生育健康的伦理学基础:个人本位还是社会本位

随着“以妇女为中心”生育健康概念的提出,女性的健康与他们在社会中享有权利的关系正引起人们的关注。然而,如何实现女性有生育过程中的主体地位,解决她们所面临的与社会选择的矛盾,在很大程度上取决于特有的社会伦理背景以及所遵循的价值原则。由于中国与西方的社会伦理发展轨迹的差异,构建生育健康的伦理框架和强调女性生育自主权的努力方向也应异于西方。     

“Other selves”: moral and legal proposals regarding the personhood of cryopreserved human embryos

This essay has two purposes. The first is to argue that our moral duties towards human embryos should be assessed in light of the Golden Rule by asking the normative question, “how would I want to be treated if I were an embryo?” Some reject the proposition “I was an embryo” on the basis that embryos should not be recognized as persons. This essay replies to five common arguments denying the personhood of human embryos: (1) that early human embryos lack ontological individuation; (2) that they are members of the species Homo sapiens but not yet human persons; (3) that the argument for personhood commits the “heap argument” fallacy; (4) that since human procreation in nature is inefficient, human embryos cannot be persons; and (5) the “burning building” scenario proves that all arguments for personhood are irrational or inconsistent. The second purpose is to set forth and criticize in light of the normative judgement defended in part one the present legal situation of cryo-preserved embryos in the U.S. The essay ends by proposing legislative reforms to protect ex utero human embryos.     

A healing relationship: Clients’ experiences of the long-term relational significance of the horse in horse assisted psychotherapy

Horse assisted psychotherapy is a type of treatment for mental ill-health in which the client forms a relationship with a horse. Research suggests that the relationship to a horse is very helpful to clients, but how the horse is experienced many years after the end of treatment has not been investigated. The aim of the present study was thus to investigate how former clients from horse assisted psychotherapy experienced the horse several years after treatment was completed. Former clients (n = 5; all females) from one and the same treatment center were interviewed and the data was analyzed with an inductive thematic approach. The analysis showed that many years after completion of treatment, the horses were still remembered as the most important individuals in the informants’ lives during the time of treatment. This was captured by the core category ‘A healing relationship’. These findings are in line with previous research that found that patients in horse assisted psychotherapy and their family members attributed improvements from treatment to the patients’ relationship to the horses, but adds that the clients also keep these views at follow-up several years after termination of treatment.     

Equine Facilitated Therapy for Children and Adolescents: A Qualitative Pilot Study

Despite recent growth in the use of equine facilitated therapy (EFT), and its potential to be an effective alternative to traditional therapeutic interventions, the literature has not yet provided a convincing explanatory account of the practices implemented within EFT. In this study, the author investigates consistency of clinical practices within the Equine Assisted Growth and Learning Association (EAGALA) model of EFT. Semi-structured interviews were conducted with mental health professionals and equine specialists (N = 10) from six Australian EFT clinics. Thematic analysis of data revealed: an absence of an underpinning theoretical model; variations between clinical practices; lack of parental involvement in therapy for children/adolescents; and inadequate research into perceived mechanisms of change driving EFT. This article concludes with a set of recommendations directed at EFT practitioners in order to increase the rigor of practice and maximize the potential of this intervention.     

Same-sex parent families in Italy: Validation of the Coparenting Scale-Revised for lesbian mothers and gay fathers

Even though Italy is still struggling to establish equal rights and access to assisted reproduction techniques for sexual minorities, an increasing number of lesbian women and gay men are now becoming parents. There are only a few studies that have evaluated coparenting in same-sex couples. However, these addressed adoptive couples and not the lesbian and gay parent families through donor insemination or surrogacy, respectively. This study examined the psychometric properties of the Coparenting Scale-Revised and its relationship with dyadic adjustment, discipline management, and internalized sexual stigma in Italian same-sex-planned families. The factor structure showed a satisfactory internal consistency and criterion validity with correlates of coparenting behaviours. While Family Integrity factor was confirmed, Disparagement and Reprimand dimensions collapsed into Conflict factor. Non-genetic parents showed lower levels of conflict than genetic parents. Most importantly, coparenting emerged as a significant function not shaped by gender, but influenced by parental status and internalized sexual stigma.     

