Giordano Simona
The Centre for Social Ethics and Policy, The University of Manchester, Williamson Building, Oxford Road, Manchester, M14 9PL, UK.
Bioethics. 2003 Jun;17(3):261-78. doi: 10.1111/1467-8519.00340.
Imposing artificial feeding on people with anorexia nervosa may be unethical. This seems to be Heather Draper's suggestion in her article, 'Anorexia Nervosa and Respecting a Refusal of Life-Prolonging Therapy: A Limited Justification.' Although this is an important point, I shall show that the arguments supporting this point are flawed. Draper should have made a brave claim: she should have claimed that people with anorexia nervosa, who competently decide not to be artificially fed, should be respected because everybody is entitled to exercise their autonomy, not only 'in the middle' of their life, but also at the end of it, or when their own life is at stake, because autonomy also extends to the most difficult moments of our life, and, ultimately, 'stretches [...] far out into the distance' at the end of it. I explain why Draper should have made the brave claim, and why she has not made it. I conclude that a defence of people's entitlement to competently refuse artificial feeding cannot rest upon the arguments developed by Draper. Whether or not we should respect competent refusal of artificial feeding depends on the normative strength that we are ready to ascribe to the principle of autonomy, to the moral relevance that we ascribe to the circumstances in which a person's autonomy is exercised, and, perhaps, eventually, on our sense of compassion.
对神经性厌食症患者强制进行人工喂养可能是不道德的。这似乎是希瑟·德雷珀在她的文章《神经性厌食症与尊重对延长生命治疗的拒绝：一个有限的正当理由》中提出的观点。尽管这是一个重要观点，但我将表明支持这一观点的论据存在缺陷。德雷珀本应提出一个大胆的主张：她应该主张，那些有能力决定不接受人工喂养的神经性厌食症患者应该得到尊重，因为每个人都有权行使自己的自主权，不仅在生命“中期”，而且在生命末期，或者当自己的生命受到威胁时，因为自主权也延伸到我们生命中最艰难的时刻，最终，在生命尽头“延伸……至远方”。我解释了为什么德雷珀本应提出这个大胆主张，以及她为什么没有这样做。我的结论是，为人们有能力拒绝人工喂养的权利进行辩护不能依赖于德雷珀提出的论据。我们是否应该尊重有能力拒绝人工喂养的决定，取决于我们准备赋予自主权原则的规范力量，取决于我们赋予人们行使自主权所处环境的道德相关性，或许最终还取决于我们的同情心。
