Schenker J G, Eisenberg V H
Department Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel.
Int J Gynaecol Obstet. 1997 Jul;58(1):167-76. doi: 10.1016/s0020-7292(97)02866-x.
There are many ethical aspects which derive from the application of reproduction control in women's health. Women's health can be enhanced if women are given the opportunity to make their own reproduction choices about sex, contraception, abortion and application of reproductive technologies. The main issues that raise ethical dilemmas following the development of assisted reproduction techniques are: the right to procreate or reproduce; the process of in vitro fertilization itself-is it morally acceptable to interfere in the reproduction process?; the moral status of the embryo; the involvement of a third party in the reproductive process by genetic material donation; the practice of surrogacy, cryopreservation of pre-embryos; genetic manipulation; experiments on pre-embryos, etc. Induced abortion raises ethical issues related to the rights of the woman versus the rights of the fetus. For those who consider life to begin at conception abortion always equals murder and is therefore forbidden. Those who believe in the absolute autonomy of the woman over her body take the other extreme approach. The discussion surrounding abortion usually centers on whether it should be legal or illegal. Access to safe abortion is critical to the health of women and to their autonomy. The development of new effective contraceptive methods has a profound impact on women's lives. By the use of contraception it is possible to lessen maternal, infant and child mortality and to reduce the prevalence of sexually transmitted diseases. Research and development of new effective reversible contraceptives for women and men is needed. Dissemination of information about the safety and effectiveness of contraceptive methods is of great importance. Female genital mutilation is still practiced worldwide due to customs and tradition among various ethnic groups. The procedure is considered to be medically detrimental to the physical and mental health of women and girls, and is considered by many as oppression of women. The practice has to be stopped. Recognition of the fetus as a 'patient' has a potential effect on women's right for autonomy; they have no legal obligation to undergo invasive procedures and to risk their health for the sake of their fetuses. The woman carries ethical obligations toward her fetus. This obligation should not be enforced by the law. At present women bear most of the burden of reproductive health. All of them have a right of access to fertility regulation. Governments and society must ensure the women's equal rights to health care just as men have in the regulation of their fertility.
生殖控制应用于女性健康会产生诸多伦理问题。如果给予女性机会,让她们就性、避孕、堕胎及生殖技术应用等做出自身的生殖选择,女性健康就能得到改善。辅助生殖技术发展后引发伦理困境的主要问题包括:生育或生殖权;体外受精过程本身——干预生殖过程在道德上是否可接受?;胚胎的道德地位;通过基因物质捐赠第三方参与生殖过程;代孕行为、胚胎冷冻保存;基因操纵;对胚胎进行实验等。人工流产引发了与女性权利和胎儿权利相关的伦理问题。对于那些认为生命始于受孕的人来说,堕胎始终等同于谋杀,因此是被禁止的。而那些坚信女性对自己身体拥有绝对自主权的人则采取了另一种极端立场。围绕堕胎的讨论通常集中在它应该合法还是非法。获得安全堕胎服务对女性健康及其自主权至关重要。新型有效避孕方法的研发对女性生活产生了深远影响。通过使用避孕措施,可以降低孕产妇、婴儿和儿童死亡率,并减少性传播疾病的流行。需要研发针对男性和女性的新型有效可逆避孕方法。传播避孕方法安全性和有效性的信息非常重要。由于不同族群的习俗和传统,女性生殖器切割在全球范围内仍在实行。该手术被认为在医学上对妇女和女孩的身心健康有害,并且被许多人视为对女性的压迫。这种做法必须停止。将胎儿视为“患者”对女性的自主权有潜在影响;她们没有法律义务接受侵入性手术,也没有义务为了胎儿而冒健康风险。女性对其胎儿负有伦理义务。这种义务不应由法律强制执行。目前,女性承担了生殖健康的大部分负担。她们都有权获得生育调节服务。政府和社会必须确保女性在生育调节方面享有与男性平等的医疗保健权利。