Enck Gavin G
Department of Clinical Ethics, Ohio Health, Columbus, OH, USA.
Med Health Care Philos. 2022 Jun;25(2):251-258. doi: 10.1007/s11019-022-10066-3. Epub 2022 Jan 11.
In end-of-life care discussions, I contend that the distinction between "having a life" vs. "being alive" is an underutilized distinction. This distinction is significant in separating different states of existence conflated by patients, families, and clinicians. In the clinical setting, applying this distinction in end-of-life care discussions aids patients' and family members' decision-making by helping them understand that being alive can differ from having a life. Moreover, this distinction helps them decide which state may be the most important to them. After applying this distinction to three complex cases, I respond to the likely objection that "having a life" vs. "being alive" is less accurate and more controversial than other distinctions. I conclude by arguing that "having a life" vs. "being alive" is more accurate and less controversial than distinctions between medically indicated vs. medically inappropriate treatments, personhood, and quantity vs. quality of life.
在临终关怀讨论中，我认为“拥有生活”与“活着”之间的区别是一种未得到充分利用的区别。这种区别对于区分患者、家属和临床医生所混淆的不同生存状态具有重要意义。在临床环境中，在临终关怀讨论中应用这种区别有助于患者和家属做出决策，帮助他们理解活着可能不同于拥有生活。此外，这种区别有助于他们决定哪种状态对他们可能最重要。在将这种区别应用于三个复杂案例后，我回应了可能的反对意见，即“拥有生活”与“活着”相比其他区别不够准确且更具争议性。我最后指出，“拥有生活”与“活着”比医学上适宜与不适宜治疗、人格以及生活数量与质量之间的区别更准确且争议性更小。
