Meyerson Denise
Bioethics. 2015 Jun;29(5):342-52. doi: 10.1111/bioe.12111. Epub 2014 Sep 3.
Demands for access to experimental therapies are frequently framed in the language of rights. This article examines the justifiability of such demands in the specific context of surgical innovations, these being promising but non-validated and potentially risky departures from standard surgical practices. I argue that there is a right to access innovative surgery, drawing analogies with other generally accepted rights in medicine, such as the right not to be forcibly treated, to buy contraceptives, and to choose to have an abortion, including a post-viability abortion where the mother's life or health is threatened by the pregnancy. I argue that we accept these rights because we believe that people are entitled to try to preserve their lives and health and to make choices of an important and intensely personal kind, and I suggest that a person's choice of medical treatment should be seen in the same light. However, since few rights are absolute, I also consider the circumstances in which it may be justifiable to limit the right to access innovative surgery. In discussing this question, I apply the human rights standard of proportionality, comparing the importance of the reasons for limiting the right with the severity of the invasion on liberty.
对获得实验性疗法的需求常常是以权利的语言来表述的。本文探讨了在外科创新这一特定背景下此类需求的合理性，外科创新是有前景但未经证实且可能偏离标准外科手术操作并存在风险的做法。我认为存在获得创新性手术的权利，通过与医学中其他普遍认可的权利进行类比，比如不被强制治疗的权利、购买避孕药具的权利以及选择堕胎的权利，包括在胎儿具有生存能力后，当母亲的生命或健康因怀孕受到威胁时选择堕胎的权利。我认为我们认可这些权利是因为我们相信人们有权努力维护自己的生命和健康，并做出重要且高度个人化的选择，而且我建议应从同样的角度看待一个人对医疗治疗的选择。然而，由于几乎没有权利是绝对的，我也考虑了在哪些情况下限制获得创新性手术的权利可能是合理的。在讨论这个问题时，我运用了相称性这一人权标准，将限制该权利的理由的重要性与对自由的侵犯程度进行比较。
