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作者(中文):董威廷
作者(外文):Tung, Wei-Ting
論文名稱(中文):論人體生殖系基因編輯技術之規範架構 —以英國、美國及中國為例
論文名稱(外文):Regulatory Framework of Human Germline Gene Editing - Evidence from UK, USA and China
指導教授(中文):范建得
指導教授(外文):Fan, Chien-Te
口試委員(中文):蔡甫昌
楊哲銘
口試委員(外文):Tsai, Fu-Chang
Yang, Che-Ming
學位類別:碩士
校院名稱:國立清華大學
系所名稱:科技法律研究所
學號:105074510
出版年(民國):109
畢業學年度:108
語文別:中文
論文頁數:169
中文關鍵詞:基因編輯技術基因編輯嬰兒生殖系基因編輯基因治療基因增強生物倫理研究倫理公眾參與
外文關鍵詞:CRISPR/Cas9Gene-edited BabiesGermline Gene Editing (GGE)Gene TherapyGene Enhancement,BioethicsResearch EthicsPublic Engagement
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2018年由中國科學家賀建奎主導的基因編輯嬰兒事件造成各個領域的恐慌,正因為該實驗係倚賴於新興基因編輯技術CRISPR/Cas9,在此顯現出對於新興基因編輯技術的管制規範尤為重要。過往需要耗費數年時間才能進行的實驗,藉由CRISPR能夠縮短實驗時程,同時幫助實驗更有效率且精確。然而,當這樣的技術涉及到人體生殖細胞時,該如何執行、於何種情境下能夠實施及可能產生的風險等問題,諸如此類的問題均值得深究。若要剖析該問題,能夠分別從倫理規範、法律管制及社會溝通的角度切入去探究。從倫理角度上來看,檢視在眾多國際組織形成的國際共識之下,生殖系基因編輯所產生的倫理爭議;在法律管制的體系下,本文以美國、英國及中國這三個生物技術強勢國家為例,從該國的法體制中,檢視基因編輯管制的底線及其所能法規範所能管制的層面及效力為何;而在社會溝通的脈絡下,則導出公眾參與於基因編輯中扮演的角色,以及透過公眾參與形塑倫理原則與法規範的過程。
最後,回顧台灣對於基因編輯規範的現況,儘管台灣現階段的法秩序得以規制該類情事發生,不過仍存在能夠借鏡其他國家的不足之處。此外,除了專業領域的研究者,絕大多數的民眾均對該技術的變遷感到陌生,僅在特定重大事件發生時才會引起關注。在此次爭議事件發生後,應足以成為警惕研究者、學者及決策者們更加關注該議題,增進學界與社會溝通,加強公眾參與並健全現階段的管制架構。
In 2018, the birth of the gene-edited babies caused panic in various fields. Such an experiment relied on the emerging gene-editing technology named “CRISPR/Cas9”, which means that the need for regulation of emerging gene-editing technology is particularly crucial. In the past, it took a couple of years to carry out experiments, now it can be shortened with CRISPR, and simultaneously improve the experiment to be more efficient and accurate. However, when such biotechnology involves human germline cells, how to implement it, under what circumstances it can be implemented, and the risks that may arise, all of these are worthy of further consideration. To analyze in a horizontal view, we can explore this issue with the perspectives of ELSI. From ethical points of view, review the ethical disputes arising from gene editing within the human germline editing under the international consensus formed by international organizations; in the legal regulation framework, this article would take these three countries (the UK, US, and China) as examples to examine the bottom line of gene editing as well as the level and effectiveness of legal regulations; and then derive the role of public participation in gene editing from the context of social communication, and the process of shaping ethical principles and legal norms through public participation.
At the end of this article, I will review the status quo of gene editing regulation in Taiwan. Although the current legal framework can suffice to prohibit such incidents, there are still places where we can learn from other countries. In addition, except for researchers in this field, the majority of the people are unfamiliar with the changes in this technology, and only when certain major events occur. After the gene-edited babies' births, it should be a vigilance signal for researchers, scholars, and policymakers to pay more attention to this issue, enhance social communication, and improve the current regulatory framework.


第一章 緒論 1
第一節 研究動機及目的 1
第二節 研究方法 5
第三節 研究範圍及限制 5
第二章 基因編輯技術之簡介 8
第一節 基因編輯方法 8
第一項 ZFNs 10
第二項 TALENs 12
第三項 CRISPR/Cas 14
第二節 基因編輯技術之臨床應用 21
第一項 基因檢測 21
第二項 基因治療 23
第三節 基因編輯技術之近況 25
第三章 2018年中國科學家基因編輯嬰兒事件 27
第一節 近年來利用CRISPR編輯人體基因引起之爭議 27
一、2015 年中國科學家 黃軍就 27
二、2016 年英國科學家 Kathy Niakan 30
三、2016 年中國科學家 范勇 31
四、2017 年美國科學家 Shoukhrat Mitalipov 33
第二節 2018年基因編輯嬰兒之事件始末 36
第一項 事實經過 36
第二項 基因編輯嬰兒事件所涉及的倫理問題 41
第三項 基因編輯嬰兒事件所涉及的法律問題 45
第三節 小結 51
第四章 在ELSI治理下的倫理角度探討基因編輯 53
第一節 生殖系基因編輯之國際倫理共識 53
第二節 初探基因編輯嬰兒案件定性問題 57
一、定性之意義 57
二、定性分類 58
三、解決方法 63
第三節 基因編輯要件之倫理審查 65
第一項 實驗對象 66
第二項 實驗實施者 72
第四節 基因編輯實施程序之倫理審查 75
第一項 實驗前程序 75
第二項 實驗過程 80
第三項 實驗後義務 83
第五節 小結 85
第五章 在ELSI治理下的法律角度探討基因編輯 87
第一節 基因編輯技術之管制意義 87
第一項 個人層面 88
第二項 機構層面 89
第三項 社會層面 90
第二節 基因編輯在各國管制架構下之審查 92
(一)人類胚胎的基礎實驗 93
(二)人類胚胎的臨床實驗 100
(三)人類胚胎的臨床應用 109
第三節 各國法規範之綜合比較 115
第六章 在ELSI治理下的社會角度探討基因編輯——以公眾參與為例 119
第一節 公眾參與之意義 119
第二節 公眾參與之管道 120
一、官方單位 121
二、非官方單位 123
第三節 公眾參與於基因編輯治理所發揮的作用及限制 130
第四節 小結 134
第七章 結論——兼談台灣現有基因編輯管制法治及其評析 137
參考文獻 143
附註一:近年內國際間就生殖系基因編輯的倫理爭議所發表之聲明 164
附件二:美國、英國及中國對生殖系基因編輯規範架構之整理 167

