| Summary: | 碩士 === 台北醫學院 === 醫學研究所 === 89 === The purposes of this study are to：explore the perspectives of medical professionals, legal professionals and the religious personnel regarding their ethical judgment and decision-makings on controversial clinical issues; compare the differences among them; investigate the relationship between demographic factors and the variety of ethical judgment and decision-makings on controversial clinical issues. The target research population was set at the three groups of people in Taipei area. Through the process of convenient sampling, 207 nurses and doctors were selected from two regional hospitals, 152 legal professionals from lawyers, judges, and law school teachers, and 199 religious personnel from priests, nuns, monks and other religious preachers. The tool of this study includes clinical ethical questions and demography information. 1,282 questionnaires were sent out, and 558 valid questionnaires were collected. The response rate is 43.5%.
The major findings of the study are the followings. (1). On issues that have been legalized, such as organ transplantation and human experiment, professionals from all three sectors tend to agree. All parties also agree that the principle governing organ distribution should be based on fairness and efficacy. There are slight disagreements on whether the decedent''s family can decide to donate his or her organs when the decedent had not clearly indicated his or her intention on this matter before death, and on the issues regarding organ donation from the death roll. The euthanasia issue was split between "totally disagree" and "reluctantly agree". There is no consensus on whether resuscitation could be withheld so as to avoid sufferings for the dying and terminal patients, on the right of active euthanasia , and on the right to death. The religious personnel strongly oppose euthanasia. This study also reveals the aggregate opinions of all three groups center between "disagree" and "reluctantly agree" on the issue of surrogate mother, with the religious group scoring the lowest and the legal professionals tilting toward "agree". The following arguments are most pointedly contested: surrogate mother should be legalized in the situation where husband offers sperm and his wife offers ovum to the surrogate mother since there is no risk of incest; the infertile woman could have her own baby by surrogate mother; single woman can rent out her uterus on her own will; surrogate mother offers services in exchange for money, which has nothing to do with moral. In the area of human cloning all three sectors disagree; however some people do agree considering the benefits of human cloning may bring in disease treatment, and in procreation.
(2). There was not much difference between the perspectives of medical and legal professional for all matters, but a significant deviation was noted from the religious sector. (3). Factors affecting the ethical judgment and decision-makings on organ transplantation include marital status, educational level, religious belief and profession. Euthanasia issue was affected by age, sex, educational level, religious belief, profession and work experience. Surrogate mother issue was affected by age, marital status, educational level, religious belief, profession and work experience. On the human cloning issue, the results vary with age, educational level, religious belief and profession, while those on human experiment vary only with age and profession.
In summary, the results of this study can serve as a reference for medical ethics education and for the medical profession on clinical ethical judgments and decision-makings when facing controversial issues.
Key words: clinical ethics, organ transplantation, euthanasia, surrogate mother, human cloning, human experiment
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