Asscher Eva, Metselaar Suzanne
Department of Ethics, Humanities & Law, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Bioethics. 2025 Jun 29. doi: 10.1111/bioe.13437.
Although we have a long-standing and well-institutionalized practice of medical aid in dying (MAID) in the Netherlands, it is insufficiently clarified which goals ethicists should pursue in the context of assisted dying, and which competencies they need to fulfil their role(s). We sought to contribute to this clarification. We argue that both in anticipation and in evaluation of MAID, ethicists fulfil a role that is highly valuable to good MAID practice, and complementary to that of other professionals. Whereas the involvement of the ethicist preceding MAID, for instance, to provide ethics support in the case of complex decision-making, is elective in the Netherlands, the participation of ethicists in evaluating performed MAID cases is obligatory, as they are required members of the interdisciplinary regional review committees that judge every case of MAID. We discuss some misconceptions and less-than-optimal performances of both these roles of the ethicist, then focus on how these roles should be perceived, and which kinds of ethics expertise are necessary for ethicists to make a valuable contribution to good MAID practice.
尽管在荷兰，我们对医疗协助死亡（MAID）有着长期且制度化良好的实践，但在协助死亡的背景下，伦理学家应追求哪些目标，以及他们需要哪些能力来履行其职责，这一点并未得到充分阐明。我们试图为这一澄清做出贡献。我们认为，在MAID的预期和评估过程中，伦理学家都发挥着对良好的MAID实践非常有价值的作用，并且与其他专业人员的作用相辅相成。例如，在荷兰，MAID之前伦理学家的参与（比如在复杂决策情况下提供伦理支持）是可选择的，而伦理学家参与已实施的MAID案例评估是强制性的，因为他们是跨学科区域审查委员会的必需成员，该委员会负责评判每一个MAID案例。我们讨论了伦理学家这两种角色的一些误解和不太理想的表现，然后重点关注这些角色应如何被看待，以及伦理学家需要哪些类型的伦理专业知识才能为良好的MAID实践做出有价值的贡献。
