医学哲学 医学倫理
Online ISSN : 2433-1821
Print ISSN : 0289-6427
生殖補助医療政策に関する「物語的正義」についての試論
宮坂 道夫
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ジャーナル フリー

2002 年 20 巻 p. 67-79

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In this paper, I will inquire about justice theories with regard to the public policy of assisted reproduction (AR). In the first part, I will criticize the classic four-principle-based frameworks of American bioethics. Firstly, it is not all-embracing, because it rejects any "communitarian" argument dependent on substantial common values such as human dignity. Secondly, it is not neutral, because practical advantage is given to liberal argument that permits any kind of AR. These liberal points of view are further analyzed as follows. (1) They impose empirical demonstrations on the autonomy-based negation of AR, (2) They permit the harm/benefit-based argument dependent on medical habits which are basically affirmative for AR, (3) They have traditionally concentrated on distributiv e justice, that is, nothing is discussed about newly developed AR, until it becomes a social resource. I will then introduce categorical and methodological expansions of justice theory as follows: (1) When we establish another category, which I call 'resourcification justice', in justice theory by questioning 'on what basis the health care service is justifiable', it will allow us to identify the nature of the conflict over AR. (2) When we adopt the two Rawlsian principles of justice only formally, rejecting any material premise, they require us to identify justly who is the worst off in the context of AR. Furthermore, the only guiding principle of fairness requires us to adopt a methodological justice, which I call 'narrativejustice', in that identification. This does not allow us to take ourselves only in the public context of policy makers and the worst off. It requires us to take ourselves at the same time in the private context of the narrator and the narratee.

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© 2002 日本医学哲学・倫理学会
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