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为何以及如何补偿活体器官捐赠者:澳大利亚新计划的伦理影响

Why and how to compensate living organ donors: ethical implications of the new Australian scheme.

作者信息

Giubilini Alberto

出版信息

Bioethics. 2015 May;29(4):283-90. doi: 10.1111/bioe.12088. Epub 2014 Mar 24.

Abstract

The Australian Federal Government has announced a two-year trial scheme to compensate living organ donors. The compensation will be the equivalent of six weeks paid leave at the rate of the national minimum wage. In this article I analyse the ethics of compensating living organ donors taking the Australian scheme as a reference point. Considering the long waiting lists for organ transplantations and the related costs on the healthcare system of treating patients waiting for an organ, the 1.3 million AUD the Australian Government has committed might represent a very worthwhile investment. I argue that a scheme like the Australian one is sufficiently well designed to avoid all the ethical problems traditionally associated with attaching a monetary value to the human body or to parts of it, namely commodification, inducement, exploitation, and equality issues. Therefore, I suggest that the Australian scheme, if cost-effective, should represent a model for other countries to follow. Nonetheless, although I endorse this scheme, I will also argue that this kind of scheme raises issues of justice in regard to the distribution of organs. Thus, I propose that other policies would be needed to supplement the scheme in order to guarantee not only a higher number of organs available, but also a fair distribution.

摘要

澳大利亚联邦政府宣布了一项为期两年的活体器官捐赠者补偿试验计划。补偿将相当于按照国家最低工资标准计算的六周带薪休假。在本文中,我以澳大利亚的计划为参考点,分析补偿活体器官捐赠者的伦理问题。考虑到器官移植的漫长等待名单以及治疗等待器官患者的医疗系统相关成本,澳大利亚政府承诺的130万澳元可能是一项非常值得的投资。我认为,像澳大利亚这样的计划设计得足够完善,能够避免所有传统上与给人体或其部分赋予货币价值相关的伦理问题,即商品化、诱导、剥削和平等问题。因此,我建议,如果具有成本效益,澳大利亚的计划应该成为其他国家效仿的模式。尽管如此,虽然我认可这个计划,但我也将论证,这种计划在器官分配方面引发了正义问题。因此,我提议需要其他政策来补充该计划,以不仅保证有更多可用器官,而且保证公平分配。

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