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美国文化与安乐死。“善终”定义的演变。

American culture and euthanasia. The changing definition of a "good death".

作者信息

Post S G

机构信息

Center for Biomedical Ethics, Case Western Reserve, School of Medicine, Cleveland.

出版信息

Health Prog. 1991 Dec;72(10):32-8.

PMID:10115211
Abstract

Divisions run deep in contemporary America over the issue of assisted suicide or mercy killing. The active, directly intended, and freely chosen self-destruction that was once unspeakable has become speakable. A recent best-seller providing "how-to" information on suicide; Initiative 119 in Washington State, which would allow "aid-in-dying"; and other publications and polls indicate that the proponents of mercy killing may have won over American culture, or at least established a dominant foothold. One of the chief criticisms of policies that permit mercy killing and assisted suicide is that they inevitably encourage suicide among those who are neither terminally ill nor suffering from physical pain. American culture is extreme in its desire to eliminate suffering. In a culture that can no longer depend on religious insights into human suffering, all kinds of preemptive strikes against suffering seem inevitable. The success of proponents of euthanasia is an indirect indictment of a healthcare system that fails to provide good palliative care and support. In our curative and rescue-oriented healthcare system, management of pain is not a priority. And our society also undervalues caring in its most basic sense. It is not so much death as the absence of caring and the denial of reality that may be the enemy. The desire to control pain has always been valid, but not the desire to press control so far as to directly cause death itself. Death by lethal injection is best understood as a tyranny of technological control.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在当代美国,围绕协助自杀或安乐死问题,分歧极为深刻。曾经难以启齿的主动、直接蓄意且自由选择的自我毁灭,如今已变得可以谈论。最近一本提供自杀“操作指南”的畅销书;华盛顿州允许“临终关怀援助”的第119号倡议;以及其他出版物和民意调查表明,安乐死的支持者可能已经征服了美国文化,或者至少站稳了主导地位。对允许安乐死和协助自杀政策的主要批评之一是,它们不可避免地会鼓励那些既非绝症患者也未遭受身体疼痛的人自杀。美国文化极度渴望消除痛苦。在一种不再能依靠宗教对人类痛苦的洞察的文化中,对痛苦的各种先发制人的打击似乎不可避免。安乐死支持者的成功是对一个未能提供良好姑息治疗和支持的医疗体系的间接控诉。在我们以治疗和救援为导向的医疗体系中,疼痛管理并非优先事项。而且我们的社会在最基本的关怀层面也不够重视。可能真正的敌人与其说是死亡,不如说是缺乏关怀和对现实的否认。控制疼痛的愿望一直是合理的,但直接导致死亡本身的控制欲则不然。注射死刑最好被理解为一种技术控制的暴政。(摘要截选至250字)

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