- 期刊
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
Why Should We Abandon an Informed Consent Organ Procurement Policy? The Moral Justification of Weak Mandated Choice
摘要
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。
並列摘要
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.