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A Tempered Rationalism for a Tempered Yuck Factor—Using Disgust in Bioethics 有节制的理性主义促进有节制的 "恶心因子"--在生物伦理学中使用 "恶心 "一词
IF 1.3 Q3 ETHICS Pub Date : 2024-03-28 DOI: 10.1007/s41649-023-00278-x
Konstantin Eckl, Konstantin Deininger

When it comes to invasive manipulation of animals on the biological level, reactions of disgust are common and often influential on people’s moral judgments. As a case in point, the Belgian Blue, a breed of hyper-enhanced cattle which will serve as a case study for the present article, has historically been met with revulsion. Traditionally, in bio- and animal ethics, this ‘yuck factor,’ has been denied any productive role in proper moral justification, since rationalism is still a dominant paradigm in those disciplines. This is not surprising since rationalism offers the fulfilment of certain expectations we have of morality, like universality, intersubjective communicability, and objectivity. Increasingly, however, the preconceptions of rationalism have been brought into question, both through empirical as well as philosophical insights. In this paper, we will explore a way in which researchers who are, accordingly, critical of rationalism, and who wish to take seriously the role disgust plays in the formation of moral judgments when it comes to biological manipulation of animals, can do so without abandoning those virtues of rationalism which make it such an appealing position. We will do so by offering what we call a ‘tempered’ kind of rationalism, that is, one which conceives of rationality in the terms of Mary Midgley, not as distinct from, but as a possible function of, well-ordered emotion.

说到对动物进行生物学层面的侵入性操纵,人们通常会产生厌恶反应,而且这种反应往往会影响人们的道德判断。比利时蓝牛就是一个很好的例子,它是一种超级强化牛,本文将以此为案例进行研究。传统上,在生物伦理学和动物伦理学中,由于理性主义仍是这些学科的主导范式,这种 "憎恶因素 "在适当的道德论证中被剥夺了任何有成效的作用。这并不奇怪,因为理性主义满足了我们对道德的某些期望,如普遍性、主体间的可交流性和客观性。然而,理性主义的先入之见越来越多地受到质疑,既有经验上的,也有哲学上的。在本文中,我们将探讨一种方法,让那些对理性主义持批判态度的研究人员,以及那些希望在对动物进行生物学操纵时认真对待厌恶在道德判断形成过程中所扮演的角色的研究人员,能够在不放弃理性主义那些使其具有吸引力的优点的情况下做到这一点。为此,我们将提出一种我们称之为 "有节制的 "理性主义,即按照玛丽-米德格利(Mary Midgley)的观点来构想理性,这种理性不是有别于秩序井然的情感,而是情感的一种可能功能。
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引用次数: 0
Developing a Framework for Self-regulatory Governance in Healthcare AI Research: Insights from South Korea 制定医疗人工智能研究自律治理框架:韩国的启示
IF 1.3 Q3 ETHICS Pub Date : 2024-03-25 DOI: 10.1007/s41649-024-00281-w
Junhewk Kim, So Yoon Kim, Eun-Ae Kim, Jin-Ah Sim, Yuri Lee, Hannah Kim

This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the ‘Research Ethics Guidelines for AI Researchers in Healthcare’ published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers’ ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future.

