Grundell Erica
Faculty of Law, University of Melbourne, Australia.
Monash Bioeth Rev. 2003 Oct;22(4):45-55. doi: 10.1007/BF03351404.
Tissue typing (TT) is a recent and controversial scientific advance. Whilst its current applications can easily be described as pro-therapeutic and within the realms of preventative medicine, its specificity and potential are often characterized as the tip of the eugenic iceberg: undermining the very basis of individual autonomy and identity in an inevitable march towards the perfect society. In addition to arguments concerning societal harms flowing from TT, significant concerns have also been raised concerning harms to the future child born as a result. In the context of current legislation and policy, this article examines two aspects of arguments concerning harm to the future child: those relating to psychological harms, and those arguing that TT is contrary to the future child's best interests. The article examines the moral basis for arguments concerning harm to the future child. It proposes that arguments concerning psychological harm may overlook or minimise the potential benefits flowing from the broader social, familial context into which the child is born. These arguments may be countered, or at least balanced, by considering the future child in this context. In relation to arguments that TT is contrary to the future child's best interests, the paper examines a non-standard consideration of best interests. It argues that this standard should be used in considering whether or not TT for bone marrow transplant is harmful to the future child, thereby extending moral consideration of interests to intra-familial interests and outcomes. On this basis, it can be argued that TT is not contrary to the interests of the future child. The paper concludes by noting a potential tension between the first guiding principle of the Infertility Treatment Act 1995 (Vic) and the current Victorian policy on TT.
组织配型（TT）是一项近期出现且颇具争议的科学进展。虽然其当前应用很容易被描述为具有治疗作用且属于预防医学范畴，但其特异性和潜力却常常被视为优生学冰山一角：在迈向完美社会的必然进程中，破坏了个人自主性和身份认同的根本基础。除了有关TT会带来社会危害的争论外，人们还对由此出生的未来儿童所受危害提出了重大担忧。在当前立法和政策背景下，本文探讨了有关对未来儿童造成危害的争论的两个方面：与心理伤害相关的方面，以及认为TT违背未来儿童最大利益的方面。本文审视了有关对未来儿童造成危害的争论的道德基础。它提出，有关心理伤害的争论可能忽视或低估了儿童出生所处更广泛社会、家庭背景所带来的潜在益处。通过在这种背景下考虑未来儿童，这些争论可能会被反驳，或者至少得到平衡。关于TT违背未来儿童最大利益的争论，本文审视了一种对最大利益的非标准考量。它认为，在考虑骨髓移植的TT是否对未来儿童有害时应采用这一标准，从而将对利益的道德考量扩展到家庭内部利益和结果。在此基础上，可以认为TT并不违背未来儿童的利益。本文最后指出了1995年《维多利亚州不育治疗法案》的首要指导原则与维多利亚州当前关于TT的政策之间可能存在的矛盾。
