Department of Philosophy & Ethics, Eindhoven University of Technology, The Netherlands.
Bioethics. 2013 Mar;27(3):140-50. doi: 10.1111/j.1467-8519.2011.01900.x. Epub 2011 Jul 29.
This article deals with the euthanasia debate in light of new life-sustaining technologies such as the left ventricular assist device (LVAD). The question arises: does the switching off of a LVAD by a doctor upon the request of a patient amount to active or passive euthanasia, i.e. to 'killing' or to 'letting die'? The answer hinges on whether the device is to be regarded as a proper part of the patient's body or as something external. We usually regard the switching off of an internal device as killing, whereas the deactivation of an external device is seen as 'letting die'. The case is notoriously difficult to decide for hybrid devices such as LVADs, which are partly inside and partly outside the patient's body. Additionally, on a methodological level, I will argue that the 'ontological' arguments from analogy given for both sides are problematic. Given the impasse facing the ontological arguments, complementary phenomenological arguments deserve closer inspection. In particular, we should consider whether phenomenologically the LVAD is perceived as a body part or as an external device. I will support the thesis that the deactivation of a LVAD is to be regarded as passive euthanasia if the device is not perceived by the patient as a part of the body proper.
本文从左心室辅助装置（LVAD）等新的维持生命的技术的角度探讨了安乐死辩论。问题是：医生应患者的要求关闭 LVAD 是否属于主动安乐死还是被动安乐死，即“杀人”还是“让其死亡”？答案取决于该设备是被视为患者身体的适当部分还是外部物体。我们通常将内部设备的关闭视为“杀人”，而外部设备的停用则被视为“让其死亡”。对于 LVAD 等混合设备，情况尤其难以判断，因为它们部分位于患者体内，部分位于体外。此外，在方法论层面上，我将论证双方给出的基于类比的“本体论”论据存在问题。鉴于本体论论据陷入僵局，互补的现象学论据值得更仔细地研究。特别是，我们应该考虑从现象学上看，LVAD 是否被视为身体的一部分还是外部设备。如果患者不将 LVAD 视为身体的适当部分，则我将支持这样的论点，即停用 LVAD 应被视为被动安乐死。
