Savulescu J
University of Melbourne, Australia.
J Med Ethics. 2001 Jun;27(3):165-71. doi: 10.1136/jme.27.3.165.
The attitudes of Australian practitioners working in clinical genetics and obstetrical ultrasound were surveyed on whether termination of pregnancy (TOP) should be available for conditions ranging from mild to severe fetal abnormality and for non-medical reasons. These were compared for terminations at 13 weeks and 24 weeks. It was found that some practitioners would not facilitate TOP at 24 weeks even for lethal or major abnormalities, fewer practitioners support TOP at 24 weeks compared with 13 weeks for any condition, and the difference in attitudes to TOP between 13 weeks and 24 weeks is most marked for pregnancies which are normal or involve a mild disorder. It is argued that a fetal abnormality criterion for late TOP is inconsistently applied, discriminatory and eugenic. Four possible moral justifications for current practice are examined, each of which would require significant changes to current practice. I argue in favour of a maternal interests criterion for any TOP.
针对临床遗传学和产科超声领域的澳大利亚从业者,调查了他们对于因胎儿异常程度从轻度到重度以及非医学原因而进行终止妊娠(TOP)的态度。对13周和24周时的终止妊娠情况进行了比较。结果发现,一些从业者即使对于致死性或重大异常情况也不会在24周时协助进行终止妊娠;与13周时相比,在任何情况下,支持24周时终止妊娠的从业者都更少;对于正常妊娠或涉及轻度病症的妊娠,13周和24周时对终止妊娠的态度差异最为明显。有人认为,晚期终止妊娠的胎儿异常标准应用不一致、具有歧视性且带有优生学色彩。研究了当前做法的四种可能的道德依据,每种依据都需要对当前做法进行重大改变。我主张对于任何终止妊娠情况都应采用符合母亲利益的标准。