器官捐献家庭优先激励的道德合理性与实际有效性  

Moral rationality and practical effectiveness of prioritized incentives for organ donor families

作　　者：唐健[1] 苗康瑞 田慧 TANG Jian;MIAO Kangrui;TIAN Hui(School of Medical Humanities,Tianjin Medical University,Tianjin 300070,China;Hospital of Stomatology,Tianjin Medical University,Tianjin 300070,China;Tianjin Human Organ Procurement Organization,Tianjin 300384,China)

机构地区：[1]天津医科大学医学人文学院,天津300070 [2]天津医科大学口腔医院,天津300070 [3]天津市人体器官获取组织,天津300384

出　　处：《中国医学伦理学》2024年第12期1421-1428,共8页Chinese Medical Ethics

基　　金：天津市哲学社会科学规划项目“人体器官捐献中的家庭伦理问题研究”(TJZX22-022)。

摘　　要：2024年,中国开始施行的《人体器官捐献和移植条例》提出了一个新的规定,确认了器官捐献者近亲属在器官移植排序中享有的优先权益。在新法规的基础上,探讨继续对家庭优先激励的道德合理性和实际有效性问题。在道德合理性问题上,首先分析家庭优先激励存在的公平性和利他主义问题,并指出家庭优先激励在中国的道德依据应该依托于儒学中的家庭主义,儒家伦理可以为该激励措施提供充分的伦理辩护。在实际有效性问题上,回顾前期开展的实证研究,并分析以色列和日本的经验,进而针对目前阶段提出三项推进实际有效性的改进建议:在法律层面表述一致,在社会宣教层面加强生命伦理和家庭伦理的内容,在临床层面重视知情同意,特别要求器官捐献协调员更审慎地表达家庭优先激励。In 2024,the Regulations on Human Organ Donation and Transplantation,which came into force in China,introduced a new norm recognizing the prioritized rights and interests of close family members of organ donors in organ transplantation sorting.Based on the new regulations,the moral rationality and practical effectiveness issues of continued family prioritized incentives were explored.On the issue of moral rationality,this paper first analyzed the fairness and altruism issues of family prioritized incentives,as well as pointed out that the moral basis of family prioritized incentives in China should rely on Confucianism’s familism.Confucian ethics can provide sufficient ethical defense for this incentive measure.On the issue of practical effectiveness,this paper reviewed the empirical studies carried out in the previous period and analyzed the experiences of Israel and Japan.Thus,three improvement suggestions were proposed to promote practical effectiveness at the current stage,including consistent expression at the legal level,strengthening the content of bioethics and family ethics at the level of social education,emphasizing informed consent at the clinical level,and specifically requiring organ donation coordinators to express family priority incentives more cautiously.

关 键 词：人体器官捐献 家庭优先激励 儒家伦理 家庭主义 《人体器官捐献和移植条例》 

分 类 号：R-052[医药卫生]