本文对韩国政府于 2023 年 8 月发布的《医疗保健领域人工智能研究人员的研究伦理指南》中概述的医疗保健领域人工智能研究伦理治理体系进行了阐释和合理化。在制定指导方针的过程中,将临床试验的四个阶段扩展为医疗人工智能研究的六个阶段:初步伦理审查(第 1 阶段);创建数据集(第 2 阶段);模型开发(第 3 阶段);训练、验证和评估(第 4 阶段);应用(第 5 阶段);以及部署后监控(第 6 阶段)。研究人员发现了临床试验与医疗人工智能研究之间的相似之处,特别是在研究对象、管理和法规以及研究成果的应用方面。在逐步阐明伦理要求方面,这种相似性得益于对现有研究伦理治理资源、研究管理和监管职能的可靠而灵活的利用。与临床试验相比,这种程序化的医疗人工智能研究治理方法有效地突出了医疗人工智能研究在研发过程、结果评估和研究结果可修改性方面的显著特点。该模式存在局限性,主要表现在依赖自我调节和缺乏明确的责任划分。虽然该模式是通过多学科审议制定的,但其在研究领域的应用仍有待检验。为了克服这些局限性,研究人员正在努力对人工智能研究人员和公众进行教育,并对指导方针进行修订,预计这将有助于在未来为韩国的医疗人工智能研究建立一个符合伦理的研究管理框架。
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引用次数: 0
The Law and Ethics of Reproduction: Experiences and Perspectives from Asia 生殖的法律与伦理:亚洲的经验与观点
IF 1.3 Q3 ETHICS Pub Date : 2024-03-25 DOI: 10.1007/s41649-024-00286-5
Graeme T. Laurie
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引用次数: 0
Support for the Right to Life among Neonatal Intensive Care Nurses in Korea 韩国新生儿重症监护护士对生命权的支持
IF 1.3 Q3 ETHICS Pub Date : 2024-02-24 DOI: 10.1007/s41649-023-00277-y
Somin Kim, Sunhee Lee

The increase of high-risk newborns due to societal changes has presented neonatal intensive care unit nurses with more ethical challenges and heightened their perception of neonatal palliative care. Therefore, this study was a descriptive survey exploring the perceptions of neonatal intensive care unit nurse regarding biomedical ethics and neonatal palliative care in neonatal intensive care units. The research participants were 97 neonatal intensive care unit nurses who had been directly involved with end-of-life care for high-risk babies. Data were collected from November to December 2021 through an online survey. The Korean version of Neonatal Palliative Care Attitude Scale and the tool of biomedical ethics were used. The collected data were analyzed using the T-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. The mean score for perception of biomedical ethics in neonatal intensive care unit nurses was 2.89 of 4, and that of neonatal palliative care in neonatal intensive care unit nurses was 3.10 of 5. Existence of a protocol of neonatal palliative care, the experience of patients dying, and the right to life of neonates were factors influencing the perception of neonatal palliative care. The explanatory power was 12.5%. The data support the importance of guidelines regarding systematic neonatal palliative care. Also, developing programs for sharing and supporting experiences of patients dying among colleagues and persistent education about the right to life of neonates for neonatal intensive care unit nurses can improve perception of neonatal palliative care.

由于社会变革,高危新生儿增多,这给新生儿重症监护病房护士带来了更多伦理挑战,也提高了她们对新生儿姑息治疗的认识。因此,本研究对新生儿重症监护病房护士对新生儿重症监护病房生物医学伦理和新生儿姑息治疗的认知进行了描述性调查。研究参与者为 97 名新生儿重症监护室护士,她们直接参与了高危婴儿的临终关怀。数据是在 2021 年 11 月至 12 月期间通过在线调查收集的。调查使用了韩国版新生儿姑息治疗态度量表和生物医学伦理工具。收集到的数据采用 T 检验、方差分析、Scheffé 检验、皮尔逊相关系数和多元回归分析进行分析。新生儿重症监护室护士对生物医学伦理的认知平均分为 2.89 分(满分为 4 分),新生儿重症监护室护士对新生儿姑息治疗的认知平均分为 3.10 分(满分为 5 分)。新生儿姑息治疗方案的存在、患者濒死的经历和新生儿的生命权是影响新生儿姑息治疗认知的因素。解释力为 12.5%。这些数据支持了系统性新生儿姑息治疗指南的重要性。此外,为同事之间分享和支持患者死亡的经验制定计划,以及对新生儿重症监护室护士进行有关新生儿生命权的持续教育,也能改善对新生儿姑息治疗的认知。
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引用次数: 0
A Dialogue between Hindu and Catholic Perspectives in Taking Care of Newborns at their End-of-Life 印度教和天主教在照顾临终新生儿方面的观点对话
IF 1.3 Q3 ETHICS Pub Date : 2024-02-01 DOI: 10.1007/s41649-023-00275-0
Giulia Adele Dinicola

