Hartling O J
The Danish Council of Ethics, Copenhagen, Denmark.
Med Law. 2006 Mar;25(1):189-99.
The paper deals with some of the more common arguments used for the legalisation of voluntary euthanasia. It looks at these arguments from an ethical and philosophical point of view. First, the argument that to offer a person the possibility of euthanasia is to respect that person's autonomy is questionable. Can a person's decision on euthanasia be really autonomous? If euthanasia were legal everybody would be conscious of this option: the patient, the doctor, the family and the nursing staff. Thus, there could be indirect pressure on the patient to make a decision. The choice is meant to be free but the patient is not free not to make the choice. Secondly, a choice that seeks to alleviate suffering and thus improve life by annihilating it is irrational. Thirdly, autonomy as to one's own death is hardly exercised freely. Even an otherwise competent person may not be competent in deciding on his own death on account of despair, hopelessness, fear or maybe a feeling of being weak, superfluous and unwanted. This is a very uncertain base for decision-making, especially in the irrevocable decision of euthanasia. Finally, a competent person usually makes any choice in a responsible way and after due consideration; a 'good' decision should consider and respect the wishes and feelings of others. This will be no less the case in making a decision on the so-called free choice of euthanasia. Thus 'normal' behaviour in decision making will only add to the tendency of the already depressed person to feel a burden on his family, the staff and even on society.
本文探讨了一些支持自愿安乐死合法化的较为常见的论据。它从伦理和哲学的角度审视这些论据。首先，认为给予一个人安乐死的可能性就是尊重其自主性的观点是值得怀疑的。一个人关于安乐死的决定真的能是自主的吗？如果安乐死合法化，每个人都会意识到这个选择：患者、医生、家属和护理人员。因此，可能会对患者形成间接压力促使其做出决定。这个选择本应是自由的，但患者却没有不做选择的自由。其次，通过消灭生命来寻求减轻痛苦从而改善生活的选择是不合理的。第三，关于自己死亡的自主性很难自由地行使。即使一个在其他方面有行为能力的人，由于绝望、无助、恐惧或者可能是一种软弱、多余和不被需要的感觉，在决定自己的死亡时也可能没有行为能力。这是一个非常不确定的决策基础，尤其是在不可撤销的安乐死决定中。最后，一个有行为能力的人通常会以负责的方式并经过适当考虑后做出任何选择；一个“好”的决定应该考虑并尊重他人的意愿和感受。在所谓的安乐死自由选择的决策中情况也不会例外。因此，决策中的“正常”行为只会增加已经情绪低落的人觉得自己给家人、工作人员甚至社会带来负担的倾向。
