Ethics Educator, Mission Services, PeaceHealth, Vancouver, WA, USA.
Adjunct Instructor of Philosophy, Portland Community College, Portland, OR, USA.
HEC Forum. 2023 Dec;35(4):389-406. doi: 10.1007/s10730-022-09475-x. Epub 2022 Feb 25.
The central concern of this article is whether early induction of labor for an anencephalic fetus can ever be morally justified, particularly by a Catholic healthcare ethics committee. By revisiting and refining arguments in articles by Drane (1992) and Bole (1992) published in this journal, a revised argument - consistent with the Catholic moral tradition - can seemingly be constructed that a Catholic healthcare ethics committee might use to justify early induction of labor in some pregnancies involving an anencephalic fetus. Such a revised argument depends upon two central claims; first, that the anencephalic fetus in question is necessarily in the process of dying when early induction of labor occurs, and second, that the fetus is judged to be undergoing extraordinary or disproportionate means of preserving their life as a result of receiving ongoing maternal support of a mother's womb. The revised argument developed in this article aims to utilize the doctrine of double effect in conjunction with these two central claims to justify early induction of labor for anencephalic fetal persons in some circumstances. Unfortunately, the revised argument - if successful - would be at odds with a stance taken in the United States Conference of Catholic Bishops (USCCB) 1996 statement "Moral Principles Concerning Infants with Anencephaly." However, there is reason to believe the revised argument offered in this article is well aligned with other guidance from the USCCB, contained in the publication Ethical and Religious Directives for Catholic Healthcare Services (2018). This article concludes by noting some important limitations of the argument and offering hope that consideration of the argument ultimately helps to strengthen the Catholic moral tradition.
本文的核心关注点在于，无脑畸形胎儿的早期引产手术是否在道德上站得住脚，尤其是对于天主教医疗伦理委员会而言。通过重新审视和精炼这篇文章中 Drane（1992）和 Bole（1992）两位作者的观点，我们可以构建一个看似符合天主教道德传统的修正论点，即天主教医疗伦理委员会可以在某些涉及无脑畸形胎儿的妊娠中，利用这一论点来为早期引产手术辩护。这一修正论点依赖于两个核心主张；首先，当早期引产手术进行时，所涉及的无脑畸形胎儿必然处于死亡过程中；其次，由于母亲子宫继续为胎儿提供支持，胎儿被判定正在经历维持生命的异常或不成比例的手段。本文中所发展的修正论点旨在利用双重效应原则，并结合这两个核心主张，在某些情况下为无脑畸形胎儿的早期引产手术提供辩护。不幸的是，修正论点——如果成功——将与美国天主教主教会议（USCCB）1996 年的立场“无脑畸形婴儿的道德原则”相冲突。然而，有理由相信本文中提出的修正论点与 USCCB 其他指导意见相吻合，这些指导意见包含在《天主教医疗保健服务的伦理和宗教指令》（2018）中。本文最后指出了该论点的一些重要局限性，并希望对该论点的考虑最终有助于加强天主教道德传统。
