Schaffner K F
International Resuscitation Research Center, University of Pittsburgh, PA 15260.
Crit Care Med. 1988 Oct;16(10):1063-8. doi: 10.1097/00003246-198810000-00021.
This paper reviews the ethical foundations of decisions to suspend life-sustaining nutrition and hydration for seriously ill and permanently comatose patients, and also examines three legal cases in this area (Barber, Bouvia, and Brophy). The cause of such patients' deaths is examined, and the current consensus that it is the underlying illness which is the identifiable cause is criticized. I argue that the responsible cause in such cases is typically the physician's decision to suspend food and/or water, made with the deliberate concurrence of the patients, families and/or courts. I also argue that with proper safeguards this is both a reasonable policy and one that should be interpreted as a general surrogate for rational, medically assisted suicide.
本文回顾了针对重症且永久昏迷患者停止维持生命的营养和水分供应的决策的伦理基础，还审视了该领域的三个法律案例（巴伯案、布维亚案和布罗菲案）。对这类患者的死亡原因进行了考察，并对目前认为潜在疾病是可确认死因的共识提出了批评。我认为，在这类案例中，责任原因通常是医生在患者、家属和/或法院的蓄意同意下做出的停止食物和/或水分供应的决定。我还认为，有了适当的保障措施，这既是一项合理的政策，也应被视为理性的、医学辅助自杀的一般替代方式。