參考文獻

一、中文文獻
(一)書籍
蔡友月、潘美玲、陳宗文(編)(2019)。《台灣的後基因體時代:新科技的典範轉移與挑戰》,初版。新竹:國立交通大學出版社。

(二)期刊論文
Hans Peter Peters(著),謝惟敏(譯)(2020)。〈科學傳播的範疇:是知識散播還是公民參與?〉(Science Communication: Knowledge Dissemination or Public Engagement?),《傳播研究與實踐》,第10卷,第1期,頁1-18。
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余秋莉(2020)。〈論人體生殖系基因編輯行為的刑法應對——兼評賀建奎「基因編輯嬰兒」案〉,《法律適用》,第4期,頁22-33。

(三)碩博士論文
郭良基(2006),《以知情同意為核心-探討醫學倫理與法律實務》,頁18,國立清華大學科技法律研究所碩士論文。
洪敏瑜(2009),《醫學研究中告知後同意之法律意涵》,頁26-27,國立清華大學科技法律研究所碩士論文。

(四)網路文獻
300餘位學者聯名:十問賀建奎。載於:http://m.zhishifenzi.com/depth/depth/4711.html?from=singlemessage&isappinstalled=0&fbclid=IwAR0fSEmg40viRVYdMjjy3QqV_q6A4mDWbTRBTT8u1bIFycbz8bR-TzgkKn0
基因編輯:賀建奎香港基因學術峰會問答實錄。BBC News。2018年 11月 28日。載於:https://www.bbc.com/zhongwen/trad/chinese-news-46367524
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三、其他資料:
ASHG Reaffirms 2017 Position Statement on Germline Genome Editing. Available at: https://www.ashg.org/publications-news/press-releases/201811-genome-editing/
NORC at the University of Chicago. Human Genetic Engineering. The Associated Press-NORC Center for Public Affairs Research. [online]. Available at: http://apnorc.org/projects/Pages/Human-GeneticEngineering.aspx.
Southern University of Science and Technology Public Statement. Available at: http://sustc.edu.cn/en/info_focus/3056
Statement on governance and oversight of human genome editing. Available at: https://www.who.int/news-room/detail/26-07-2019-statement-on-governance-and-oversight-of-human-genome-editing
Statement by the Organizing Committee of the Second International Summit on Human Genome Editing. Available at: http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11282018b&_ga=2.249302087.1763336184.1543479972-2055095648.1543479972#_ftn1
Statement on Claim of First Gene-Edited Babies by Chinese Researcher. Availa-ble at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-claim-first-gene-edited-babies-chinese-researcher
Statement on NIH funding of research using gene-editing technologies in human embryos. Available at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-nih-funding-research-using-gene-editing-technologies-human-embryos
Statement on Claim of First Gene-Edited Babies by Chinese Researcher. Available at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-claim-first-gene-edited-babies-chinese-researcher
Statement on NIH funding of research using gene-editing technologies in human embryos. Available at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-nih-funding-research-using-gene-editing-technologies-human-embryos
Statement on Genome Editing Technologies and Human Germline Genetic Modification. Available at: http://www.hinxtongroup.org/Hinxton2015_Statement.pdf
Statement by the Organizing Committee of the Second International Summit on Human Genome Editing. Available at: http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11282018b&_ga=2.249302087.1763336184.1543479972-2055095648.1543479972#_ftn1
WHO國際臨床試驗註冊平台。載於:https://www.who.int/ictrp/zh/
中國臨床試驗中心。載於:http://www.chictr.org.cn/registry.aspx
試管嬰兒成功率,三代試管嬰兒技術介紹與比較。載於:https://www.ivftaiwan.tw/care/?3473.html
南方科技大學:賀建奎實驗室官方頁面(網頁存檔)。載於:http://web.archive.org/web/20181126135349/http://www.sustc-genome.org.cn/for_public.html
世界醫師會《赫爾辛基宣言》載於:http://www.femh-irb.org/content_pages/files_add/doc_arb/L01_10306241106.pdf
《幹細胞研究和臨床轉化指南》載於:https://www.isscr.org/docs/default-source/all-isscr-guidelines/guidelines-2016/guidelines-for-stem-cell-research-and-clinical-translation-may2016---chinese2da71a731dff6ddbb37cff0000940c19.pdf?sfvrsn=6
行政院(2018),行政院會通過「再生醫療製劑管理條例」草案。載於:https://www.ey.gov.tw/Page/9277F759E41CCD91/a602e0f5-ee02-40cb-a955-25e31c4c4cc5
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