Sveinsson Olafur Arni
Laeknir og Heimspekingur.
Laeknabladid. 2007 Jul-Aug;93(7-8):543-51.
Euthanasia has been heatedly discussed in Western countries over the last years. Only a few nations have legalized euthanasia or physician assisted suicide with the Dutch at the forefront of that field. Proponents of euthanasia mostly argue for euthanasia on two grounds. Firstly, that the patient has a right to die and secondly, that there is no substantial difference between euthanasia and palliative care. In this paper I will argue against both of the above. I discuss the arguments against euthanasia which are in principle four. Firstly, it is held by many that taking a human life is wrong under all circumstances. Secondly, that it is an unjustifiable demand to ask a person to take another person's life. In relation to that argument, euthanasia is not in accordance with the basic principles of medicine and nursing as they have evolved over the years and could therefore easily disrupt the therapeutic relationship. Thirdly, as shown from Holland there is empirical evidence that euthanasia is not under good enough surveillance and therefore invites misuse. Fourthly, even though euthanasia might possibly be justifiable under certain circumstances, legalisation might well invite abuse because of the message and pressure that the option places on both patients and professionals in terminal care. My answer to the euthanasia demand is palliative care, where dialogue between the patient and doctor is central. But the dialogue cannot be effective, unless both partners are willing and able to engage in sincere and frank conversations.
在过去几年里,安乐死在西方国家一直是激烈讨论的话题。只有少数几个国家将安乐死或医生协助自杀合法化,荷兰在这一领域处于领先地位。安乐死的支持者主要基于两个理由主张安乐死。其一,患者有死亡的权利;其二,安乐死与姑息治疗没有本质区别。在本文中,我将反驳上述两个观点。我讨论了反对安乐死的理由,原则上有四条。其一,许多人认为在任何情况下夺取他人生命都是错误的。其二,要求一个人夺取另一个人的生命是不合理的要求。关于这一论点,安乐死不符合多年来发展起来的医学和护理的基本原则,因此很容易破坏治疗关系。其三,正如荷兰的情况所示,有经验证据表明安乐死没有得到足够好的监管,因此容易被滥用。其四,即使安乐死在某些情况下可能是合理的,但合法化很可能会导致滥用,因为这一选择给临终关怀中的患者和专业人员都带来了信息和压力。我对安乐死需求的回应是姑息治疗,其中患者与医生之间的对话是核心。但除非双方都愿意并能够进行真诚坦率的对话,否则这种对话不会有效。