人类干细胞研究的伦理学争论

关于干细胞研究的伦理学争论越来越成为热门话题。2000年8月23日,美国卫生研究所颁布了涉及人类多能胚胎干细胞研究的指南。指南允许联邦政府资助的研究者进行干细胞研究,但是按照布什总统2001年8月9日的决定,政府只资助有限制的干细胞研究。而在英国、法国、日本、澳洲、以及其他国家,干细胞研究不仅在私人的实验室里而且也在政府的实验室里进行着。无论如何,人类干细胞研究应该按照一定规范谨慎进行。     

The Rights of Man: Libertarian Concern for Men's,But Not Women's,Reproductive Autonomy

Libertarianism enshrines individual autonomy as its central political principle, but it has been criticized for applying this principle selectively. Reproductive decisions can stress the concept of individual autonomy by placing into conflict the claimed rights of each biological parent to choose. Two studies (N₁ = 296; N₂ = 580) show that among U.S. participants, libertarianism is associated with opposition to women's reproductive autonomy and support for men's. Libertarianism was associated with opposition to abortion rights and support for men's right both to prevent women from having abortions (male veto) and to withdraw financial support for a child when women refuse to terminate the pregnancy (financial abortion). Adjusting for the association between libertarianism and conservatism, only the relationship with opposition to abortion rights was rendered nonsignificant. Mediation analyses suggest that hostile sexism may account for libertarians' selective support for men's and not women's reproductive autonomy.     

一例隐瞒多次婚育史的妊娠高风险患者助孕的伦理探讨

以一例隐瞒多次婚育史、再次妊娠高风险的患者要求行夫精人工授精助孕的案例为例,探讨特殊情形下辅助生殖技术实施时存在的伦理冲突及可能引发的伦理问题。辅助生殖技术的实施,首先要符合我国现行法律法规政策,符合技术实施的适应证;其次,在技术实施前要充分预估风险及获益,加强医患沟通。遵循有利于患者原则、充分知情同意原则、保密原则等辅助生殖技术伦理原则,权衡患者隐私权与配偶知情权,在夫妇双方充分知情同意下,帮助患者解决实际问题。

     

The experience of counselling for UK egg providers

Objective

The aim of this study was to address current gaps in knowledge regarding the appropriateness and quality of counselling provided to egg donors in the UK.

Methods

The present study used a cross-sectional, qualitative design. Semi-structured interviews were carried out with 29 UK egg donors to explore their experiences of egg donation and the counselling received.

Results

Of the 29 participants, 24 had received counselling. The remaining five did not receive counselling because they were either not accepted as a donor (n = 4) or were offered, but chose not to take up the session (n = 1). The findings are presented in relation to five themes: feeling supported via counselling; feeling well-informed; welcoming an individualised approach; the counselling setting; and thinking about the future.

Conclusion

Egg donors in this study had varying experiences of counselling offered to them as part of the egg donation process in the UK.

Implications

The findings indicate that there are some aspects of counselling in the UK that could be improved, including the routine offering of counselling throughout the egg donation process and the tailoring of counselling to meet egg donors' individual needs.     

关于人类克隆的哲学思考

总结了8年来人们反对生殖性克隆人的主要理由,分析了反对人类生殖性克隆及支持治疗性克隆的理由的合理性,揭示了克隆人争论给我们的启示。     

代孕需求方生殖自主权实现的道德界限辨析

辅助生殖技术的诞生,颠覆了人类的自然生殖模式,为不孕不育者提供了生殖选择的平等机会。从意志自由的视角看,代孕需求方具有生殖自主权。然而,生殖自主权不仅包含代孕需求方的尊严和意志自由内涵,还应包含对后代的养育责任内涵,体现生殖自主权与养育义务的结合。因此,基于保护后代利益原则,权衡尊重自主与不伤害原则,辨析代孕需求方在生殖动因、婚姻关系、养育能力以及与后代联系的道德界限;提出在医学动因的前提下夫精妻卵妊娠型代孕与其他类型代孕的根本区别是道德界限的内外之别。

     

CREATED CO-CREATOR AND THE PRACTICE OF MEDICINE

Abstract There is a crisis of interpretation experienced by those making critical‐care decisions and creating health‐care policies and by the patients and families who make life‐and‐death decisions. For example, at both the beginning and end of life, new technologies are changing the way we define life and death. We can prolong life or hasten death in ways that we could not earlier have imagined. This crisis of interpretation demands new ways of thinking and doing. My task is to explicate how the created co‐creator can be used as a springboard to help link theological concepts with feminist concerns about two issues: interpreting the culture and practice of medicine in a new way, and explicating the ambiguity of decision making when considering issues of life and death.     

ART临床应用伦理调控的特点

解决ART应用中引发的伦理问题、难题的基本对策之一是加强医学伦理调控 ,推进医学伦理精神对医学过程的渗入 ,ART医疗机构伦理委员会是医学伦理调控体制化的表现和实现这种调控的重要途径 ,它以特定的主体形式和审查、咨询、教育、督查、建议等活动方式 ,形成对调控对象某种监督的客观效果。     

进化观点下的幸福研究

人类社会生活的一项重要目标是追求幸福(happiness), 影响幸福体验的因素有食物、财富、婚姻及友谊等。寻求幸福与避免痛苦能让人们的幸福需求得到满足。幸福和痛苦不是人类通过进化获得的一种最终机能, 然而幸福和痛苦对人类远古祖先的影响在于调节行为活动以增加生存与繁衍可能。为什么有些环境刺激比其他刺激更能让人体验幸福？为什么回避痛苦与追求幸福同样重要？为什么幸福体验有相对性、过度性与目标性的特点？这些问题可以在进化观点中得到较好回答。人们的幸福感可以在认识基因与环境关系的基础上得到加强, 如加强亲属联系、强化社会合作、重视婚姻承诺以及满足本能欲望等。     

Long-acting reversible contraception: A route to reproductive justice or injustice

This article presents information on unintended pregnancies and the ongoing efforts of policy makers to promote long-acting reversible contraception (LARC) to reduce the numbers of such pregnancies. Also discussed is the tension between the encouragement of LARC to promote the public's interests in achieving that goal versus the need to assure that all women can decide about their bodies and reproductive needs. Our discussion includes information, primarily from the United States, on (a) risks associated with unintended pregnancies, (b) LARC devices approved in the United States (copper intrauterine devices (IUDs), hormone IUDs, and implants), (c) public and social benefits of increasing the use of LARC, (d) disadvantages and barriers to using LARC, (e) dangers of promoting LARC in unjust ways, and (f) the meaning of reproductive justice and its connection to social justice. By sharing the information with the audience of this journal, we hope that it will be integrated into clinical work and research on mental health and development. We also hope that experts in those fields will become discussants in the conversation regarding women's reproductive health and social justice that is taking place in the United States and elsewhere.