Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
PLoS One. 2012;7(2):e31735. doi: 10.1371/journal.pone.0031735. Epub 2012 Feb 15.
People have fought for their civil rights, primarily the right to live in dignity. At present, the development of technology in medicine and healthcare led to an apparent paradox: many people are fighting for the right to die. This study was aimed at testing whether different moral principles are associated with different attitudes towards end-of-life decisions for patients with a severe brain damage.
We focused on the ethical decisions about withdrawing life-sustaining treatments in patients with severe brain damage. 202 undergraduate students at the University of Padova were given one description drawn from four profiles describing different pathological states: the permanent vegetative state, the minimally conscious state, the locked-in syndrome, and the terminal illness. Participants were asked to evaluate how dead or how alive the patient was, and how appropriate it was to satisfy the patient's desire.
We found that the moral principles in which people believe affect not only people's judgments concerning the appropriateness of the withdrawal of life support, but also the perception of the death status of patients with severe brain injury. In particular, we found that the supporters of the Free Choice (FC) principle perceived the death status of the patients with different pathologies differently: the more people believe in the FC, the more they perceived patients as dead in pathologies where conscious awareness is severely impaired. By contrast, participants who agree with the Sanctity of Life (SL) principle did not show differences across pathologies.
These results may shed light on the complex aspects of moral consensus for supporting or rejecting end-of-life decisions.
人们一直在争取自己的公民权利，主要是尊严生活的权利。目前，医学和医疗保健技术的发展导致了一个明显的悖论：许多人正在争取死亡的权利。本研究旨在检验不同的道德原则是否与严重脑损伤患者的临终决策的不同态度有关。
我们专注于对严重脑损伤患者停止维持生命治疗的伦理决策。帕多瓦大学的 202 名本科生接受了来自四个描述不同病理状态的描述之一：永久性植物人状态、最小意识状态、闭锁综合征和终末期疾病。参与者被要求评估患者的死亡或存活程度，以及满足患者愿望的适当性。
我们发现，人们所信仰的道德原则不仅影响人们对停止生命支持的适当性的判断，还影响对严重脑损伤患者死亡状态的感知。特别是，我们发现支持自由选择（FC）原则的人对不同病理状态的患者的死亡状态有不同的看法：越多人相信 FC，他们就越认为意识严重受损的患者死亡。相比之下，同意生命神圣（SL）原则的参与者在不同的病理状态下没有表现出差异。
这些结果可能揭示了支持或拒绝临终决策的道德共识的复杂方面。
