Miller F G, Fins J J, Snyder L
University of Virginia, Charlottesville, USA.
Ann Intern Med. 2000 Mar 21;132(6):470-5. doi: 10.7326/0003-4819-132-6-200003210-00008.
The continuing debate over the deeply controversial issue of physician-assisted suicide has been complicated by confusion about how this practice resembles or differs from refusal of life-sustaining treatment. Perspectives on ethics and policy hinge on the contested issue of whether a valid distinction can be made between assisted suicide and withdrawal of treatment. This paper uses three illustrative cases to examine leading arguments for and against the recognition of a fundamental distinction between these practices. The first case involves assisted suicide by ingestion of prescribed barbiturates, the second involves withdrawal of artificial nutrition and hydration, and the third involves a decision to stop eating and drinking. On theoretical and practical grounds, this paper defends the position that there is a valid distinction between assisted suicide and refusal of treatment.
围绕医生协助自杀这一极具争议性的问题持续不断的争论，因对这种做法与拒绝维持生命治疗之间的相似性或差异的混淆而变得复杂。关于伦理和政策的观点取决于在协助自杀和停止治疗之间能否做出有效区分这一有争议的问题。本文通过三个说明性案例来审视支持和反对承认这些做法之间存在根本区别的主要论点。第一个案例涉及通过服用处方巴比妥酸盐进行协助自杀，第二个案例涉及停止人工营养和水分补充，第三个案例涉及停止进食和饮水的决定。基于理论和实际理由，本文捍卫这样一种立场，即协助自杀和拒绝治疗之间存在有效区分。
