胚胎植入前基因檢測使用之規範方式 －以倫理諮商為輔助模式－

Regulating the Practice of Preimplantaion Genetic Diagnosis－ Ethical Consultation as an Assisting Pattern

林鈞琪(Chun-Chi Lin)

指導教授 ： 李崇僖

中原大學/商學院/財經法律研究所/碩士(2011年)

https://doi.org/10.6840/CYCU.2011.00198

摘要

中文摘要
胚胎植入前基因檢測（Preimplantation Genetic Diagnosis, PGD），係屬於廣義的產前遺傳基因檢測，以人工方式於體外製造受精卵後，利用分子生物學診斷技術，就此胚胎為基因檢測，篩選出帶有異常基因或染色體之胚胎，再將正常胚胎植入婦女子宮內發育。
我國對於胚胎植入前基因檢測之使用並無明確直接的法律規範，是以，隨著該技術的擴大使用，人類越發高度介入生命的製造，則越發干預生命本身的價值，而過度使用的結果將會導致各種社會問題產生。是以，本文將使用胚胎植入前基因檢測所產生的爭議分為三類：健康寶寶、救命寶寶，以及訂作寶寶，先分析何種類型應納入管制，再論述應適用何種管制模式。
胚胎植入前基因檢測技術之使用，涉及憲法層級的父母生殖自由權與胚胎的生命權、健康權、自我決定權，以及，價值觀選擇的社會倫理問題，係三方面之衝突，本文以為，科技的倫理問題，不應僅以法益衡量之方式來決定哪種憲法價值具有優先性，再進而以制訂法律決定有無權利使用即認為已解決問題，主要考量的，是俾使做決定的人，亦即使用者，是在獲得充分完整的資訊後，理解所牽涉的價值衝突關係，考量到密切相關之人的利益後，做出最好的決定。是以，公權力宜不再扮演傳統的角色，應是要更具彈性的、得以適時與新科技發展及社會需要相對應的角色，因此本文建議應採用倫理諮商為輔助模式。
倫理諮商模式，主要是針對病人在進行醫療時出現道德兩難時，透過諮商，對醫護人員和病人及家屬提供專業的倫理解說、分析和疏解，對病人及家屬提供合理及適當的倫理忠告，並指引醫護人員在執行職務時如何能夠謹守專業倫理要求並為病人提供最佳服務，而倫理諮商人員，就是醫病雙方共識生成的媒介。在觀察我國實踐倫理諮商上，發現醫療機構對於倫理諮商制度之建立仍處於起步階段，因而提出改善之道，盼能提供我國未來建立相關制度之參考。

關鍵字

胚胎植入前基因檢測 ； 倫理諮商

並列摘要

Abstract
Preimplantation Genetic Diagnosis (PGD), considered as an early form of prenatal diagnosis, is a process in which embryos developed outside the womb are tested for specific genetic abnormalities that cause serious disease before being transferred to the uterus, and may enable transfer of unaffected embryos only.
Lately, PGD is used not only to diagnosis and avoid genetic disorders, but also to select for certain characteristics, such as matching tissue type for a therapeutic purpose of an existing sibling. In addition, the demands to use PGD for fully non-medical purposes are increasing. Therefore, in order to avoid the overuse of PGD and the highly interference of human life’s production, which could create every kind of social problems, this article tries to classify issues resulted from PGD in three types: Healthy Baby, Rescue Baby and Designed Baby, and then find out a proper regulation to it.
The central ethical questions relating to PGD are the embryos and maternal rights which were protected by the constitution, and conflicting ethical views. However, instead of merely evaluating which constitutional rights have priority, we should even make sure that the person who applies PGD gets full information and considers the interest of relevant party and the conflicting ethical problems involved before making the decision. And so, we need Ethical Consultation, which is more flexible and be able to timely respond to the need of society than law, as an assisting pattern.
Ethical Consultation, a process by which trained consultants to help patients, family members and healthcare providers deal with difficult ethical conflicts, issues or questions that arise in patient care, can identify ethical problems in the care of a particular patient, clarify these problems through a careful analysis of the values involved, provide proper and reasonable advice to patients, resolve ethical problems through a process of shared decision-making, and guide healthcare providers to present best services for each patients. After figuring out the defects of the practice of Ethical Consultation in our country, this article tries to offer some suggestions helping make a better improvement.

並列關鍵字

PGD ； Ethical Consultation

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