Oehmichen M, Meissner C
Department of Legal Medicine, Medical University of Lübeck, Germany.
Gerontology. 2000 Jul-Aug;46(4):212-8. doi: 10.1159/000022162.
Around the world heated debates have broken out on the topic of active euthanasia. Specialists in the field of 'forensic medicine' have taken full part in these discussions.
The present survey from the point of view of forensic medicine begins with a look at current terminology and at the laws pertaining to euthanasia in Germany. These laws are then contrasted with actual practice, including a description of the increasing acceptance of active euthanasia by the German population and its legalization in Holland. The main argument against active euthanasia is that its formal acceptance in law would cause the dam of restraint to burst, culminating in widespread misuse, as already seen in recent serial killings by nurses in hospitals and homes for the elderly around the world.
Contrasted to this are the arguments for taking active steps at the end of life, including emotional considerations such as the revulsion against mechanized medicine and the fear of pain and rational arguments such as the necessity to end a 'life unworthy of life', to save medical costs, and obtaining prior consent in 'living wills'. Such considerations have put in jeopardy the moral integrity of the medical profession - and thus the layperson's trust in physicians - around the world. In Germany especially the history of mass killing during the Nazi era constitutes a fundamental argument against active euthanasia. As a consequence, in Germany active euthanasia will not receive legal sanction, although recommendations on rendering dying more bearable are permitted.
在全球范围内，围绕主动安乐死这一话题引发了激烈的辩论。“法医学”领域的专家充分参与了这些讨论。
本次从法医学角度进行的调查首先审视了当前的术语以及德国与安乐死相关的法律。然后将这些法律与实际做法进行对比，包括描述德国民众对主动安乐死的接受程度日益提高以及在荷兰其合法化的情况。反对主动安乐死的主要论点是，其在法律上的正式认可会导致约束的堤坝决口，最终导致广泛滥用，正如最近在世界各地医院和养老院发生的护士连环杀人案中所看到的那样。
与此形成对比的是，支持在生命末期采取积极措施的论点，包括情感方面的考虑，如对机械化医疗的反感以及对疼痛的恐惧，还有理性的论点，如结束“无价值生命”的必要性、节省医疗成本以及在“生前遗嘱”中获得事先同意。这些考虑危及了全球医疗行业的道德完整性——进而危及外行人对医生的信任。尤其是在德国，纳粹时代大规模杀戮的历史构成了反对主动安乐死的根本论据。因此，在德国，主动安乐死不会得到法律认可，尽管允许提出让死亡更可承受的建议。