Hinduism is considered one of the most ancient religions in the world. Although the technological innovation of modernization has undermined the reliance on their traditions, Hindus may still rely on Hindu Scripture when making decisions. From their standpoint, contrary to Western medicine, human lives cannot be reduced to statistical and empirical facts. They focus more on preserving the spirit, rather than considering survival as one of the goals of medicine. Consequently, when a preterm infant is born, Hindu parents might struggle to understand the goals of Western neonatologists. This divergence may create misunderstandings when discussing end-of-life decisions. Since they value relational aspects to be of utmost importance, they may accept treatments only in the likelihood of good neurological outcomes. Being able to interact allows Hindus to act virtuously with the aim of purifying their soul toward moksa. When it comes to end-of-life decisions on behalf of newborns, Hindu parents may opt to forgo treatments and let the baby peacefully die, while praying for their soul to have a better rebirth. This paper aims to evaluate quality-of-life assessment in the Hindu tradition in comparison with the Catholic tradition. It draws parallelisms between these two different religions to investigate whether an inter-religious dialogue is possible. This work will help Catholic, and more broadly Western, doctors to have a better understanding of the Hindu end-of-life views.

印度教被认为是世界上最古老的宗教之一。虽然现代化的技术革新削弱了对其传统的依赖,但印度教徒在做决定时仍会依赖印度教经文。在他们看来,与西方医学相反,人的生命不能简化为统计数字和经验事实。他们更注重保护精神,而不是将生存作为医学的目标之一。因此,当早产儿出生时,印度教父母可能很难理解西方新生儿专家的目标。在讨论临终决定时,这种分歧可能会造成误解。由于他们将亲情视为最重要的因素,因此他们可能只在神经功能良好的情况下才接受治疗。印度教徒能够进行互动,从而以善行来净化自己的灵魂,实现 "莫克萨"(moksa)的目标。在代表新生儿做出生命终结的决定时,印度教父母可能会选择放弃治疗,让婴儿平静地死去,同时祈祷他们的灵魂得到更好的重生。本文旨在对比天主教传统,评估印度教传统中的生命质量评估。它将这两种不同的宗教相提并论,以探讨宗教间对话是否可能。这项工作将有助于天主教医生以及更广泛意义上的西方医生更好地理解印度教的临终观点。
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引用次数: 0
The Impact of Clinical Ethics Consultations on Physicians in a Latin American Context 拉丁美洲背景下临床伦理咨询对医生的影响
IF 1.3 Q3 ETHICS Pub Date : 2024-01-24 DOI: 10.1007/s41649-023-00271-4
Nathalia Rodríguez-Suárez, Paula Prieto-Martínez

Clinical bioethics plays a significant role in hospital settings through bioethics consultations, which focus on providing ongoing assistance in complex situations within the doctor-patient dynamic. These consultations entail regular interaction between physicians and clinical bioethicists. This situation prompts an exploration into how bioethics consultations affect physicians. The current research aims to understand the influence of bioethics consultations on physicians’ bioethical knowledge by analyzing the lexical content in their patients’ medical records. Medical records are a synthesis carried out by physicians, often reflecting collaborative efforts, and capturing verbal statements indicative of thought processes suggestive of learning. The study is a sequential mixed-methods design with a retrospective descriptive approach, comparing medical records from the early years of the Department of Humanism and Bioethics’ operation (2013–2015) to the more recent ones (2019). Technical bioethical terminology such as “therapeutic effort limitation,” “futility,” “beneficence,” and “respect for autonomy” is more prevalent in recent medical records. This trend may stem from the positive impact of bioethics consultations conducted by the Department, with haptic communication serving as a particularly effective form of interaction with others during experiences of moral distress. This appears to be characteristic of cultures like those in Latin America.

