生殖補助医療における選択-配偶子提供者をめぐるフランスの現状

本論文では、フランス生命倫理法を対象とし、生殖補助医療の実施に際して、配偶子（精子・卵子）の提供者はどのような基準に従って、どのように選ばれているのかを検討する。配偶子提供の制度という「見える文化」から、フランス社会における配偶子提供者のいちづけという「見えない文化」を明らかにすることを目指す。フランスでは、産婦人科のある大学病院や公立病院に併設されているCECOS ( Centre d\u27 Etudes de Conservation des OEufs et du Sperme : 卵子精子研究保管センター）が提供配偶子を提供者から受け入れ、保管、利用のための受け渡しを行っている。精子提供は、CECOS設立以降、CECOSの精子取り扱い基準、つづいて、1994年からは生命倫理法に基づいて設けられた配偶子の提供者に関する基準にしたがって実施される。提供者は、感染症の検査や家族歴と病歴の聴取に医学的な問題が発見されず、生殖の経験があり（実子がおり）、書面による同意を行った者である。生殖能力を損なう医療処置を受ける予定があり、後の自己の利用を目的として配偶子や生殖組織を保存する者は、生殖の経験がなくとも、保存する配偶子の一部を提供することができるようになった。SECOSの精子取り扱い基準やこれを踏襲した1994年の生命倫理法が規定していた要件ー提供者がカップルの一員であること、生殖の経験が必須であることーは、2004年と2011年の生命倫理法改正の際に提供者不足の解消を目的として緩和されてきた。提供者を、受領者からの要望はなく、議論もなされていない。提供者の要件の緩和から、提供者を確保するために、提供者の「非人間化」（南　2010）がゆるやかに進んできたことをみてとることができる。How is the gamete donor chosen, and what are the criteria on which this selection is based? This paper reports on the current situation surrounding gamete donation in France, and discusses the selection criteria of donors. The present study lays open the invisible culture that determines how the donor is regarded in French society by analyzing the visible culture of the institution of donation regulated by the Bioethics law (1994, revised in 2004 and 2011) .In France, CECOS (Centre d\u27Etude et de Concervation des OEufs et du Sperme/Center for the Study and Preservation of Eggs and Sperm) conducts the gamete donation. According to the Bioethics law, recipient couples are not eligible to choose the donor by preference. The donor has to be healthy, have a biological child, and give written consent. From 2011, the donor can be nulliparous when he/she keeps his/her own gametes for future use after a medical procedure like Chemotherapy treatment. The former legal requirements of the donor being a member of a couple and parenthood were relaxed to resolve the shortage of donors. This relaxation of donor requirements shows how human donors are increasingly \u27dehumanized\u27 (Minami 2010) for the purpose of securing a gamete-biological product

Restrictions on monetary payments for human biological substances in Japan: The mu-shou principle and its ethical implications for stem cell research

Introduction: Restrictions on financial gains from the sale of human body parts is a leading policy issue surrounding the use of human tissues and cells. However, discrepancies exist between regulations and reality. In stem cell research, in which diverse sources of tissues and cells can be used, unclear regulations can impede research. Thus, using the Japanese system as a case study, we examined the challenges in the implementation of the “no payment” or the mu-shou principle in stem-cell research over the years. Methods: We reviewed 28 Japanese laws and governmental guidelines and summarized the scope of restrictions on payments for the donation and supply of human biological samples (HBS). Results: As part of restrictions on financial rewards, the mu-shou principle emerged in Japanese laws and administrative documents in the 1990s. Although the Japanese mu-shou generally means “free” or “gratis” in English, its interpretation in research and development settings remains ambiguous. Traditionally, this principle was used to deny remuneration to donors. However, it is also inconsistently applied while processing and transferring human tissue after donation, which creates confusion among the various stakeholders. Recent policies have interpreted the principle in multiple ways: (1) treating the use of HBS for cell-processing as a non-profit activity; (2) a flexible interpretation of the principle to broaden the scope of user payments; and (3) removal of the principle itself to allow for commercial use. Conclusions: The inconsistencies in the monetary payment requirements for HBS could hinder research and development. After scrutinizing the principle's background, an effective approach is needed that considers the concerns of the providers, users, and society alike