Arras J D
Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, NY 10467.
Milbank Q. 1990;68(3):353-82.
The risks of perinatal HIV transmission do not currently constitute grounds for morally criticizing the reproductive choices of particular infected women. A contextualized assessment of morally relevant factors might in some cases, however, justify judgments of reproductive irresponsibility. Although no women should be subject to any form of coercive pressure when making the decision to initiate or continue pregnancy, a "moral-education" model of nondirective counseling may be appropriate for women carrying HIV. Not even highly desirable, concerted public efforts to foster social justice will eliminate the ethical questions of whether these women should have children and how to counsel them.
目前,围产期艾滋病毒传播的风险并不构成从道德上批评特定感染妇女的生育选择的依据。然而,对道德相关因素进行情境化评估在某些情况下可能会证明对生育不负责任的判断是合理的。尽管在决定开始或继续妊娠时,任何妇女都不应受到任何形式的强制压力,但对于感染艾滋病毒的妇女,非指导性咨询的“道德教育”模式可能是合适的。即使是非常可取的、为促进社会正义而进行的协调一致的公共努力,也无法消除这些妇女是否应该生育以及如何为她们提供咨询等伦理问题。