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DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 王皇玉(Huang-Yu Wang) | |
dc.contributor.author | Li-Hsuan Wu | en |
dc.contributor.author | 吳俐萱 | zh_TW |
dc.date.accessioned | 2021-05-17T15:59:46Z | - |
dc.date.available | 2020-01-21 | |
dc.date.available | 2021-05-17T15:59:46Z | - |
dc.date.copyright | 2020-01-21 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-01-13 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/7130 | - |
dc.description.abstract | 當等待捐贈的名單越來越長,成為每個社會醫療的龐大支出和必須面對的問題時,許多相應的法律制度和政策紛紛出現,用來提高器官捐贈的比率。其中所涉及的問題不容忽視,而對於現存的法令制度亦有待檢討。就法律的解釋面向,過去在器官移植領域所遵從的腦死標準,漸漸轉變到心臟死的討論。心臟死固然是死亡概念下最自然不過的判準,但是在移植的範疇下卻出現疑慮,並且有待更細緻化的規範。而一向被視為鐵律的死後捐贈原則,似乎也隨著時代需求,變得不再重要。除了將死亡定義之解釋擴大,捐贈者的同意權也是一個著手的目標。傳統上知情同意是被認為較符合自主權的作法,但是隨著教育的推廣和大眾觀念的改變,許多人是有意願成為捐贈者的,而採用推定同意的作法可以大幅提升捐贈率。最能避免爭議的作法或許是強制選擇,但是實行之難度也有待討論。另外,個人的意願雖然重要,但是家屬的參與也是必然的,如何在每個制度中兼顧兩者的利益甚為關鍵。
除了屍體捐贈的鬆綁,活體捐贈也受到關切,認為應該給予更少的限制。以往為了杜絕器官交易,及保護捐贈者的健康利益,將活體捐贈限於一定親等間。不過基於深厚情感基礎的捐贈亦應該被容許,且親屬間是否會造成不當的壓力也容有疑問。為了能提高捐贈的機會和效率,法律也開放各種新型態的配對模式,期待嘉惠更多受贈者。在器官捐贈的議題下,有償的金錢介入一直是禁忌,但是捐贈者因為移植手術所受的各類損失,應具有受補償的正當性。補償的手段和額度也是討論的核心,該如何有效地達到補助的目的,卻不會構成經濟性的誘因導致買賣的質疑,是一個挑戰。以上的四大議題,參照其他國家的法律政策,期望提供台灣修法的參考。 | zh_TW |
dc.description.abstract | As the waiting list continues to grow, the demand for organ supply increases. The shortage of organs has brought heavy burden to medical expenses in every society, and has become a serious problem. Therefore, many laws and policies are carried out as solutions to boost the donation rate. Concerns derive from these regulations and methods to enhance the supply of organ, and there are still room for improvement and debate in the current system.
In terms of legal interpretation, brain death used to be the common standard in the field of organ transplantation, yet the discussion of cardiac death has gained attention recently. Cardiac death, without doubt, is the most natural and straightforward understanding of the concept of death, but under the topic of organ transplantation, suspicions and worries appear. Hence, the need for detailed and complete guidelines is inevitable. Moreover, the authoritative dead donor rule seems to face its challenge and become less important in the modern world. Besides the expansion the definition of death in law, donor’s consent is also a target to increase organs. Traditionally, informed consent(opt-in system)is considered to correspond to one’s autonomy, yet as the promotion of education becomes prevalent leading to the change of public’s attitude towards organ donation, many actually are willing to become donors. However, due to some reasons, they may not take actions to obtain the donor card. In this case, the implement of presumed consent(opt-out system)can help lift organ donation rate, without violating one’s autonomy. Perhaps, the best system is mandated choice, ensuring everyone’s wish is recorded, nonetheless the operation of such system can have difficulties. In addition, though one’s autonomy should be respected, families’ participation cannot be neglected. Reaching balance for both sides is crucial. In addition to the movement in corpse donation, living donation has gained attention too, hoping to remove some of the present restrictions. For the purpose of banning organ sales and protecting donors’ interests and health, living donation is limited to donations between certain relatives. Nevertheless, donors who share deep emotional connection with the recipients should be allowed to donate as well. Also, whether donation among certain relatives will bring undue pressure to the donor is a question. In order to benefit more patients and achieve efficiency, new models of pairing have been created, and are legalized in law. When it comes to organ donation, the involvement of monetary payment has always been a taboo, but donors’ loss due to the transplantation surgery should have the ground to be compensated. The means of compensation and its level are open to debate. How such compensation can function properly without turning into an economic incentive is a challenge. In the hope of offering references to Taiwan’s laws and policies, the four topics mentioned above are researched and compared with other nations’ laws and policies. | en |
dc.description.provenance | Made available in DSpace on 2021-05-17T15:59:46Z (GMT). No. of bitstreams: 1 ntu-109-R04a41032-1.pdf: 2497901 bytes, checksum: 40c59d1b30f744ccdacfb4a562b86205 (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | 目錄
第一章 緒論 1 第一節 研究動機與目的 1 第二節 研究範圍與研究方法 5 第三節 論文架構 7 第二章 人體器官移植制度之倫理爭議 9 第一節 器官捐贈與醫學倫理 9 第二節 屍體捐贈之死亡時點認定 13 第一項 心肺功能喪失說 13 第二項 三徵候說(綜合判斷說) 14 第三項 腦死說 14 第三節 死後捐贈原則 16 第一項 心臟死相關爭議 17 一、 美國法上之爭議 18 二、 可否捐心臟之疑義 19 三、 死亡時點認定與不接觸期 20 四、 死後介入措施 23 五、 死前介入措施 25 第二項 死後捐贈原則之揚棄? 28 第三項 我國心臟死爭議 33 第三章 人體器官移植之同意及相關政策 41 第一節 表態同意與表態退出 41 第一項 不同制度之器官捐贈率 42 第二項 不同制度與自主同意權 48 第三項 強制選擇 55 第四項 家屬參與 60 第五項 小結 66 第四章 其他人體器官移植之相關政策 69 第一節 活體配對政策之開放 69 第一項 非親屬捐贈之可行性 72 第二項 新型態配對制度 74 第三項 台灣活體捐贈法制其他議題 80 第四項 小結 83 第二節 鼓勵捐贈模式(經濟補償) 83 第一項 補償制度漸成趨勢 84 第二項 伊朗模式 86 一、支持伊朗模式 87 二、反對伊朗模式 89 第三項 對於補償的新看法 91 第四項 其他模式 94 第五項 小結 97 第五章 結論 99 參考文獻 102 | |
dc.language.iso | zh-TW | |
dc.title | 人體器官移植之法律與政策 | zh_TW |
dc.title | Legal Issues and Policies of Human Organ Transplantation | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 許恒達(Heng-Da Hsu),吳志正(Chih-Cheng Wu) | |
dc.subject.keyword | 心臟死,死後捐贈原則,表態同意,表態退出,活體捐贈,器捐補償, | zh_TW |
dc.subject.keyword | Cardiac death,Dead donor rule,Opt-in,Opt-out,Living donation,Compensation of Organ transplantation, | en |
dc.relation.page | 128 | |
dc.identifier.doi | 10.6342/NTU202000077 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2020-01-13 | |
dc.contributor.author-college | 法律學院 | zh_TW |
dc.contributor.author-dept | 科際整合法律學研究所 | zh_TW |
顯示於系所單位: | 科際整合法律學研究所 |
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