口腔专业适宜技术与诊疗最优化

推行适宜技术和诊疗最优化的原则是避免过度医疗的有效途径。而在口腔专业中必须要体现其特殊性。口腔治疗的总体目标是健康、美观,这一目标有赖于患者的主观评价;患者在治疗中具有自主选择的权利,而医生提供专业上的支持和具体的执行。因此口腔科适宜技术的基本要求是:适合患者的自身条件和需求、符合医学专业诊疗原则的要求以及适合医生的个人技术水平。然而对于我国现阶段而言,适宜技术是一个宽泛且较低的标准,而口腔临床工作中应该以最优化的治疗作为实际追求的目标。     

人类精子冷冻保存的回顾与思考

回顾人类精子冷冻保存方法的历史,分别比较分析精液保存的常规冷冻法、玻璃化冷冻法和冷冻干燥保存法的特点和前景。认为人类精子冷冻保存方法是低温生物学与辅助生殖技术相互发展和基础理论研究与临床应用相互作用的结果,简便可靠的冷冻保存方法仍需进一步研究。     

Ethical reflections on the status of the preimplantation embryo leading to the German embryo protection act

Ethical conflicts have always been connected with new techniques of reproductive medicine such as in-vitro fertilization. The fundamental question is: When does human life begin and from which stage of development should the embryo be protected? This question cannot be solved by scientific findings only. In prenatal ontogenesis there is no moment during the development from the fertilized oocyte to a human being which could be recognized as an orientation point for all ethical problems connected with the question of the right to dispose of prenatal life (interruption of pregnancy, research on embryos). The protection of an individual human life must be valid for all in the same manner and from the very beginning on. It must not depend on value judgments or on stages of development, so-called grades of humanity, because these would then become selection criteria. Procreated life must have the right to be born. These were the essential ethical arguments which led to the German Embryo Protection Law.     

Research Misconduct in the Age of Open Science: The Case of STAP Stem Cells

In early 2014, Dr Haruko Obokata and her co-authors caused a global media storm by publishing two scientific papers in Nature on stem cells. The papers proposed a surprisingly simple new method called stimulus-triggered acquisition of pluripotency (STAP) to generate pluripotent stem cells for research purposes in a fast and inexpensive way. To the dismay of many, both papers were retracted within six months of their release due to data fabrication and falsification. The rise and fall of the STAP research illustrates the impacts of open science practices of quality control and validation on new scientific claims. In the STAP case, collective action generated through two online forums—the Knoepfler Lab Stem Cell Blog and PubPeer—exposed not only data manipulation in the two papers but also the irreproducibility of the purported new cellular reprogramming method. The case brings to the fore the tentative possibilities as well as potential pitfalls of ‘accelerated virtual witnessing’ through crowdsourced post-publication peer reviews that value accessibility and inclusiveness. Indeed, it calls for empirically grounded discussion on the ongoing reconfiguration of the shared system of values and norms or the moral economy of science.     

Discursive Construction of Political Categories and Moral Fields: God Versus Rights and Access in a Reproductive Health Legislative Debate

Using a discursive lens, we argue that politicians rhetorically construct categories, storylines, and moral fields. We further claim that such discursive products are action‐oriented toward gaining popular support in a public sphere that is politically fault lined along similar moral orders. As a case in point, we analyze speeches delivered during congressional voting on a Reproductive Health bill (RH bill). Employing a mixed methods strategy, we first implement a quantitative lexical analysis of frequently used words, followed by a qualitative detection of cohering storylines on both sides of the debate. Results show that oppositionists mark their speeches with a deployment of the word God, while bill supporters use the word access conspicuously. One storyline claims that The RH bill stands against God, while the other purports that The RH bill advocates rights and access. Although both storylines assert moral righteousness, they invoke two different moral orders backed by power blocs and the public at large. The God story appeals to a Catholic discourse and the moral order loudly supported by the politically powerful Catholic Bishops Conference of the Philippines. The rights/access narrative references a liberal morality frame maintained by social liberals and Philippine President Aquino. We end our paper by introducing the idea of an intrastate discursive lens to analyze moral fields constructed by politicians, oriented toward winning support from the public at large.