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临终癌症患者谈论安乐死。

Dying cancer patients talk about euthanasia.

作者信息

Eliott Jaklin A, Olver Ian N

机构信息

Cancer Council Australia, School of Psychology, The University of Adelaide, Adelaide, SA 5000, Australia.

出版信息

Soc Sci Med. 2008 Aug;67(4):647-56. doi: 10.1016/j.socscimed.2008.04.004.

Abstract

Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

摘要

在发达国家,关于安乐死作为面对无法忍受的痛苦时自主选择死亡的适当性,公众辩论日益增多,且有明显的支持态度。调查报道了在安乐死接受率方面的社会人口统计学差异,但对于安乐死在个人的社会和道德生活中是如何被理解和定位的,尤其是对于那些可能被视为合适人选的人——例如晚期癌症患者,几乎没有深入分析。在与澳大利亚的28名此类患者讨论临终医疗决策时,13名患者主动提及了安乐死,其余患者则被专门询问了此事。24名患者对安乐死持肯定态度,其中19人也表达了一些担忧。没有人将安乐死视为当前青睐的选择。4人完全反对。对安乐死的支持是在假设的未来背景下,或是针对假设的其他人,或者在时间上与急性疼痛相关。支持安乐死的论点将该问题框定为选择自由的问题、在死亡中维护尊严的问题,以及遏制患者及其周围人的无法忍受的痛苦的问题。一个常见的类比是对狗实施安乐死。这些论点通常被视为安乐死不言而喻的正当理由,被视为一种合适的死亡选择,而反对者则被定位为道德上低人一等或无知。然而,确保“选择”的困难以及“选择死亡”的道德内涵,使得对特定个体实施安乐死的适当性成为一个问题。我们建议对与安乐死相关的道德和社会意义进行进一步的实证研究。

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