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研究生: 曾金鳳
CHIN-FENG TSENG
論文名稱: 從辛格的功利主義論基因治療:產前篩選與生殖細胞基因治療
指導教授: 李瑞全
Shui-Chuen Lee
口試委員:
學位類別: 碩士
Master
系所名稱: 文學院 - 哲學研究所在職專班
Graduate Institute of Philosophy
畢業學年度: 95
語文別: 中文
論文頁數: 96
中文關鍵詞: 胚胎植入前診斷基因疾病體細胞基因治療生殖細胞基因治療利益平等考量原則偏好功利主義基因增強優生學產前基因篩檢墮胎滑坡論證生命商品化
外文關鍵詞: sanctity of life, slippery slope argument, Pre-implantation Genetic Diagnosis, genetic malady, abortion, somatic cell gene therapy, preference utilitarianism, germ-line cell gene therapy, principle of equal consideration of interest, genetic enhancement, eugenics, prenatal genetic screening, the life commercialized
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  • 生物科技的發展,使得人類進一步解開生命的謎題,同時,也不可免地改變人類對生命、醫療、價值等觀念,在醫學研究方面,基因治療的發展使得許多不是現行發病的病人也可能成為病人,改變我們對於疾病的定義與對人類生命本身的理解。基因療法主要有兩類,其一是體細胞治療,所有的干預修飾都在體細胞內,基因的改變不會傳遞給子代;其二是生殖細胞治療,在精子、卵或受精卵中進行遺傳質改變,這些變化將傳遞給後代。瓦特、龐門(Leroy Walters & Julie Gage Palmer)等學者所採取的觀點是--即體細胞基因治療僅只是傳統療法的進一步擴大化,而非另類的嶄新療法。生殖細胞基因治療因為能改變缺陷基因,徹底杜絕遺傳疾病或是可能醫治其他人們束手無策的重大疾病而廣受注目。未來的病人在疾病尚未發生以前,疾病就已經被根治了。甚至於他的後代在未來也都不會再帶有這些有缺陷的基因。
    辛格認為為人父母希望小孩有最佳的立足點,可有三種模式:第一,透過試管內受精,在植入前做篩檢;第二,產前期診斷和選擇性墮胎;第三,他們從優良的人那取得卵子、精子或胎兒,本文即依此探討產前篩選與生殖細胞基因治療所引發的道德爭議,尋找道德上可接受的論據。辛格為功利主義者,依此為進路我們藉此瞭解功利主義的理論內容、原則,並瞭解他對身心障礙者的看法。第三章介紹疾病的定義而衍伸出基因疾病也能適用的定義,進而治療。基因治療的種類及消極、積極基因治療的界線問題,基因增強、優生學也是我們的重點。而辛格對於產前篩選與基因選擇的論據而推出他對生殖細胞基因治療的可能看法;最後討論生殖細胞基因治療的正反兩面爭議,及辛格對反對論據之回應。


    The development of bio technology, make hum an beings solve to th e
    mystery of the life and change human beings concept of the life , medical
    treatment, value, etc. Development of gene therapy make a lot o f future
    patients that have illness might become current patients in med ical research
    and change us to the definition of the disease. Gene therapy h as two kinds:
    the first therapy is the somatic cell gene therapy, changed of the gene will not
    be transmitted to the sublings. The second therapy is germ-line cell gene
    therapy, changed the hereditary quality to change in the sperm, ovum or zygote.
    Leroy Walters& Julie Gage Palmer' s view, that somatic cell gene therapy is
    expanding of traditional treatme nt. Because germ-line cell gene therapy can
    change the defect gene and stop th e hereditary disease to subli ngs. The future
    patient is radical cured before the disease has not taken place . Yet their
    sublings cann''t happen defective genes in future.
    Singer think, parents already do their best to influence the
    environmental factors that undoubtedly also play a part in shaping these
    characteristics. They can now influence genetic factors as well as
    environmental ones , in one of three ways . By using in vitro fertilization,
    they can have the embryo screened before implantation ; they can use prenatal diagnosis and selective abortion ; and they can obtain eggs , sperm
    or embryos from people they regard as genetically superior . According to
    reasons, we discuss prenatal genetic screening and germ-line ce ll gene therapy
    to cause morals dispute with loo king for the acc eptable argumen t . Singer is an
    utilitarian. We will realize his theory and his view to the han dicapped person.
    Chapter 3 introduced the defini tion of the disease that the gen e disease can be
    suitable, and then treat. The kind of gene therapy, gene enhanc ement and
    eugenics are our focal points. S inger argues to prenatal geneti c screening and
    gene selection to presume germ-line cell gene therapy. Finally, we discuss the
    dispute of germ-line cell gene t herapy and Singer' s response
    Key words: genetic malady, somat ic cell gene therapy, germ-line cell gene
    therapy , preference utilitarianism, principle of equal conside ration of interest,genetic enhancement, e ugenics, prenatal ge netic screening, abor tion,
    Pre-implantation Genetic Diagnosis, sanctity of life, slippery slope argument,
    the life commercialized.

