摘要
酗酒者肝移植的公正分配一直是生命伦理学研究领域备受争议的主题。这些激烈的争论围绕的主题主要包括:酗酒是疾病还是道德恶;酗酒者肝脏分配的责任(医学责任、道德责任以及责任能否作为稀缺医疗资源的分配标准);公众意见在酗酒者肝移植分配中的作用。研究发现,绝对排除酗酒者的肝移植资格在当前的争论中不被支持,而伦理上的论证更倾向于支持降低酗酒者肝移植优先权的决定。为了进一步实现我国肝脏分配的公平性,需要加强酗酒者肝移植的个例评估,严格控制酗酒者肝移植术后的酒精摄入,并且重视公众意见在国家制定器官分配指南中的重要作用。笔者就当前酗酒者肝移植公正分配的争议现状作一综述,以期为临床器官分配及国家制定肝脏分配指南提供一定参考。
The fair allocation of liver transplants to alcoholics has been a subject of great controversy in the field of bioethics. These heated debates cluster around the themes that mainly include considering alcoholism to be a disease or a moral vice, the responsibility of liver transplant allocation on alcoholics(medical responsibility, moral responsibility, and whether responsibility can be used as a criterion for the allocation of scarce medical resources), and the role of public opinion in liver transplant allocation for alcoholics. The investigations found that the consideration of absolutely excluding alcoholics from eligibility for liver transplantation is not supported in the current debate, and ethical arguments are more inclined to support the decision to give a lower priority to liver transplantation for alcoholics. To further achieve the equity in liver allocation in China, it is imperative to strengthen case assessment of liver transplantation in alcoholics, strictly control alcohol intake after liver transplantation, and put more emphasis on the role of public opinion in the establishment of national guidelines for organ allocation. Here, the authors summarize the current controversial status of fair and equitable allocation of liver transplantation in alcoholics, so as to provide some reference for clinical organ allocation and national guidelines for liver allocation.
作者
胡蝶花
张欣
HU Diehua;ZHANG Xin(Department of Philosophy,School of Literature and Journalism,Central South University,Changsha 410075,China;Medical Ethics Committee,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2023年第1期117-127,共11页
China Journal of General Surgery
基金
国家留学基金资助项目(202106370089)
湖南省教育厅研究生科研创新基金资助项目(CX20210089)
中南大学研究生自主探索创新基金资助项目(2021zzts0001)。
关键词
肝移植
酗酒者
器官分配
伦理学
临床
综述
Liver Transplantation
Alcoholics
Organ Allocation
Ethics
Clinical
Review
