異種移植之倫理法制議題分析

鑒於全球器官短缺問題日益嚴重，異種移植(Xenotransplantation)相較於費用更加昂貴的體外培育人體器官或細胞之方式，異種移植具有成本較為低廉，異種移植物將來轉變為癌症的可能性較低等特性，故醫學界在面對器官短缺此一問題上，對於異種移植寄予厚望。但異種移植除了在技術上仍有許多尚待克服的關鍵技術，其伴隨錯綜複雜的倫理、道德、宗教與法律問題，亦使得許多先進國家已開始正視並探討異種移植的相關爭議。本文擬究針對異種移植伴隨可能產生的風險問題，後續的處置措施所將伴隨之倫理、社會及法律爭議重要爭點加以探討分析，包含告知後同意、公共衛生風險、基本權的侵害以及動物權等相關爭點加以論述分析。異種移植因涉及高度不確定公共衛生風險，在風險尚未明確評估了解下，可應用預防原則(The Precautionary Principle)架構公眾健康安全相關之防禦措施，政策決定者應採取較為限縮的方式處理，避免引發傳染病。包含事前與事後之監督追蹤，通報系統之建立，甚至是人身自由管制措施。此外，法律制定面上，由於接受異種移植後，勢必將伴隨許多嚴重限制基本人權的措施，本文分析可能涉及的問題如(1)受試者將受到必要之限制。(2)手術將產生未預期之風險。(3)經過移植手術後影響日後生活品質。(4)跨物種傳染疾病的風險。(5)對病患長期的監督追蹤等。同時亦搜集並整理部分國家對於異種移植所進行之調查報告，從實證角度分析社會對於異種移植的觀點，以供未來我國政府對於異種移植政策推動與否的參考資料。

關鍵字

異種移植；告知後同意；基本權

並列摘要

Amid the increasingly dire problem of organ shortage, xenotransplantationation offers a lower cost when compared with the more expensive methods of in vitro cultivating human organs or cells, and its characteristics in how xenotransplantationation has a lower probability of turning into cancers, has drawn the medical sector to bestow high hopes on xenotransplantationation when confronting the problem or organ shortage. Yet xonotransplant not only has many key technologies that need to be conquered in terms of its technical viability, but also accompanies it of the infinitely complex ethical, moral, religious and legal issues that have drawn many industrialized countries to confront it and examine xenotransplantationation-related controversies. This paper aims to examine and analyze critical ethical, social and legal issues arisen from the subsequent response measures by focusing on risk problems that are likely to occur, and to reason and analyze relevant controversial points including the informed consent, public health risks, infringement of basic human rights and animal rights. Thus, this paper makes an attempt to explore related issues as followings: (1)The test recipient would be placed under necessary restrictions. (2)The procedure creates unanticipated risks. (3)Receiving a transplant procedure is poised to hinder an individual's later quality of life. (4)Xenotransplantation comes with the risk of infecting diseases. (5)The patient is subjected to long-term monitoring and follow-up, among others. Besides, this paper gathers and compiles survey reports on xenotransplantation by some of the countries and provides certain empirical reference for the Taiwan government to decide whether to promote a xenotransplantation research policy.