    第一章 導論----------------------------------------------------------------------------------------1 第一節、研究動機與目的-------- -----------------------------------------------------------2 第二節、文獻整理-------------------------------------------------------------------------------9 第三節、各章簡述-------------------------------------------------------------------------------15 第二章 辛格的功利主義立場-----------------------------------------------------------17 第一節、功利主義立場----------------------------------------------------------------------17 第二節、辛格的功利主義-------------------------------------------------------------------18 第三節、辛格利益平等考量原則應用於身心障礙者--------------------------27 第三章 基因治療的相關問題------- -----------------------------------------------------35 第一節、疾病與基因疾病的概念-------------------------------------------------------35 一、 疾病的定義----------------------------------------------------------------------------------35 二、 基因疾病- ------------------------------------------------------------------------------------38 第二節、基因治療的概念-------------------------------------------------------------------40 一、基因治療的定義--------------------------------------------------------------------------40 二、基因治療的種類--------------------------------------------------------------------------41 三、基因治療的發展--------------------------------------------------------------------------43 第三節、基因治療與基因增強-----------------------------------------------------------48 第四節、優生學與基因治療---------------------------------------------------------------51 第四章 辛格論基因治療--------------------------------------------------------------------57 第一節、辛格對產前篩選之論據-------------------------------------------------------57 第二節、辛格對於基因選擇的論據---------------------------------------------------64 第三節、從辛格的利益平等原則分析生殖細胞基因治療------------------71 第五章 辛格對反生殖細胞基因治療之回應---------------------------------74 第一節、生殖細胞基因治療之論證-----------------------------------------------------74 一、扮演上帝-------------------------------------------------------------------------------------74 二、減少人類基因庫的多樣性-----------------------------------------------------------75 三、違反代間正義------------------------------------------------------------------------------76 四、滑坡論證--------------------------------------------------------------------------------79 五、其他替代方案-------------------------------------------------------------------------80 六、生命商品化-----------------------------------------------------------------------------81 七、社會正義--------------------------------------------------------------------------------82 第二節、辛格對反對論據之回應-------------------------------------------------------82 第三節、結論--------------------------------------------------------------------------------88 參考文獻--------------------------------------------------------------------------------------------90

    甲、中文參考書目
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    二、 中文期刊、論文:
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    廖淑惠,2004,《論基因倫理:基因治療及基因增強所涉及之倫理爭議》,中壢:中
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    周業勤, < 基因技術應用於優生學的倫理爭論> , 引自網路資料:
    http://www.aecna.com/dispArticle.Asp?ID=505。
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    http://www.hkbu.edu.hk/~cscsnet/articles/lo2_f.html,瀏覽日期:95.11.22。
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    Singer, Peter , 2003,“Shopping at Genetic Supermarket" in Song Sang-Yong, Koo
    Young-Mo& Darryl R.J. Mace(r Ed. )Asian Bioethics in the 21st Century, Eubios Ethics
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    Tooley, Michael “ Personhood " in Helga Kuhse and Peter Singe(r Eds.)A Companion To
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    Young, Frank E,1997, “Genetic Therapy" in Kilner, John F., Pentz, Rebecca D. and Young,
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    三、網路資料
    96
    Peter Singer, “ The costly appliance of science " , 瀏覽日期: 95.12.03
    http://commentisfree.guardian.co.uk/peter_singer/2006/09/post_385.html.

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