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本文引用的文献

1
Towards a concept of embodied autonomy: In what ways can a patient's body contribute to the autonomy of medical decisions?迈向具身自主的概念:患者的身体在哪些方面可以为医疗决策的自主性做出贡献?
Med Health Care Philos. 2023 Sep;26(3):451-463. doi: 10.1007/s11019-023-10159-7. Epub 2023 Jun 9.
2
Marginal parent donors-Process and ethics.边缘性亲体供者——流程与伦理。
Pediatr Transplant. 2021 Aug;25(5):e14062. doi: 10.1111/petr.14062. Epub 2021 Jun 2.
3
[Young Adult Donor's Experiences of Living Donor Liver Transplantation].[年轻成人活体肝移植供体的经历]
J Korean Acad Nurs. 2021 Feb;51(1):105-118. doi: 10.4040/jkan.20235.
4
Understanding family dynamics in adult-to-adult living donor liver transplantation decision-making in Taiwan: Motivation, communication, and ambivalence.理解台湾成人对成人活体供肝移植决策中的家庭动态:动机、沟通和矛盾心理。
Am J Transplant. 2021 Mar;21(3):1068-1079. doi: 10.1111/ajt.16281. Epub 2020 Sep 23.
5
Did parents have it right all along? Parents, risk, and living kidney donation: Revisiting the arguments for and against parental living donation of kidneys.父母一直以来都是正确的吗?父母、风险与活体肾捐赠:重新审视支持和反对父母活体捐赠肾脏的论据。
Pediatr Transplant. 2018 May;22(3):e13153. doi: 10.1111/petr.13153. Epub 2018 Jan 30.
6
Pediatric liver transplant patients' transition to adulthood: Patient and parent experiences.小儿肝移植患者向成年期的过渡:患者及家长的经历
Nurs Health Sci. 2017 Sep;19(3):393-399. doi: 10.1111/nhs.12358. Epub 2017 Aug 4.
7
Ethical Considerations of Transplantation and Living Donation for Patients with Alcoholic Liver Diseases.酒精性肝病患者移植与活体捐赠的伦理考量
AMA J Ethics. 2016 Feb 1;18(2):163-73. doi: 10.1001/journalofethics.2016.18.2.sect1-1602.
8
Coercion and choice in parent-child live kidney donation.亲子活体肾捐赠中的强制与选择
J Med Ethics. 2015 Apr;41(4):304-9. doi: 10.1136/medethics-2013-101988. Epub 2014 Nov 6.
9
A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others.一种关于移植医学伦理学的现象学方法:与他人一起生活和面对死亡时的社会性与共享性。
Theor Med Bioeth. 2014 Oct;35(5):369-88. doi: 10.1007/s11017-014-9307-3.
10
Neither property right nor heroic gift, neither sacrifice nor aporia: the benefit of the theoretical lens of sharing in donation ethics.既非产权亦非英雄式馈赠,既非牺牲亦非困境:捐赠伦理中共享理论视角的益处。
Med Health Care Philos. 2014 May;17(2):171-81. doi: 10.1007/s11019-013-9514-0.

给予即回报:迈向活体肝移植的身体伦理学

Giving as repaying: towards an embodied ethics of living donor liver transplantation.

作者信息

Lin Ya-Ping, Chen Huei-Ya

机构信息

Department of Medical Humanities and Education, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.

Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan.

出版信息

Med Health Care Philos. 2025 Sep;28(3):517-531. doi: 10.1007/s11019-025-10275-6. Epub 2025 Jun 5.

DOI:10.1007/s11019-025-10275-6
PMID:40471532
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12380939/
Abstract

This article explores the lived experiences and ethical complexities of the decision- and meaning-making journey involved in living donor liver transplantation (LDLT) through a case study of a young adult who donated part of his liver to his father. Utilising embodied phenomenology and narrative analysis, we present an in-depth exploration of personal stories and interconnected narratives that reveal the intricate layers and nuances inherent in child-to-parent LDLT within the Taiwanese sociocultural milieu. This study examines the embodied, relational, temporal and normative dimensions through a dynamic, iterative process of careful reading and analysis, from which four plotlines emerged [(1) indebtedness, (2) thrownness, (3) struggle for selfhood and (4) family seniority] along with a postscript. The findings illuminate the complex interplay of body, self, family, intergenerational dynamics and sociocultural norms throughout the decision-making process. The analysis aims to lay the groundwork for a refined framework for understanding concepts such as giving, relationality, agency, temporality and normativity within bioethical discourses on organ transplantation. Furthermore, the study offers insights for healthcare professionals to develop culturally sensitive approaches in LDLT care ethics and practice, with particular attention to vulnerability, relational autonomy and embodied intersubjectivity as normative foundations.

摘要

本文通过一个年轻成年人将自己部分肝脏捐献给父亲的案例研究,探讨了活体肝移植(LDLT)决策与意义构建过程中的生活经历和伦理复杂性。运用身体现象学和叙事分析方法,我们深入探究了个人故事及相互关联的叙事,揭示了台湾社会文化背景下亲体肝移植中固有的复杂层面和细微差别。本研究通过仔细阅读和分析这一动态、反复的过程,审视了身体、关系、时间和规范维度,从中浮现出四条情节线[(1)感恩之情,(2)被抛状态,(3)自我身份的挣扎,(4)家庭辈分]以及一个后记。研究结果揭示了整个决策过程中身体、自我、家庭、代际动态和社会文化规范之间的复杂相互作用。该分析旨在为完善一个框架奠定基础,以便在器官移植的生物伦理话语中理解诸如给予、关系性、能动性、时间性和规范性等概念。此外,本研究为医疗保健专业人员在活体肝移植护理伦理与实践中制定具有文化敏感性的方法提供了见解,特别关注将脆弱性、关系自主性和身体主体间性作为规范基础。