History, Philosophy, and Ethics in Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 13-17, 68167, Mannheim, Germany.
Recent Results Cancer Res. 2021;218:219-232. doi: 10.1007/978-3-030-63749-1_14.
There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. Being unable to die can be worse than death, one might say or think. But until we ourselves have crossed that frontier, we do not know this for certain. To die could be worse than not being able to die. One case is difficult to distinguish from the other. But we pretend we can distinguish them if we praise assisted suicide and euthanasia as solutions to a problem that we not only do not solve, but make worse. Do we need assisted suicide in the face of non-dying skills? The author's answer is no: we do not need euthanasia, neither in that nor in any other case. The logic of euthanasia itself decrees that it cannot be restricted to exceptional cases, based as it is on the idea that the patient's autonomy is to be valued more highly than their actual illness. But if autonomy were of absolute value, it could not be limited to cases of severe disease. The reasons which supporters of euthanasia cite for limiting assisted suicide to the most serious cases of illness, therefore, speak against euthanasia in general. Once the first step has been taken, the application can no longer be limited if, on the one hand, the 'autonomous' desire for death is superior to any counter-argument, and on the other hand, no state of illness is conceivable that could call into question the alleged autonomy.
毫无疑问，有些病人遭受了极大的痛苦，当然，这种情况不应该发生。任何患有绝症的病人都不应该被折磨数月或数年，以至于他们只想死却没有办法自杀。人们可能会说或认为，无法死亡可能比死亡更糟糕。但在我们自己越过那个边界之前，我们不能确定这一点。死亡可能比无法死亡更糟糕。一种情况很难与另一种情况区分开来。但如果我们称赞协助自杀和安乐死是解决我们不仅没有解决反而使情况恶化的问题的办法，我们就可以假装能够区分它们。面对非致死性技能，我们是否需要协助自杀？作者的回答是否定的：我们不需要安乐死，无论是在这种情况下还是在任何其他情况下。安乐死的逻辑本身就规定，它不能仅限于特殊情况，因为它基于这样一种观念，即患者的自主权比他们的实际疾病更应受到重视。但是，如果自主权具有绝对价值，它就不能仅限于严重疾病的情况。因此，安乐死支持者为将协助自杀限制在最严重的疾病病例中而提出的理由，一般来说是反对安乐死的。一旦迈出了第一步，如果一方面“自主”的死亡愿望优于任何反驳意见，另一方面，没有任何可以质疑所谓自主权的疾病状态可以想象，那么协助自杀的申请就不能再被限制。
