人工流產：婦女權利、障礙和醫學倫理

Artificial Abortion: Women's Rights, Obstacles, and Medical Ethics

美國最高法院在1973 年以7 比2 裁決通過「羅訴韋德案」，但是人工流產合法化以後，相關的爭議持續存在，社會的爭辯和分裂成了美國政治地景上常見的景觀。同樣地，台灣的優生保健法在1984 年開始施行，現在也面臨意見分歧和來自立法院的修法壓力。對於人工流產的看法在歷史上有不同的演化過程，不同國家因為各自不同的文化、宗教和法律，對於人工流產也有相異的態度。惟有透過演化論和相對論的兩項基本元素，並且透過醫學歷史、道德學說、醫療科技進展以及哲學的方法途徑，醫療提供者才能暸解人工流產的過去、現在和未來。醫療提供者對於人工流產相關的議題都有不同的觀點，但是在現代醫院提供婦女合法人工流產請求服務的醫師更容易受到醫院不同階層權威的干涉。無論台灣或世界其他地方，人工流產仍然遭逢許多有形和無形的障礙。本文將提出台灣常見的一些不同形式的人工流產障礙，並且提出論據說明，儘管難以劃下一條清楚的線；但是對於醫療提供者而言，人工流產最關鍵的考量應該是婦女的生育自主權。

In 1973 the United States Supreme Court ruled 7-2 on 'Roe v Wade'. Since then, the controversies over artificial abortion have continued. Debates and divisions in society are common scenes in the American political landscape; Likewise, Taiwan's "Eugenic Health Law" set in 1984, has also witnessed a divide in opinion and is currently encountering a pressure for change in the Legislative Yuan (Taiwan's Parliament). Opinions on the subject of artificial abortion have constantly evolved throughout history and different countries have developed their respective attitudes towards the topic in terms of culture, religion and law. Only from the fundamentals of evolutionism and relativism and also by means of medical history, moral theories, medical advances, and philosophy can healthcare providers visualize the past, present, and future of artificial abortion. Healthcare providers have various viewpoints on artificial abortion related issues. However, doctors who provide service in modern hospitals are prone to being interfered by the different levels of authority when managing legal artificial abortions requested by women. Obstacles set explicitly or implicitly for artificial abortions are common in Taiwan and elsewhere in the world. This article deals with various forms of barriers commonly seen in Taiwan and argues that for healthcare providers, despite no clear line drawn, the crucial consideration should be the rights of women.