临床生物伦理学通过生物伦理学会诊在医院环境中发挥着重要作用,其重点是在医患关系复杂的情况下提供持续的帮助。这些会诊需要医生和临床生物伦理学家之间的定期互动。这种情况促使人们探索生命伦理学咨询如何影响医生。目前的研究旨在通过分析病人病历中的词汇内容,了解生命伦理学咨询对医生生命伦理学知识的影响。病历是医生进行的综合分析,通常反映了合作的努力,并捕捉到了表明学习的思维过程的口头陈述。本研究采用顺序混合方法设计,采用回顾性描述方法,比较人文主义与生命伦理学系运行初期(2013-2015 年)和近期(2019 年)的医疗记录。在近期的医疗记录中,"治疗努力限制"、"徒劳"、"受益 "和 "尊重自主权 "等生物伦理技术术语更为普遍。这一趋势可能源于该部开展的生命伦理学咨询所产生的积极影响,在经历道德困境时,触觉交流是与他人互动的一种特别有效的形式。这似乎是拉丁美洲文化的特点。
{"title":"The Impact of Clinical Ethics Consultations on Physicians in a Latin American Context","authors":"Nathalia Rodríguez-Suárez,&nbsp;Paula Prieto-Martínez","doi":"10.1007/s41649-023-00271-4","DOIUrl":"10.1007/s41649-023-00271-4","url":null,"abstract":"<div><p>Clinical bioethics plays a significant role in hospital settings through bioethics consultations, which focus on providing ongoing assistance in complex situations within the doctor-patient dynamic. These consultations entail regular interaction between physicians and clinical bioethicists. This situation prompts an exploration into how bioethics consultations affect physicians. The current research aims to understand the influence of bioethics consultations on physicians’ bioethical knowledge by analyzing the lexical content in their patients’ medical records. Medical records are a synthesis carried out by physicians, often reflecting collaborative efforts, and capturing verbal statements indicative of thought processes suggestive of learning. The study is a sequential mixed-methods design with a retrospective descriptive approach, comparing medical records from the early years of the Department of Humanism and Bioethics’ operation (2013–2015) to the more recent ones (2019). Technical bioethical terminology such as “therapeutic effort limitation,” “futility,” “beneficence,” and “respect for autonomy” is more prevalent in recent medical records. This trend may stem from the positive impact of bioethics consultations conducted by the Department, with haptic communication serving as a particularly effective form of interaction with others during experiences of moral distress. This appears to be characteristic of cultures like those in Latin America.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"16 4","pages":"635 - 651"},"PeriodicalIF":1.3,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139601869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Wearable Devices for Long COVID: Prospects, Challenges and Options 用于长 COVID 的可穿戴设备:前景、挑战和选择
IF 1.3 Q3 ETHICS Pub Date : 2024-01-20 DOI: 10.1007/s41649-023-00272-3
Hui Yun Chan

Post COVID-19 infections resulting in long COVID symptoms remain persistent yet neglected in healthcare priorities. Although long COVID symptoms are expected to decline after some time, many people continue to endure its debilitating effects affecting their daily lives. The diversity of characteristics amongst long COVID patients adds to the complexity of communicating personal health predicaments to healthcare providers. Recent research towards building an evidence base for long COVID with the aim of delivering responsive healthcare interventions for long COVID patients has utilised datasets generated from wearable devices. This paper examines the prospects presented by wearable devices for long COVID patients and physicians. It highlights distinct ethical and legal challenges arising from their use in practice. Several recommendations aiming to support their usage amongst long COVID patients are outlined for future research using wearable devices for long COVID treatment.

