我国安乐死立法的障碍分析

安乐死是目前伦理学、法学讨论的焦点问题;也是医生、患者和社会关注的热点问题.本文介绍安乐死立法的历史及现状,并从传统观念、医生角度和法律角度三方面剖析了我国对安乐死立法存在的障碍.     

我国安乐死立法障碍与构想

随着疾病谱的转变与人类思想的进步,安乐死逐渐成为社会公众关注的热点问题。尽管各国对安乐死合法化问题持比较谨慎的态度,但一些国家相继出台了安乐死法案。本文从探讨安乐死的立法现状及立法必要性着手,分析实施安乐死与我国现行法律存在的冲突,提出我国安乐死立法的基本构想,即由全国人大首先对相关的法律进行修订,再由国务院制定具体的安乐死法规。     

安乐死道德与法律关系浅探

安乐死问题之所以受到关注,在于它的道德与法律之间的关系不很明朗.安乐死是否道德一定要根据具体情况而定,它是事实判断与价值判断的统一.道德先于法律而存在,安乐死道德也是如此,我们不能因为安乐死还未立法而在道德面前止步,这是当今人们对安乐死问题认识的一个主要障碍.     

放弃治疗与安乐死的伦理争论

放弃治疗与安乐死是医学伦理学界争论的一个重要伦理问题,争论的问题包括放弃治疗与安乐死的伦理意义、标准与对象界定、赞成与反对的伦理争论、安乐死的立法、及医学与法律基本程序,本文从不同的视角较为全面地阐述了上述问题,并做了充分的解释和说明.     

安乐死的法理与伦理学探讨

总结并分析了安乐死的概念、立法现状、伦理研究及不同人群的态度等方面,并提出了对这一焦点问题的建议和设想,认为医护人员应树立安乐死的新理念、明确新观点、关注并积极推行临终关怀、严格执行法律程序,从而在法理与伦理之间找出一个准确的切入点,为我国尽早对安乐死立法做出应有的努力。     

我国安乐死立法探讨

十多年来 ,安乐死问题在我国日渐受到人们的关注 ,并引起激烈讨论。其结果主要存在两种观点 :一种观点认为 ,安乐死明显违背社会主义人道主义原则 ,从法学角度看 ,它不符合我国立法精神 ;同时也违反社会主义医德 ,在社会主义中国是绝对行不通的。另一种观点则认为 ,安乐死减轻了患者的痛苦 ,减轻了家庭和社会的负担 ,符合社会主义人道主义原则 ,不具备社会危害性 ,在我国法律中应当立法确认。本文拟从安乐死的概念 ,实施安乐死行为是否构成故意杀人罪 ,是否符合伦理道德和人道主义原则 ,国外安乐死立法状况以及在我国实施安乐死的立法设想五…     

关于安乐死立法的几点建议

安乐死是一种文明的死亡状态，现已成为当代世界的一个热点问题，有的国家已经或正在为安乐死立法。我国对该问题的讨论始于本世纪80年代，现在医学界、伦理学界、法学界、社会科学工作者正对安乐死立法的必要性和可行性进行探讨。多数观点认为，立法既是必要的，又是可行的，但对于立法及其实施所必须解决的一些理论观点和法律原则还存有争议，笔者就争议中的几个问题谈点认识。1正确认识安乐死我国对安乐死的界定的认识和研究，大体划分为两个阶段。1．1本Mta90年代以前：这一阶段也称为沿用西方解释阶段。尽管有的学者对安乐死的本质有…     

安乐死合法化的哲学辩护:以自由主义哲学为视角

安乐死问题一直都是一个争议性话题。从学理上,安乐死可以分为自愿安乐死和无意愿安乐死。自由主义在伦理学上则可以分为两大立场,即义务论和功利主义。以自由主义哲学观来审视两类安乐死合法化问题：自愿安乐死体现病人自由意志的选择,是人格尊严之自主性的结果：无意愿安乐死是利益相关人意志的选择,符合社会利益的最大化。通过严格立法来规范安乐死行为,也应成为我国法律的理性选择。     

关于安乐死制度设计的几点设想

我国的安乐死尚处于理论研究层面。从伦理的角度考量安乐死立法有助于夯实该项立法的基础;从制度建设的角度对安乐死立法开展前瞻性探讨,也是未来该项立法更科学、更符合我国国情的需要。从这两个角度出发探讨安乐死,希望能够引起对安乐死问题的深入研究。     

安乐死权的性质及伦理法理评价

安乐死权指的是死亡状态权,而不是所谓的“死亡权“与生命权.把安乐死视为“致死行为“作为前置条件,不论是将安乐死权归类于生命权还是“死亡权“,从而做出对安乐死权肯定或否定回答,都不符合安乐死权属于死亡状态权的含义.安乐死权的认定,不能离开安乐死作为优化死亡状态的合理内涵.法律应当赋予个人安乐死的权利,这不仅在于安乐死作为优化死亡状态的本质不违背现行法律,也在于不论从个人、他人及社会角度分析,安乐死权的认可有其合理性基础.     

