2012年人工流產修法爭議之分析

An analysis of the controversy over proposed revisions to Taiwan’s abortion legislation in 2012

目標：2012年有四個人工流產修法版本交付立法院。其中楊麗環立委提案，提出「強制思考期6天」、「強制輔導諮商」，賴士葆立委提出「需經過二位醫師同意權」，均希冀降低墮胎率，提升生育率。政院版則主張「強制醫療諮詢」、「強制思考期3天」。吳宜蓁立委提出「醫療機構應提供人工流產資訊」、「各級地方政府應提供民眾生育健康諮詢」。故本文針對修法之爭辯論述進行分析。方法：本文採取三種研究法分析三類資料：（1）以論述分析分析國內外學術文獻、國際組織、政府統計數據與媒體新聞資料。（2）以描述性統計（descriptive statistics）分析2007及2008年分別對婦女和婦產醫師進行「強制思考期」、「強制輔導諮商」之調查結果。（3）以文本分析方式分析婦女和醫師回答調查問卷中開放性的問題。結果：楊版與政院版提出的「強制思考期」，與實情不符。本研究調查，孕婦從知道非預期懷孕到決定人工流產，再到實際求醫都已經等待、思考超過一週甚至一個月。楊版與政院版提出的「強制輔導諮商」則是違反人權公約與諮商專業倫理。賴版的「二位醫師同意」，對婦女就醫造成困難，受到婦產科醫師的反對。結論：在2012年修法爭議中浮現二種論述，其中「嚴格管控論述」缺乏學術研究支持，與本研究提出的婦女與醫師的調查結果不符合，也不合乎心理諮商專業倫理原則。眾多研究也顯示「強制思考期」與墮胎率高低無顯著關連。「婦女中心論述」合乎婦女的實際現狀的需求，而本研究中婦產科醫師提出的「病患為中心」論述的倫理實踐，則可作為支持「婦女中心論述」的依據。至於有效降低墮胎率，政策制訂者應重視避孕措施的普及，改善經濟與社福大環境，促使婦女願意保留非預期懷孕之胎兒。

2012 and raised controversy. Legislators led by Li-huan Yang proposed a six-day ‘mandatory waiting periods’ coupled with ‘mandatory counseling’. Legislators led by Shi-bao Lai proposed ‘consent from two doctors’. Both of these aimed to reduce the abortion rate and increase the birth rate. The Administrative Yuan for its part proposed a ‘mandatory waiting period’ of three days plus ‘mandatory counseling’. And finally, legislators led by Yi-chen Wu proposed that medical institutions should provide all kinds of information related to abortion’, and that local government 'should provide birth counseling to citizens’. This paper aims at analyzing the controversy. Methods: Three methods are adopted. (1) Discourse analysis is applied on documents collected from legal and medical research papers, government data and news reports. (2) Descriptive statistics is applied on two surveys conducted in 2007 and 2008 on women and obgynecologists nationwide respectively. (3) Text analysis is applied to the written texts provided by women and ob-gynecologists on some open-ended questions in the survey. Results: The ‘Mandatory waiting periods’ as proposed by Yang and the Administrative Yuan is found to lack consideration of reality, as our survey shows that most women considering the terminating of an unplanned pregnancy have already been thinking much longer than the stipulated period, typically having already done this for periods ranging from over one week to a whole month. As regards ‘mandatory counseling’, this is found to be in violation of human rights and professional ethics. As to ‘consent from two doctors’, this is found to create difficulties for women, and is opposed by a majority of ob-gynecologists. Conclusions: Two types of discourse appear in the controversy, the ‘restrictive and controlling discourse’ receives little support from academic research, or in surveys of women and physicians, and also runs counter to the professional ethics of counseling. Many research findings have shown that ‘Mandatory waiting periods’ do not contribute to the reduction of the abortion rate. The ‘women centered discourse’ reflects the women’s needs and practice on the matter, and the ‘patient centered discourse’ practiced by ob-gynecologists can give support to ‘women centered discourse’. As for an effective reduction of abortion rate, the paper finds that policy makers would achieve greater success by promoting greater use of contraceptives, and improving economic and social welfare, thus enabling women to consider keeping unplanned fetuses.