Did Bioethics Matter? A History of Autonomy, Consent, and Intersex Genital Surgery.
Did Bioethics Matter? A History of Autonomy, Consent, and Intersex Genital Surgery.
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生物伦理学重要吗？
DOI：
10.1093/medlaw/fwz007
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发表时间：
2019
影响因子：
1.7
通讯作者：
Elizabeth Reis
中科院分区：
文献类型：
--
作者：
Elizabeth Reis
本文认为，生物伦理学在二战后时代的兴起和20世纪50年代末知情同意法律原则的出现，应该对具有双性特征(非典型性发育)的患者产生比他们更大的影响，因为他们强调尊重自主和对患者的仁慈。相反，这些进步的趋势与双性人管理转向对婴儿的管理相冲突，婴儿无法就自己的医疗护理提供自主同意。在一个比我们今天所知的更有等级的环境中，当父母听取了医生的建议时，患者自主权就退居次要地位了。对婴儿和成人的双性人护理继续需要改进。生物伦理学的抽象理想--尊重、患者自主和知情同意的要求--是否单独足以确保这种改善，或者是否需要采取法律行动(或诉讼威胁)或一些其他改革来实现这种改变，仍然是一个悬而未决的问题。
This article argues that the rise of bioethics in the post-WWII era and the emergence of the legal doctrine of informed consent in the late 1950s should have had a greater impact on patients with intersex traits (atypical sex development) than they did, given their emphasis on respect for autonomy and beneficence toward patients. Instead, these progressive trends collided with a turn in intersex management toward infants, who were unable to provide autonomous consent about their medical care. Patient autonomy took a back seat as parents heeded physicians' advice in an environment even more hierarchical than we know today. Intersex care of both infants and adults continues to need improvement. It remains an open question whether the abstract ideals of bioethics-respect, patient autonomy, and the requirement of informed consent-are alone adequate to secure that improvement, or whether legal actions (or the threat of litigation) or some other reforms will be required to effect such change.