Emanuel E J
Dana-Farber Cancer Institute, Boston, Massachusetts.
Ann Intern Med. 1994 Nov 15;121(10):793-802. doi: 10.7326/0003-4819-121-10-199411150-00010.
Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pains of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about the ethics of euthanasia raged in the United States and Britain, culminating in 1906 in an Ohio bill to legalize euthanasia, a bill that was ultimately defeated. The arguments propounded for and against euthanasia in the 19th century are identical to contemporary arguments. Such similarities suggest four conclusions: Public interest in euthanasia 1) is not linked with advances in biomedical technology; 2) it flourishes in times of economic recession, in which individualism and social Darwinism are invoked to justify public policy; 3) it arises when physician authority over medical decision making is challenged; and 4) it occurs when terminating life-sustaining medical interventions become standard medical practice and interest develops in extending such practices to include euthanasia.
关于安乐死和医生协助自杀的伦理辩论可追溯至古希腊和古罗马时期。乙醚发明后，医生们开始主张使用麻醉剂来减轻死亡的痛苦。1870年，塞缪尔·威廉姆斯首次提议使用麻醉剂和吗啡来故意结束患者的生命。在接下来的35年里，美国和英国围绕安乐死的伦理展开了激烈辩论，1906年，俄亥俄州一项使安乐死合法化的法案达到高潮，该法案最终被否决。19世纪支持和反对安乐死的论点与当代的论点相同。这些相似之处表明了四个结论：公众对安乐死的关注1）与生物医学技术的进步无关；2）在经济衰退时期盛行，此时个人主义和社会达尔文主义被用来为公共政策辩护；3）当医生对医疗决策的权威受到挑战时出现；4）当终止维持生命的医疗干预成为标准医疗实践，且将此类实践扩展至包括安乐死的兴趣发展起来时发生。
