Kirby Jeffrey
Department of Bioethics, Faculty of Medicine, Dalhousie University, C-320, 5849 University Avenue, Halifax, Nova Scotia, B3H 4H7, Canada.
J Bioeth Inq. 2017 Dec;14(4):475-483. doi: 10.1007/s11673-017-9808-7. Epub 2017 Oct 5.
There has been contentious debate over the years about whether there are morally relevant similarities and differences between the three practices of continuous deep sedation until death, physician-assisted suicide, and voluntary euthanasia. Surprisingly little academic attention has been paid to a comparison of the uses of these practices in the two types of circumstances in which they are typically performed. A comparative domains of ethics analysis methodological approach is used in the paper to compare 1) the use of the three practices in paradigm circumstances, and 2) the use of the practices in paradigm circumstances to their use in non-paradigm circumstances. The analytical outcomes suggest that a bright moral line cannot be demonstrated between any two of the practices in paradigm circumstances, and that there are significant, morally-relevant distinctions between their use in paradigm and non-paradigm circumstances. A thought experiment is employed to illustrate how these outcomes could possibly inform the decisions of hypothetical deliberators who are engaged in the collaborative development of assisted dying regulatory frameworks.
多年来，关于持续深度镇静直至死亡、医生协助自杀和自愿安乐死这三种做法之间在道德上是否存在相关的异同，一直存在着有争议的辩论。令人惊讶的是，对于这些做法在它们通常实施的两种情况下的使用情况进行比较，学术关注极少。本文采用了一种比较伦理分析方法论方法，来比较：1）这三种做法在典型情况下的使用；2）这些做法在典型情况下的使用与其在非典型情况下的使用。分析结果表明，在典型情况下，这三种做法中的任何两种之间都无法划出一条清晰的道德界限，而且它们在典型情况和非典型情况下的使用之间存在重大的、与道德相关的区别。运用了一个思想实验来说明这些结果如何可能为参与协助死亡监管框架协同制定的假设审议者的决策提供信息。
