Brassfield Elizabeth R, Mishra Manisha, Buchbinder Mara
Narrat Inq Bioeth. 2019;9(1):67-72. doi: 10.1353/nib.2019.0019.
This case study illustrates the complex role that a physician's conscience can play in end-of-life care. We examine a case from Vermont in which a terminally ill patient requests aid-in-dying from her primary care physician under the state's "Patient Choice and Control at End of Life" Act (Act 39). The physician feels conflicted: she is opposed to prescribing death-hastening medication but does not want to abandon her patient. Much of the medical ethics literature on conscience focuses on whether health care professionals should be permitted to abstain from providing morally contested medical services. Our analysis highlights the interplay of conflicting values that inform the physician's engagement with aid-in-dying, demonstrating that the issue is often more nuanced than the question of whether or not a physician can (or should) opt out.
本案例研究说明了医生的良知在临终关怀中可能发挥的复杂作用。我们审视了佛蒙特州的一个案例，在该案例中，一名绝症患者根据该州的《临终患者选择与控制权法案》（第39号法案），向其初级保健医生请求协助死亡。这位医生感到矛盾：她反对开具加速死亡的药物，但又不想抛弃她的患者。医学伦理文献中关于良知的大部分内容都集中在医疗保健专业人员是否应被允许避免提供存在道德争议的医疗服务上。我们的分析强调了相互冲突的价值观之间的相互作用，这些价值观影响着医生在协助死亡问题上的参与，表明这个问题往往比医生是否能够（或应该）选择退出的问题更为微妙。