Passive euthanasia

The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an "Ethics Task Force" established by the European Association of Palliative Care (EAPC) in February 2001. It claims that the expression "passive euthanasia" is a contradiction in terms and hence that there can be no such thing. This paper critically assesses the main arguments for the Task Force's view. Three arguments are considered. Firstly, an argument based on the (supposed) wrongness of euthanasia and the (supposed) permissibility of what is often called passive euthanasia. Secondly, the claim that passive euthanasia (so-called) cannot really be euthanasia because it does not cause death. And finally, a consequence based argument which appeals to the (alleged) bad consequences of accepting the category of passive euthanasia.We conclude that although healthcare professionals' nervousness about the concept of passive euthanasia is understandable, there is really no reason to abandon the category provided that it is properly and narrowly understand and provided that "euthanasia reasons" for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons.     

安乐死适用条件刍议

从对“谁”可以实施安乐死这一路径入手，揭示安乐死适用条件中所存在的、值得进一步思考和探究的问题。如果尚未从理论上界定安乐死及其相关概念的内涵，那么为安乐死立法或者使之合法化自然也就无从谈起。     

Alberta Euthanasia Survey: 3-year follow-up.

OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 to 1146 physicians who could be traced through the 1994 Medical Directory of the provincial college of physicians and surgeons; 25 questionnaires were returned because they could not be delivered. OUTCOME MEASURES: Physicians' opinions about (a) the morality of active euthanasia, (b) changes in the law to permit active euthanasia and (c) the practice of legalized euthanasia. RESULTS: Of the 1121 physicians sent a follow-up questionnaire 866 (77%) returned it completed. The responses of these same 866 physicians in 1991 provided a basis for comparison. Of the 866, 360 (42%) stated in the 1994 survey that it is sometimes right to practise active euthanasia; a similar proportion (384 [44%]) gave this response in 1991. However, other opinions changed significantly. In 1991, 250 of the respondents (29%) indicated that they would practise active euthanasia if it were legalized, as compared with 128 (15%) in 1994 (p < 0.01). In 1991, 429 (50%) of the respondents thought that the law should be changed to permit active euthanasia, as compared with 316 (37%) in 1994 (p < 0.01). Religious activity was the most important characteristic associated with changes in opinion. Despite the decrease in support for the practice and legalization of active euthanasia between 1991 and 1994, in both surveys at least 70% of those who responded to this question indicated that active euthanasia, if it were legalized, should be performed only by physicians and should be taught at medical sites. CONCLUSION: Alberta physicians' support for the practice and legalization of active euthanasia decreased considerably between 1991 and 1994. However, most physicians remain in favour of restricting active euthanasia, if it were legalized, to the medical profession. These results suggest a need for caution and deliberation when changes in the law concerning active euthanasia are examined.     

Involvement of nurses in euthanasia: a review of the literature

In ethical debates about euthanasia, the focus is often exclusively on the involvement of physicians and the involvement of nurses is seldom given much attention. Yet nurses occupy a central position in the care of terminal patients, where being confronted with a euthanasia request is an ever present possibility. To assess the involvement of nurses in euthanasia, this article provides an overview of relevant findings from the scientific literature. From this it becomes apparent that nurses are involved in various phases of the euthanasia process: observing the request for euthanasia, decision making, carrying out of euthanasia, and the aftercare for the patient's family members.     

中国安乐死实施的不可行性分析

目前，国内外关于安乐死立法的呼声日益高涨。但是，从我国的国情、立法环境和文化风俗来看，安乐死尚不具备实施的可行性。从社会宏观角度看，由于受传统伦理道德和价值观念的束缚，民众观念需要转变。同时，由于对生命权也未作规定。政治经济等各方面原因，医疗科研水平存在局限，我国对安乐死基本问题和判断标准无法达成一致。从微观角度来看，安乐死行为涉及患者、医务人员、患者家属和医疗机构四方利益，实施安乐死存在安全隐患。本丈将从这两个方面分析我国实施安乐死的现实可行性，论证目前在我国实施安乐死的条件和时机还不成熟。     

Attitudes of medical students towards euthanasia in a multicultural setting

A cross-sectional survey of 400 medical students of multicultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes, and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease while 48% of them were against it. Seventy-one percent of the students involved in the study were against the idea of active euthanasia i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. Thirty-two percent of the respondents favoured the legalization of euthanasia in Malaysia while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities.     

从滑坡现象和风险社会理论看安乐死

“安乐死”问题一直是一个极具争论的议题，赞成者和反对者各持一方，近年来，国内赞成安乐死的呼声越来越高，笔者从风险社会理论角度出发，对比分析荷兰安乐死立法的社会背景和实践中的滑坡现象。认为像我们这样有着深厚传统文化，卫生资源相对贫乏，医疗保障水平低，法制还不十分健全的国家，在目前社会条件下，对安乐死的问题应审慎。     

儒家生命伦理视阈下的安乐死

安乐死的研究者往往强调死得"安乐",但是安乐死首先面对的问题仍然是"生"与"死"的问题,本文从儒家世界观,人生观,价值观方面来探讨安乐死问题,儒家世界观认为"天人一体",在死亡面前,应该坦然接受死亡,这为安乐死研究提供了一个逻辑起点。儒家人生观认为,并非存在持续性的痛苦的患者都可以申请安乐死,只有疾病已阻止到了对人格理想的追求时才可以申请安乐死,并且痛苦不包含精神上的痛苦。生命权的地位问题是安乐死的一个热点问题,儒家价值观认为,生命权并不是绝对神圣的,还对安乐死所附带的功利主义效果予以肯定,虽然这种功利主义效果不能作为实行安乐死的理由。