Consent versus Presumed Consent: The Role of the Family in Organ Donations,”。

圖書
1.	Dworkin, Ronald(1994)。Life’s Dominion: An Argument about Abortion, Euthanasia,and Individual Freedom。New York：Vintage。
2.	VEATCH, ROBERT M.(2000)。TRANSPLANTATION ETHICS。Washington, D.C.：Georgetown University Press。
3.	Caplan, Arthur L.(2008)。“Organ Transplantation,”。From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns。NY。
4.	Institute of Medicine U.S. Committee on Increasing Rates of Organ Donation(2006)。Organ Donation: Opportunities for Action。Washington, D.C。

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