Smith G P
Columbus School of Law, Catholic University of America, Washington, D.C.
J Palliat Care. 1990 Summer;6(2):24-32.
Death cannot be viewed properly as either an event or a configuration. Indeed, multiple parts of the body can continue to live long after the disintegration of its central organization is recorded. Instead of collapsing at a moment in time, technological mechanisms are capable of sustaining the major bodily processes indefinitely--all designed to allow for the harvesting of needed organs for transplantation. State legislative efforts have been undertaken in America to define those specific circumstances when death occurs legally. Although always allowed to exercise reasonable discretion in their decision making, attending physicians will nonetheless be aided by these laws that only limit their legal liability but assure for the patient that his final choices will be honored consistent with basic principles of self-determination. The Law Reform Commission of Canada recommended in 1987 that criminal liability be rejected for the offenses of helping, advising, or inciting a person to commit suicide. This is an exceedingly wise and humane position to follow. Instead of being held captive to words such as "rational suicide" or "euthanasia", what is needed is an acceptance of more contemporary watchwords such as autonomy and self-determination. When at all possible, final choices about death should be made by the patient's family and their medical advisers--and not be subjected to judicial scrutiny.
死亡既不能被恰当地视为一个事件,也不能被看作一种状态。事实上,在身体的核心组织解体之后,身体的多个部分仍能存活很长时间。技术机制并非在某一时刻瞬间崩溃,而是能够无限期地维持身体的主要生理过程——所有这些都是为了便于获取所需的移植器官而设计的。美国已进行州立法,以界定死亡合法发生的具体情形。尽管主治医生在决策时始终被允许行使合理的自由裁量权,但这些法律将对他们有所帮助,这些法律不仅限制了他们的法律责任,而且向患者保证,其最终选择将根据自决的基本原则得到尊重。加拿大法律改革委员会在1987年建议,对于帮助、建议或煽动他人自杀的罪行,不应追究刑事责任。这是一个极其明智和人道的立场。我们需要接受诸如自主权和自决等更现代的口号,而不是被“理性自杀”或“安乐死”等词汇所束缚。在一切可能的情况下,关于死亡的最终选择应由患者家属及其医疗顾问做出,而不应受到司法审查。