論文摘要 現今產前篩檢透過不同的檢測技術與方式,不但可以確保懷孕婦女妊娠期間的身心狀況,更重要的是得以提供胎兒的相關資訊,及早預測下一代的健康狀況,使受孕夫妻能夠做出符合個人價值、社經狀況的決定。然而,除了礙於產前篩檢在技術上的侷限性,有所謂的「偽陰性」、「偽陽性」外,一旦發生諸如告知與判讀錯誤等人為方面的疏失,就有可能導致受孕夫妻無法獲得正確的資訊做出決定—如未能及時中止懷孕等,進而生下患有遺傳疾病、染色體變異或是有先天缺陷的孩子。基於這種錯誤告知,使父母因而產下有缺陷的孩子,即為「計畫外生育」(wrongful birth)與「計畫外生命」(wrongful life)。 生殖涉及個人對於生命延續的價值肯認而受憲法保障,因此當產前篩檢所揭露的資訊發生了偏移,無異是讓受孕夫妻無法在正確的資訊下行使其生育自主權益,此包括女性生育自主內涵之一—「中止懷孕」的權利。由於醫療專業人員未能在合於科技與專業知識的範圍,內作出正確判斷與告知,亦未及時修正其判斷,導致女性無法及時行使其中止懷孕、受孕夫妻無法正確行使其生育自主決定,自應成立「計畫外生育之損害賠償責任」,除了賠償受孕夫妻懷孕與分娩的費用、小孩額外支出的醫療費用、人力照顧費用、特殊教育費用與精神慰撫金外,本文認為亦應包括「扶養費用」。 醫療專業人員的判讀與告知錯誤,不但對於受孕夫妻可以成立「計畫外生育」民事損害賠償,針對那些深受遺傳疾病或先天缺陷所苦,而認為自己「未出生較出生為佳」的孩子,本文認為亦應成立「計畫外生命」損害賠償。就此,不少學說基於已經出生的人無法想像「未出生」的感受而堅持生命的客觀價值,並主張「出生可能是種損害」無疑是對生命價值的一種貶抑。然而,我們是否會因為一個仍然存在的生命無法體會「死後」的世界,就宣稱自然死權的不存在?出生與存在究竟是否為損害,最終是繫諸於個人感受。 產前篩檢不僅引發計畫外生育與計畫外生命在損害賠償與法哲學上的討論,該技術的便利性、普遍性、可預測性等特徵,無形中也醞釀著社會層面的焦慮與不安。當「優生」、「烙印」與「歧視」正在社會輿論所建構的需求中逐漸發酵時,國家更應該在產前篩檢與其社會效應間的微妙關聯中,取得一個適當的介入角色、擬定適當的社會政策,不應放任產前篩檢的全面運用。本文主張國家應對於產前篩檢的項目諸如「多因性晚發型」的疾病檢測,做適當的介入以矯治偏見的持續擴大,並提供完整的諮商服務包括產前篩檢後的結果諮詢與輔助管道,以緩和身心障礙者被歧視的感受與社會大眾對之錯誤的烙印效果。
Abstract With the aid of prenatal screening, physicians and parents can now detect the fetus’ status of health throughout the pregnancy. In Taiwan, more than 98﹪pregnant women receive information about fetus’ well-being through prenatal screening. However, many children are still born with defect. Part of the reason is, physician may falsely inform parents out of negligence. This provides a ground for parents to bring a claim of wrongful birth. This article intends to explore the foregoing issues. Respectively, I will clarify whether pregnant women and parents have a right to abortion and procreative freedom protected under Taiwan’s Constitution; what are their implication for a wrongful birth claim in Taiwan; and how can such claim be justified. Moreover, this article will examine article 1114, 1084 and 1089 of Taiwan’s Civil Code, and analyze the relationship between care-taking expense and due care. I will argue that, the damage for care taking expense should take into account women’s actual experiences. More than the claim of wrongful birth, injury as a matter of life in wrongful life is a crucial issue. Based on the theory about “grass is always greener”, criticism of the wrongful life action argue the child suffers nothing in present condition. However, is impaired life always preferable to nonexistent? I will propose a different solution inspired with right-to-die cases to challenge the major opinion. Recognition of wrongful birth and wrongful life claim, importantly, there is a special relationship between prenatal screening and the culture of motherhood. We cannot ignore the potential psychological, social, and financial risks of prenatal screening and testing. Legal liability for wrongful birth and wrongful life is not good enough to offer every screening test available. States have to take legislative measures and social policy, such as counseling, for guaranteeing that those prenatal screening contribute to individual and health. Besides, we should take notice of respect for current and future people with disabilities. This essay classify some issues in analyzation of wrongful birth and wrongful life, and try to solve contradictory between genes and disability.