COVID-19 后感染导致的长期 COVID 症状仍然持续存在,但却被医疗保健优先事项所忽视。尽管长COVID症状在一段时间后会有所缓解,但许多人仍在忍受其对日常生活造成的衰弱影响。长期慢性阻塞性肺气肿患者的特征多种多样,这增加了与医疗服务提供者沟通个人健康困境的复杂性。为建立长期慢性阻塞性肺病的证据基础,以便为长期慢性阻塞性肺病患者提供有针对性的医疗干预措施,最近的研究利用了可穿戴设备生成的数据集。本文探讨了可穿戴设备为长期慢性阻塞性肺病患者和医生带来的前景。它强调了在实践中使用可穿戴设备所面临的伦理和法律挑战。本文概述了几项建议,旨在支持将可穿戴设备用于长期慢性阻塞性肺病治疗的未来研究。
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引用次数: 0
The Role of Male Consent in Assisted Reproductive Technology Procedures: an Examination of Japanese Court Cases 男性同意在辅助生殖技术程序中的作用:日本法院案例研究
IF 1.3 Q3 ETHICS Pub Date : 2024-01-18 DOI: 10.1007/s41649-023-00274-1
Yuko Muraoka, Minori Kokado, Kazuto Kato

With the development of assisted reproductive technologies, medical, ethical, legal, and social issues have arisen that did not exist when natural conception was the only means of childbirth. In Japan, men tend to believe that assisted reproductive technologies are not directly related to them, with the literature showing that men are often reluctant to be involved in fertility treatment processes. To better understand this situation, this study analyzes the role of male consent during assisted reproductive technology procedures in Japan. First, we examined Japanese court cases that dealt with issues related to male consent during assisted reproductive technology procedures and identified three situations in which problems related to male consent during such procedures may arise. Next, we analyzed the background of such issues and the implications of the lack of consent regarding men’s reproductive rights. Finally, we explored the need for legislation on assisted reproductive technologies. The study concludes that discussions on the scope of male partner rights in assisted reproductive technology procedures are key for minimizing unnecessary conflict between partners, thus ensuring both the rights of women who wish to have children and the welfare of their children.

随着辅助生殖技术的发展,出现了一些医学、伦理、法律和社会问题,而这些问题在自然受孕是唯一的生育手段时是不存在的。在日本,男性往往认为辅助生殖技术与他们没有直接关系,文献显示男性往往不愿意参与生育治疗过程。为了更好地理解这种情况,本研究分析了日本男性在辅助生殖技术过程中的同意作用。首先,我们研究了涉及辅助生殖技术程序中男性同意相关问题的日本法院案例,并确定了在此类程序中可能出现男性同意相关问题的三种情况。接下来,我们分析了此类问题的背景以及未经同意对男性生殖权利的影响。最后,我们探讨了辅助生殖技术立法的必要性。本研究的结论是,讨论男性伴侣在辅助生殖技术程序中的权利范围是将伴侣间不必要的冲突降至最低的关键,从而确保希望生育的妇女的权利及其子女的福利。
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引用次数: 0
Ethical and Regulatory Gaps in Aesthetic Medical Practice in Top Asian Medical Tourism Destinations 亚洲顶级医疗旅游目的地美容医疗实践中的伦理与监管空白
IF 1.3 Q3 ETHICS Pub Date : 2023-11-29 DOI: 10.1007/s41649-023-00267-0
Nishakanthi Gopalan

Aesthetic medicine merges art and medical sciences, focusing on the modification and enhancement of physical appearance through surgical and non-surgical procedures. While it is not globally recognized as a medical specialty, aesthetic medicine has become a cornerstone of medical tourism in several Asian countries, including India, Malaysia, Singapore, South Korea, and Thailand. Despite its popularity, there is notable gap in literature concerning its ethical and regulatory perspective. This study aims to provide a comprehensive analysis of existing regulations and ethical considerations in aesthetic medicine within the context of the selected Asian countries. Given the field’s growth and its potential impact on both domestic and international health practices, this study is significant for healthcare providers, policymakers, and consumers alike. By identifying areas for improvement in current regulatory frameworks, the paper advocates for further examination to ensure that stakeholder rights and well-being are adequately protected.

