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四项原则能有助于基因筛查决策吗?

Can the four principles help in genetic screening decision-making?

作者信息

Mallia Pierre, ten Have Henk

机构信息

Fac. Medicine and Surgeons, University of Malta.

出版信息

Health Care Anal. 2003 Jun;11(2):131-40. doi: 10.1023/a:1025601012761.

Abstract

Although principles, as a framework to resolving moral dilemmas are still debated and seem to be in a philosophical quagmire, there are strong arguments that by specification one can resolve case-specific dilemmas in certain areas of bioethics. When it comes to genetic screening and testing however, the problem at the base is a moral disagreement on higher-order principles--such as the status of the embryo and parental issues. No amount of specification can resolve these issues without a dose of relativism. We explore a possibility of agreement on debatable areas specifically in regard to genetics--such as conferring status to the embryo solely for purposes of preventing genetic selection; but it is difficult to see how this can be incorporated into law without extrapolation to other areas. We conclude therefore that the four-principles approach, albeit valuable for expounding opposing views and discussing issues, cannot either alone or by specification, help resolve issues of genetic screening and testing without agreeing on higher order principle. This does not seem to be a possibility in the near future.

摘要

尽管作为解决道德困境框架的原则仍存在争议,似乎陷入了哲学困境,但有强有力的论据表明,通过具体化,人们可以在生物伦理学的某些领域解决特定案例的困境。然而,在基因筛查和检测方面,根本问题是在高阶原则上存在道德分歧,比如胚胎的地位和父母相关问题。如果没有一定程度的相对主义,再多的具体化也无法解决这些问题。我们探讨了在有争议领域,特别是在遗传学方面达成一致的可能性,比如仅为防止基因选择而赋予胚胎地位;但很难看出在不类推到其他领域的情况下,这如何能纳入法律。因此,我们得出结论,四原则方法虽然在阐述对立观点和讨论问题方面有价值,但无论是单独使用还是通过具体化,在未就高阶原则达成一致的情况下,都无法帮助解决基因筛查和检测问题。在可预见的未来,这似乎不太可能实现。

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