Lipworth Wendy
Centre for Values, Ethics and the Law in Medicine, Unit for the History and Philosophy of Science, The University of Sydney, Australia.
J Bioeth Inq. 2005;2(3):130-41. doi: 10.1007/BF02448594.
In the biomedical field, calls for the generation of new regulations or for the amendment of existing regulations often follow the emergence of apparently new research practices (such as embryonic stem cell research), clinical practices (such as facial transplantation) and entities (such as Avian Influenza/'Bird Flu'). Calls for regulatory responses also arise as a result of controversies which bring to light longstanding practices, such as the call for increased regulation of human tissue collections that followed the discovery of unauthorised post-mortem organ retention. Whilst it seems obvious that new regulations should only be generated if existing regulations are inadequate (a practice referred to in this paper as 'regulatory syncretism'), this does not always occur in practice. This paper examines the conceptual steps involved in generating regulatory responses to emerging phenomena. Two decision points are identified. First, a stance is taken as to whether the emerging phenomenon raises unique ethical or legal issues (exceptionalism versus non-exceptionalism). Second, the decision is made as to whether new regulation should be generated only for truly unique phenomena (syncretism versus asyncretism). It is argued here that it is important to make a careful assessment of novelty, followed by a reflective and deliberative choice of regulatory syncretism or asyncretism, since each type of regulatory response has advantages which need to be harnessed and disadvantages which need to be managed--something that can only occur if regulators are attentive to the choices they are making.
在生物医学领域,新的法规出台或现有法规的修订往往是在出现明显的新研究实践(如胚胎干细胞研究)、临床实践(如面部移植)和实体(如禽流感/“禽流感”)之后。由于争议引发了长期存在的实践问题,也会出现对监管回应的呼吁,例如在发现未经授权的死后器官留存后,要求加强对人体组织采集的监管。虽然显而易见的是,只有在现有法规不足时才应制定新法规(本文将这种做法称为“监管融合主义”),但在实际中并非总是如此。本文探讨了针对新出现的现象做出监管回应所涉及的概念性步骤。确定了两个决策点。首先,要对新出现的现象是否引发独特的伦理或法律问题表明立场(例外主义与非例外主义)。其次,要决定是否仅应为真正独特的现象制定新法规(融合主义与非融合主义)。本文认为,仔细评估新颖性,然后经过深思熟虑选择监管融合主义或非融合主义非常重要,因为每种监管回应都有需要加以利用其优势和加以应对的劣势——只有监管者关注他们所做的选择,这一点才能实现。