美容医学融合了艺术和医学科学,侧重于通过外科和非外科手术改变和提升外貌。虽然美容医学并不是全球公认的医学专科,但在一些亚洲国家,包括印度、马来西亚、新加坡、韩国和泰国,美容医学已成为医疗旅游的基石。尽管美容医学很受欢迎,但有关其伦理和监管角度的文献却明显不足。本研究旨在对选定的亚洲国家美容医学的现有法规和伦理因素进行全面分析。鉴于该领域的发展及其对国内外医疗实践的潜在影响,本研究对医疗服务提供者、政策制定者和消费者都具有重要意义。通过确定当前监管框架中需要改进的地方,本文主张进一步审查,以确保利益相关者的权利和福祉得到充分保护。
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引用次数: 0
Counseling Elective Egg Freezing Patients considering Donation of Unused Surplus Frozen Eggs for Fertility Treatment 为考虑捐赠未使用的剩余冷冻卵子用于生育治疗的选择性冷冻卵子患者提供咨询
IF 1.3 Q3 ETHICS Pub Date : 2023-11-29 DOI: 10.1007/s41649-023-00268-z
Alexis Heng Boon Chin, Jean-Didier Bosenge Nguma, Charles Nkurunziza, Ningyu Sun, Guoqing Tong

The majority of women who freeze their eggs for non-medical or social reasons, commonly referred to as elective egg freezing (EEF), do not eventually utilize their frozen eggs. This would result in an accumulated surplus of unused frozen eggs in fertility clinics worldwide, which represents a promising source of donation to infertile women undergoing IVF treatment. Rigorous and comprehensive counseling is needed, because the process of donating one’s unused surplus frozen eggs involves complex decision-making. Prospective EEF donors can be broadly categorized into those who have achieved motherhood and those who remained childless and have given up on motherhood aspirations. A two-step systematic counseling protocol is proposed. Firstly, it is imperative to verify and ensure that these women do not want to conceive any children with their surplus frozen eggs before proceeding with further counseling and signing of consent forms. Secondly, various motivating and dissuading factors in the donation of unused surplus frozen eggs should then be comprehensively discussed with egg freezers to facilitate informed decision-making. Key motivating factors for donation include reciprocity in wanting to share the joys of motherhood among egg freezers who already have children, goodwill to help others in need, and avoiding the wastage of surplus frozen eggs after expending so much money, time, and effort. Key dissuading factors include fear of accidental incest between natural and unknown donor-conceived offspring, as well as apprehension of unexpected future contact with unknown donor-conceived offspring due to either donor anonymity being abolished in their jurisdiction or widespread consumer DNA testing.

大多数出于非医疗或社会原因而冷冻卵子的女性(通常称为选择性冷冻卵子(EEF)),最终并没有使用其冷冻卵子。这将导致全球不孕不育诊所中未使用的冷冻卵子累积过剩,为接受试管婴儿治疗的不孕妇女提供了一个很有前景的捐赠来源。由于捐献未使用的剩余冷冻卵子的过程涉及复杂的决策,因此需要进行严格而全面的咨询。潜在的冷冻卵子捐献者可大致分为已成为母亲的捐献者和仍未生育并放弃做母亲愿望的捐献者。我们提出了一个分两步走的系统咨询方案。首先,在进行进一步咨询和签署同意书之前,必须核实并确保这些妇女不想用其多余的冷冻卵子受孕。其次,应与卵子冷冻者全面讨论捐赠未使用的剩余冷冻卵子的各种动机和劝阻因素,以促进知情决策。捐赠的主要动机因素包括希望与已经有孩子的卵子冷冻者分享做母亲的喜悦的互惠性、帮助其他有需要的人的善意,以及在花费了大量金钱、时间和精力后避免浪费多余的冷冻卵子。主要的劝阻因素包括担心亲生后代和未知捐献者所怀后代之间发生意外乱伦,以及担心将来会与未知捐献者所怀后代发生意想不到的接触,因为在他们的管辖范围内,捐献者匿名制度已经废除,或者消费者 DNA 检测已经普及。
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引用次数: 0
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Asian Bioethics Review
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