a Norwegian University of Science and Technology.
Am J Bioeth. 2019 Mar;19(3):10-20. doi: 10.1080/15265161.2018.1561961.
Withholding and withdrawing treatment are widely regarded as ethically equivalent in medical guidelines and ethics literature. Health care personnel, however, widely perceive moral differences between withholding and withdrawing. The proponents of equivalence argue that any perceived difference can be explained in terms of cognitive biases and flawed reasoning. Thus, policymakers should clear away any resistance to accept the equivalence stance by moral education. To embark on such a campaign of changing attitudes, we need to be convinced that the ethical analysis is correct. Is it? In this article, I take a closer look at the moral relation between withholding and withdrawing. My conclusion is that withholding and withdrawing are not in general ethically equivalent. Thus, medical guidelines should be rewritten, and rather than being "educated" away from their sound judgments, medical professionals and patients should have nuanced medico-ethical discussions regarding withholding and withdrawing treatment.
在医学指南和伦理文献中， withholding 和 withdrawing treatment 被广泛认为在伦理上是等同的。然而，医护人员普遍认为 withholding 和 withdrawing 之间存在道德差异。等同论的支持者认为，任何感知到的差异都可以用认知偏差和有缺陷的推理来解释。因此，政策制定者应该通过道德教育消除任何接受等同立场的阻力。要开展这样一场改变态度的运动，我们需要确信伦理分析是正确的。是这样吗？在本文中，我更仔细地研究了 withholding 和 withdrawing 之间的道德关系。我的结论是，一般来说 withholding 和 withdrawing 在伦理上并不等同。因此，医学指南应该重写，而不是通过“教育”来消除他们合理的判断，医护人员和患者应该就 withholding 和 withdrawing 治疗进行细致入微的医学伦理讨论。
