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通过对“临终实践”进行价值中立的分类,克服“安乐死”和“协助自杀”的定义冲突。

Overcoming Conflicting Definitions of "Euthanasia," and of "Assisted Suicide," Through a Value-Neutral Taxonomy of "End-Of-Life Practices".

机构信息

Department of Philosophy, University of New South Wales, High St, Kensington, Sydney, New South Wales, 2052, Australia.

出版信息

J Bioeth Inq. 2023 Mar;20(1):51-70. doi: 10.1007/s11673-023-10230-1. Epub 2023 Feb 2.

Abstract

The term "euthanasia" is used in conflicting ways in the bioethical literature, as is the term "assisted suicide," resulting in definitional confusion, ambiguities, and biases which are counterproductive to ethical and legal discourse. I aim to rectify this problem in two parts. Firstly, I explore a range of conflicting definitions and identify six disputed definitional factors, based on distinctions between (1) killing versus letting die, (2) fully intended versus partially intended versus merely foreseen deaths, (3) voluntary versus nonvoluntary versus involuntary decisions, (4) terminally ill versus non-terminally ill patients, (5) patients who are fully conscious versus those in permanent comas or persistent vegetative states, and (6) patients who are suffering versus those who are not. Secondly, I distil these factors into six "building blocks" and combine them to develop an unambiguous, value-neutral taxonomy of "end-of-life practices." I hope that this taxonomy provides much-needed clarification and a solid foundation for future ethical and legal discourse.

摘要

“安乐死”一词在生命伦理文献中的使用方式存在冲突,“协助自杀”一词也是如此,这导致了定义上的混淆、歧义以及偏见,这些对于伦理和法律讨论都是适得其反的。我旨在分两个部分纠正这个问题。首先,我探讨了一系列相互冲突的定义,并基于以下区别确定了六个有争议的定义因素:(1) 杀人与放任死亡;(2) 完全意图与部分意图与仅预见的死亡;(3) 自愿与非自愿与非自愿决定;(4) 绝症患者与非绝症患者;(5) 完全有意识的患者与处于永久昏迷或持续性植物状态的患者;(6) 正在受苦的患者与未受苦的患者。其次,我将这些因素提炼成六个“构建块”,并将它们组合起来,制定了一个明确的、价值中立的“临终实践”分类法。我希望这个分类法能够提供急需的澄清,并为未来的伦理和法律讨论奠定坚实的基础。

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