Changing our perspective: Is there a government obligation to promote autonomy through the provision of public prenatal screening?
Changing our perspective: Is there a government obligation to promote autonomy through the provision of public prenatal screening?
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DOI：
10.1111/bioe.12779
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发表时间：
2020-07-06
期刊：
影响因子：
2.2
通讯作者：
Asai, Atsushi
中科院分区：
文献类型：
--
作者：
Enzo, Aya;Okita, Taketoshi;Asai, Atsushi
在许多国家，通过公共资助的筛查计划提供某些胎儿异常的产前检测。生育自主权的概念被认为是许多此类方案的正当依据。本研究的目的是重新审视公共产前筛查胎儿异常的规范基础，从自主的角度转变为义务。在澄清了对公共产前筛查项目的理由中所采用的自主权的理解之后，我们发现了关于这一理由的两个问题：第一，政府有义务满足这一需求的程度并不明显;第二，不清楚提供公共筛查是否是促进自主权的最适当方式。接下来，为了解决这些问题，我们将重点放在奥诺拉奥尼尔的权利和义务的论点。借鉴这一论点，我们表明，在解决上述问题，重要的是要改变我们的规范的角度从权利或自主义务。我们的论证将表明，由于政府没有无可争议的促进自治的基本义务，因此需要在与其他基本义务的兼容性方面对这一义务加以限制。此外，即使政府有义务在某种程度上促进自治，也可能有比提供公共产前检查更适当的手段来实现这一目标;因此，政府的义务没有必要延伸到提供公共产前检查。
In many countries, prenatal testing for certain fetal abnormalities is offered via publicly funded screening programs. The concept of reproductive autonomy is regarded as providing a justificatory basis for many such programs. The purpose of this study is to re-examine the normative basis of public prenatal screening for fetal abnormalities by changing our perspective from that of autonomy to obligation. After clarifying the understanding of autonomy adopted in the justification for public prenatal screening programs, we identify two problems concerning this justification: first, the extent to which the government is obliged to meet this demand is not evident; and, second, it is not clear whether the provision of public screening is the most appropriate way to promote autonomy. Next, to tackle these problems, we focus on Onora O'Neill's argument of rights and obligations. Drawing on this argument, we show that, in addressing the problems above, it is important to change our normative perspective from rights or autonomy to obligation. Our argument will show that since the government does not have an incontrovertibly fundamental obligation to promote autonomy, this obligation needs to be constrained in terms of compatibility with other fundamental obligations. In addition, even if a government is obliged to promote autonomy to some degree, there could be more appropriate means to achieve it than providing public prenatal screening; therefore, it is not necessary for government obligations to extend to the provision of public prenatal screening.