論愛滋高風險群孕婦強制HIV檢驗

Mandatory HIV testing for High risk groups of AIDS of Pregnant Women

謝淑鳳(Shu- Feng Hsieh)

指導教授 ： 李瑞全

國立中央大學/文學院/哲學研究所/碩士(2008年)

摘要

本文的研究動機在於愛滋病乃是全世界的流行病之ㄧ，比起世界其他國家感染愛滋病情況，國內的感染人數雖然較少，但是卻有逐年增加的情況，其中女性感染人數急速竄升，尤其又以毒癮者所佔比率最多，故而我們可以預見未來藉由母胎垂直傳染愛滋病毒於胎兒的人數必定是愈來愈多。綜觀全世界大規模的研究顯示，為防止母子愛滋病毒垂直感染，母親在產前應接受抗病毒藥物治療，分娩應選擇在產痛開始前採取剖腹生產，產後則應禁止母乳哺育，而且要儘早對嬰兒投予預防性抗病毒藥物，以徹底根絕愛滋病毒的垂直傳播。如果都能按照此一原則，嬰兒感染愛滋的比率可從20-45%降為1%，國內目前實施的是自願性HIV 檢驗，然而這樣的檢驗方式實施以來，卻還是有許多漏網之魚，因此本文提出針對愛滋高風險群孕婦進行強制HIV 檢驗。 本文首先釐清高風險群與高風險行為的差異，接著證成政府必須履行健康權的義務實施HIV 檢驗，並論述孕婦進行各種形式HIV 檢驗的兩難之處，隨之提出愛滋高風險群孕婦強制HIV 檢驗的倫理爭議，最後，試圖透過查爾斯的五條件說、功利主義、康德義務論、儒家生命倫理等哲學理論，證成此議題的道德正當性，以深入探討孕婦HIV 檢驗之公共健康議題。

關鍵字

功利主義 ； 強制HIV檢驗 ； 高風險群 ； 母子愛滋病毒垂直感染 ； 儒家生命倫理 ； 康德義務論

並列摘要

The motive of this research is that AIDS is one of the epidemic diseases in the world,although the domestic number of the infected people is less than other countries of the world, it isincreasing year by year, the number of the infected women is risen rapidly from 2004, especially people with drug addiction accounting for the highest proportion. Therefore, we can expect that the number of people with maternal-fetal HIV transmission grows intensively. The extensivere searches in the world show that, in order to prevent maternal-fetal HIV transmission anderadicate HIV transmission, mothers in antenatal should accept AZT, mothers in childbirth should accept Caesarian operation before aching, mothers in postpartum should be forbidden feeding infants breast milk, and should inject infants with AZT. If we are in accordance with this principle, the rate of infected infants with AIDS can be lowered from 20-45% to 2%. Therefore, HIV testing suggested to pregnant women in many countries. It is implemented at present with voluntary HIV testing in domestic. However, there are still many infected people undetected according to theprevious methods of examination. Therefore, the thesis pointed out mandatory HIV testing for high risk groups of AIDS of pregnant women.
First, the thesis distinguished the difference between high risk group and high risk behavior
and explained the reason of adopting high risk group. The government has to fulfill the
obligation of health right and to implement HIV testing, as health right is the basic human rights.
Secondly, the thesis discussed the difficulty of proceeding various of HIV testing. Thirdly, the
thesis pointed out the ethics dispute of mandatory HIV testing for high risk groups of AIDS of
pregnant women. Finally, the thesis attempted to pass philosophy theories as Principlism,Utilitarianism, Kantianism, and Confucian Bioethics not only to prove that the topic is proper inethics but also to probe thoroughly into the public health topic of HIV testing for pregnant women.

並列關鍵字

mandatory HIV testing ； Utilitarianism ； Kantianism ； Confucian Bioethics ； high risk group ； maternal-fetal HIV transmission

參考文獻

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