Rabiu Abdul-Rasheed, Sugand Kapil
Imperial College School of Medicine, Sir Alexander Fleming Building, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
Philos Ethics Humanit Med. 2014 Feb 22;9:5. doi: 10.1186/1747-5341-9-5.
The medical profession consistently strives to uphold patient empowerment, equality and safety. It is ironic that now, at a time where advances in technology and knowledge have given us an increased capacity to preserve and prolong life, we find ourselves increasingly asking questions about the value of the lives we are saving. A recent editorial by Professor Raanan Gillon questions the emphasis that English law places on the sanctity of life doctrine. In what was described by Reverend Nick Donnelly as a "manifesto for killing patients", Professor Gillon argues that the sanctity of life law has gone too far because of its disregard for distributive justice and an incompetent person's previously declared autonomy. This review begins by outlining the stance of the sanctity of life doctrine on decisions about administering, withholding and withdrawing life-prolonging treatment. Using this as a foundation for a rebuttal, a proposal is made that Professor Gillon's assertions do not take the following into account:1) A sanctity of life law does not exist since English Common Law infringes the sanctity doctrine by tolerating quality of life judgements and a doctor's intention to hasten death when withdrawing life-prolonging treatment.2) Even if a true sanctity of life law did exist:a) The sanctity of life doctrine allows for resource considerations in the wider analysis of benefits and burdens.b) The sanctity of life doctrine yields to a competent person's autonomous decision.This review attempts to demonstrate that at present, and with the legal precedent that restricts it, a sanctity of life law cannot go too far.
医学专业始终致力于维护患者的自主权、平等和安全。具有讽刺意味的是,如今在技术和知识取得进步,使我们延长生命的能力有所提高的时代,我们却越来越多地在问自己,我们所挽救的生命的价值何在。拉南·吉利翁教授最近的一篇社论对英国法律对生命神圣教义的强调提出了质疑。尼克·唐纳利牧师称其为“杀害患者的宣言”,吉利翁教授认为,生命神圣法走得太远了,因为它无视分配正义以及无行为能力者先前声明的自主权。本评论首先概述生命神圣教义在关于给予、 withholding 和 withdrawing 延长生命治疗的决策上的立场。以此为反驳的基础,有人提出吉利翁教授的断言没有考虑到以下几点:1)不存在生命神圣法,因为英国普通法通过容忍生活质量判断以及医生在 withdrawing 延长生命治疗时加速死亡的意图,侵犯了神圣教义。2)即使真的存在生命神圣法:a)生命神圣教义在对利益和负担的更广泛分析中允许考虑资源因素。b)生命神圣教义服从有行为能力者的自主决定。本评论试图表明,目前,鉴于限制它的法律先例,生命神圣法不会走得太远。
原文中“withholding”和“withdrawing”未明确合适中文释义,暂保留英文。