| 摘要: | 近年來器官移植技術成熟發展，對器官衰竭病者來說，器官移植依然是延續生命的主要方式。亞洲人的輪迴觀念，讓器官捐贈的問題變成人們避而不談的議題，往生時要保留全屍的老舊觀念仍存在，造成來源供應短缺，等待器官移植的受贈者忍受等待與死神搏鬥的煎熬，更有些受贈者因等不及適合的器官而結束了生命。本文的研究希望喚起大眾對器官捐贈的關注，在往生時捐出自己可用的器官，幫助有需要的人。
器官捐贈在倫理上碰到的難題包括自願捐贈與買賣的兩難，器官移植來源的方式，對捐贈者或接受者可能產生的危害等。由於器官短缺狀況難以改善，醫學界努力拓展人造器官的研發，但仍然很有限制；動物器官的移植，則有與人體排斥的困難；跨物種器官移植只在初步研究之中，因此，人類之間的器官移植還是最重要的方法。本文檢討了腦死與屍捐，羅爾斯與丹尼爾斯的公義論與基準用於捐贈器官之分配公平性，法律上對活體和屍捐的規定之合理性，最後是從宗教、家庭倫理、商業買賣等角度檢討開拓移植器官來源的方式。
作為增加器官之移植功能，從腦死病患取得器官是一個主要的方法和來源，而從腦死的病患中取得器官，移植的效果較好。最讓人敬佩的是發揮大愛精神的人，自願把自己身上良好的器官或組織，以無償的方式，捐贈給器官衰竭急需器官移植的患者，讓他們能夠延續生命。至於稀少的器官如何分配，必須依據正義來實現器官的分配公平制度，本文藉由羅爾斯的公義論及丹尼爾斯的十個公平性標記來闡述如何達到公平分配，由此反省各國和台灣對器官分配所制定的法律，如何將器官公平地給予最需要的人使用，而不至危害可能的捐贈者。然而增加器官來源才是解決之道，其中一個方法是藉由宗教力量來鼓勵大家捐贈，聖嚴法師、星雲法師、證嚴法師等都出面呼籲信徒響應器官捐贈，幫助需要器官移植的重症病患。本文也考量器官買賣以增加器官來源的提議，但器官買賣所產生的對弱勢者的傷害之嚴重問題，使我們不能接受商業化器官移植的方法。至於非親屬之間的家庭互捐，具有縮短病患等待器官的時間、增加器官的來源、取得未受損器官等諸多優點，是值得支持的制度。
;In recent years the technology of organ transplantation is much matured, and organ transplantation is still the main way of maintaining of life for patients of organ failure. Asian concept of reincarnation; makes organ donation a somewhat taboo because of the traditional idea of maintaining a whole and complete body after death is still very popular. It is one of the reasons that causes a shortage of organ supply, and many patients waiting for organ transplantation suffer and die without receiving the needed organs. In this thesis, I would like to investigate the problem and call to public attention the need of organ transplantation, hoping that more people would donate their organs upon their farewell to the world.
There are ethical dilemmas facing organ donations such as voluntary versus selling, the proper ways of solicitation of organs, possible harms to the donor or the recipient, and others. There have been various ways to solve the problem of shortage of organs. Medical researchers have been trying to devise artificial organs but with limited success; animal organ transplantation has the problem of rejection by the body’s defensive mechanism; transgenic organ transplantation is in its infancy. Inter—human transplantation is still the most important solution. In this thesis, I examine the issues of brain-dead donation, fair distribution of organs by the theory of justice of John Rawls and Norman Daniels’s benchmarks, the reasonableness of related legal arrangement, and finally consider from the perspective of religion, family relation, as well as trading to find ways to improve sources of organs for transplantation.
To increase organs for transplantation by obtaining organs from brain-dead patients is one of the main methods and sources, and the result of transplantation is usually better. People are greatly praised for their altruistic donation of organs to save the lives of the needed patients. I try to evaluate the fairness of legal organ transplantation arrangement of Taiwan in comparison with other countries with John Rawls’s theory of justice and Norman Daniels’s benchmarks of fairness. However, increasing organ supply is the solution. One of the powerful ways is by appealing to religion. Many of the most revered Buddhists of Taiwan such as Master Sheng Yen, Master Hsing Yun, Master Cheng Yen have called upon their followers to support organ donation to help critically ill patients who need organ transplantations. This article also consider the pros and cons of organ trading as a proposal for sources of organ supply, but the serious harms and exploitations of the disadvantaged and vulnerable prevents us to take this step for the solution of organ shortage. However, the arrangement of paired live donations between non-related family members is a good way to shorten the waiting time for an organ, improve the sources and have better organs for transplantation. It is a system that should be widely established. |
