Inthorn Julia, Schicktanz Silke, Rimon-Zarfaty Nitzan, Raz Aviad
Department of Medical Ethics and History of Medicine, University Medical Center Goettingen, Humboldtallee 36, 37073, Goettingen, Germany,
Med Health Care Philos. 2015 Aug;18(3):329-40. doi: 10.1007/s11019-014-9606-5.
National legislation, as well as arguments of experts, in Germany and Israel represent opposite regulatory approaches and positions in bioethical debates concerning end-of-life care. This study analyzes how these positions are mirrored in the attitudes of laypeople and influenced by the religious views and personal experiences of those affected. We qualitatively analyzed eight focus groups in Germany and Israel in which laypeople (religious, secular, affected, and non-affected) were asked to discuss similar scenarios involving the withholding or withdrawing of treatment, physician-assisted suicide, and euthanasia. In both countries, respect for patient autonomy and patients' wishes to die with dignity found broad consent. Laypeople argued in favor of accepting such wishes when they were put down in an advance directive. Laypeople in non-religious groups in both countries argued on the basis of a respect for autonomy for the possibility of euthanasia in severe cases but, at the same time, cautioned against its possible misuse. National contrast was apparent in the moral reasoning of lay respondents concerning the distinction between withholding and withdrawing treatment. The modern religious laypeople in Israel, especially, argued strongly, on the basis of the halakhic tradition, against allowing the withdrawal of treatment in accord with a patient's wish. We conclude by discussing the emergent notion of shared responsibility and views of professional responsibility, which we connect through relevant cultural themes such as religion and national culture.
在德国和以色列，国家立法以及专家观点在关于临终关怀的生物伦理辩论中代表了相反的监管方法和立场。本研究分析了这些立场如何在普通民众的态度中得到体现，以及如何受到相关人员宗教观点和个人经历的影响。我们对德国和以色列的八个焦点小组进行了定性分析，在这些小组中，普通民众（包括宗教人士、世俗人士、受影响者和未受影响者）被要求讨论涉及停止或撤销治疗、医生协助自杀和安乐死的类似情景。在这两个国家，尊重患者自主权以及患者有尊严地死亡的愿望得到了广泛认可。普通民众认为，当这些愿望在预先指示中写明时，应予以接受。两国非宗教群体中的普通民众基于对自主权的尊重，主张在严重情况下安乐死的可能性，但同时也告诫要防止其可能被滥用。在普通受访者关于停止治疗和撤销治疗区别的道德推理中，国家间的差异很明显。特别是以色列的现代宗教普通民众，基于哈拉卡传统，强烈反对根据患者意愿允许撤销治疗。我们通过讨论共同责任这一新兴概念以及专业责任观点来得出结论，我们通过宗教和民族文化等相关文化主题将它们联系起来。
