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对生死问题进行诉讼。

Litigating life and death.

作者信息

Rhoden N K

出版信息

Harv Law Rev. 1988 Dec;102(2):375-446.

Abstract

In cases involving the "right to die," courts are faced with the agonizing task of developing legal standards governing termination of an incompetent patient's medical treatment. In this Article, Professor Rhoden criticizes the two dominant approaches courts have developed--the "subjective" and "objective" tests--and proposes that these standards be abandoned for a legal presumption in favor of family decisionmaking. She maintains that the "subjective" test, which requires the family to provide clear proof that termination of treatment is what the incompetent would have chosen, is often unworkable because a patient's character traits, and even her prior statements about medical treatment, seldom rise to the evidentiary level that courts purport to require. Similarly, she argues that the "objective" test, which requires the family to prove that the burdens of the patient's life, measured in terms of pain and suffering, clearly and markedly outweight its benefits, dehumanizes patients by suggesting that only their present, physical sensations count. Professor Rhoden suggests that the subjective and objective tests are not nearly as distinct as courts have made them. She argues that the rigidity of these legal standards reflects courts' acceptance of the medical profession's presumption in favor of continued treatment, a presumption that places a heavy burden on families seeking to terminate treatment. Drawing on the special qualifications of families as decisionmakers in such cases, Professor Rhoden proposes that courts recognize a presumptive right of families to exercise discretion over treatment decisions. Such a standard would recognize that, although doctors and others can readily prove that terminating the treatment of a patient who can still enjoy life is wrong, it is very hard for families to meet the current standards, which essentially require them to prove that termination is right.

摘要

在涉及“死亡权利”的案件中,法院面临着制定关于终止无行为能力患者医疗治疗的法律标准这一艰巨任务。在本文中,罗登教授批评了法院制定的两种主要方法——“主观”和“客观”测试,并提议摒弃这些标准,转而采用有利于家庭决策的法律推定。她认为,“主观”测试要求家庭提供明确证据,证明终止治疗是无行为能力患者本来会选择的做法,但这往往行不通,因为患者的性格特点,甚至她之前关于医疗治疗的陈述,很少能达到法院声称要求的证据水平。同样,她认为,“客观”测试要求家庭证明以痛苦和折磨来衡量的患者生命负担明显超过其益处,这种做法将患者非人化,因为它暗示只有患者当前的身体感觉才重要。罗登教授指出,主观和客观测试并不像法院所认为的那样截然不同。她认为,这些法律标准的僵化反映了法院接受了医学界支持继续治疗的推定,这一推定给寻求终止治疗的家庭带来了沉重负担。基于家庭在这类案件中作为决策者的特殊资质,罗登教授提议法院承认家庭在治疗决策上行使酌处权的推定权利。这样一种标准将认识到,尽管医生和其他人能够轻易证明终止对仍能享受生活的患者的治疗是错误的,但家庭很难达到当前的标准,这些标准实际上要求他们证明终止治疗是正确的。

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