Snyder L, Sulmasy D P
American College of Physicians-American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106, USA.
Ann Intern Med. 2001 Aug 7;135(3):209-16. doi: 10.7326/0003-4819-135-3-200108070-00015.
Medical professional codes have long prohibited physician involvement in assisting a patient's suicide. However, despite ethical and legal prohibitions, calls for the liberalization of this ban have grown in recent years. The medical profession should articulate its views on the arguments for and against changes in public policy and decide whether changes are prudent. In addressing such a contentious issue, physicians, policymakers, and society must fully consider the needs of patients, the vulnerability of particular patient groups, issues of trust and professionalism, and the complexities of end-of-life health care. Physician-assisted suicide is prominent among the issues that define our professional norms and codes of ethics. The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) does not support the legalization of physician-assisted suicide. The routine practice of physician-assisted suicide raises serious ethical and other concerns. Legalization would undermine the patient-physician relationship and the trust necessary to sustain it; alter the medical profession's role in society; and endanger the value our society places on life, especially on the lives of disabled, incompetent, and vulnerable individuals. The ACP-ASIM remains thoroughly committed to improving care for patients at the end of life.
长期以来,医学专业准则一直禁止医生参与协助患者自杀。然而,尽管存在伦理和法律上的禁令,但近年来要求放宽这一禁令的呼声却越来越高。医学界应该就支持和反对公共政策变革的论据阐明自己的观点,并决定变革是否审慎。在处理这样一个有争议的问题时,医生、政策制定者和社会必须充分考虑患者的需求、特定患者群体的脆弱性、信任和专业精神问题以及临终医疗保健的复杂性。医生协助自杀是界定我们专业规范和道德准则的诸多问题中较为突出的一个。美国内科医师学会-美国内科医学协会(ACP-ASIM)不支持医生协助自杀合法化。医生协助自杀的常规做法引发了严重的伦理和其他问题。合法化将破坏医患关系以及维持这种关系所需的信任;改变医学界在社会中的角色;并危及我们社会对生命,尤其是对残疾、无行为能力和脆弱个体生命的重视。ACP-ASIM仍然坚定致力于改善临终患者的护理。