软法治理:器官捐献和移植中脑死亡标准的合理进路

Soft law governance: a rational approach to brain death criteria in organ donation and transplantation

  • 摘要: 在器官捐献与移植领域,死亡判定面临医学标准与社会认知分离的困境,可能阻碍医学实践,并导致法律评价上的争议。以“硬法”模式确立脑死亡标准是目前许多国家所采取的路径,但存在法律中死亡定义权的归属、脑死亡标准的技术迭代与法律安定性间的冲突、忽视死亡概念的社会建构性等局限性。基于渐进社会工程理论与社会系统论,以“软法”模式确立脑死亡标准兼具科学适应性及治理弹性,且有利于脑死亡标准社会共识的培育。在实现进路上,应该以脑死亡标准“软法”制定主体的高阶化、实施主体的专业化、制定过程的公开化以及风险交流策略的制度化为核心要点,并同时强化近亲属的知情同意和设计脑死亡误判纠纷解决机制以防范可能的不当风险。

     

    Abstract: In the field of organ donation and transplantation, the determination of death faces the dilemma of the separation between medical standards and social cognition, which may hinder medical practice and lead to controversial legal evaluations. Establishing brain death criteria through the "hard law" model is the path currently adopted by many countries. However, this approach has limitations, such as the attribution of the right to define death in the law, the conflict between the technological iteration of brain death criteria and legal stability, and the neglect of the social construction of the concept of death. Based on the theory of gradual social engineering and social systems theory, establishing brain death criteria through the "soft law" model has both scientific adaptability and governance flexibility, and is conducive to cultivating social consensus on brain death criteria. In terms of implementation, it is essential to focus on the high-level positioning of the "soft law" formulation entities for brain death criteria, the professionalization of the implementation entities, the publicization of the formulation process, and the institutionalization of risk communication strategies. At the same time, it is necessary to strengthen the informed consent of close relatives and design a dispute resolution mechanism for misjudgments of brain death to guard against potential improper risks.

     

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