再論輔助生殖技術的規範立場【醫法新論】 試閱
Rethinking the Regulatory Position on Assisted Reproductive Technology
新近文獻中提出的「絕對禁止代孕」立場值得商榷。首先，代孕的倫理判斷與立法選擇本質上體現了多元價值間的「善惡權衡」而非「是非決斷」，倫理絕對化具有漠視技術倫理情景依賴性與發展多元性的根本缺陷。其次，就「輔助生殖技術因針對無疾病者實施而違背醫學倫理」的觀點，透過類比器官捐獻等醫療行為，可以反證以此指責代孕違背醫學倫理不具有說服力。第三，輔助生殖技術由「醫療機構經濟利益驅動」的質疑不能成立，輔助生殖技術實施由患者意願主導，現行監管體系也對醫療機構的逐利動機具有抑制作用。最後，無視需求的絕對禁止不僅無法遏制地下代孕市場及其引發的健康與法律風險，反而加劇權利侵害與司法困境，基於成本的合理補償與非商業性並不矛盾。立法應回應現實需求，在妥協中尋求正義，建議實施代孕的原則禁止、有限許可與嚴格監管，在維護女性尊嚴、兒童利益與社會倫理前提下，實現輔助生殖技術善治。
The stance of “absolute ban on surrogacy” proposed in recent literature is open to discussion. First of all, ethical judgments and legislative choices regarding surrogacy essentially reflect a trade-off between good and evil among multiple values rather than a simple judgment of right and wrong. Ethical absolutism has a fundamental flaw of ignoring the situational dependence and developmental diversity of technological ethics. Secondly, some argue that assisted reproductive technology violates medical ethics because it is applied to people without illnesses, can be disproved unconvincing by analogy with medical practices such as organ donation. Thirdly, the suspicion that the practice of assisted reproductive technology is driven by the economic interests of medical institutions is untenable. The application of assisted reproductive technology is dominated by patients’ willingness, and the current regulatory system also restrains the profit-seeking motives of medical institutions. Finally, an absolute ban that ignores actual demands can neither curb the underground surrogacy market nor the consequent health and legal risks; on the contrary, it aggravates rights infringements and judicial dilemmas. Reasonable compensation based on costs is not contradictory to non-commercialization. Legislation should respond to practical demands and pursue justice through compromise. This paper proposes to adopt a regulatory model of general prohibition, limited permission and strict supervision for surrogacy, so as to realize sound governance of assisted reproductive technology while safeguarding women’s dignity, children’s interests and social ethics.
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