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…     

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。     

以“生产力标准”来探讨我国安乐死立法问题——读“第二届全国安乐死与临终关怀学术研讨会”交流论文有感

本文提出了我国实施安乐死立法应依据的思路及可行性方法。     

以“生产力标准”来探讨我国安乐死立法问题：读“第二届全国安乐死与临终关…

本文提出了我国实施安乐死立法应依据的思路及可行性方法。     

更新传统观念 提倡安乐死的实施

目前，癌症已占我国死亡第一因素，而且他们在生命最后阶段要承受巨大的精神和肉体的痛苦，因此，笔者主张提倡实施安乐死，但必须在法律保护下。安乐死优点：减少病人痛苦，节省人力、财力。就我国传统观念来看，认为“好死不如赖活”，因此，对安乐死不理解，也不接受，这是一种落后的、不科学的、不进步的传统观念，他阻碍安乐死在我国的实施。     

安乐死在我国立法的可行性

安乐死是一种文明的死亡状态,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20世纪80年代,现在医学界、伦理学界、法学界、社会科学界的学者们正在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,但必须解决理论与实践中存在的一些问题。     

不同人群对安乐死态度及现状的调查

目的：调查中小城市不同人群对安乐死及其现状的态度,了解公众对安乐死的认同度以及安乐死在我国实施的合理性和可能性,发现我国安乐死合法化进程中遇到的主要困难并提出建议。方法：采用自制问卷,在当地社区进行问卷的发放和回收,发放问卷210份,共回收有效问卷202份,回收率为96.2％。结果：市民对于安乐死问题了解不足,仅有36％的被调查者表示对安乐死问题有了解,有75％的人赞同在我国实施安乐死,被调查的11名医生全部赞成在我国实施安乐死;有宗教信仰的人对安乐死的认同度较低;文化程度越高,越能意识到解决安乐死问题立法是关键。结论：中小城市市民对于安乐死问题了解偏少,不同人群对其在我国实施的合理性及主要困难认识存在差异,这在社会上引起了广泛争议,阻滞了我国安乐死合法化的进程。为推动安乐死在我国实施,有必要加强对市民的宣传教育,改革我国教育体制,推动安乐死立法工作进行,为我国的安乐死合法化提供保障。     

The complexity of nurses' attitudes toward euthanasia: a review of the literature

In this literature review, a picture is given of the complexity of nursing attitudes toward euthanasia. The myriad of data found in empirical literature is mostly framed within a polarised debate and inconclusive about the complex reality behind attitudes toward euthanasia. Yet, a further examination of the content as well as the context of attitudes is more revealing. The arguments for euthanasia have to do with quality of life and respect for autonomy. Arguments against euthanasia have to do with non-maleficence, sanctity of life, and the notion of the slippery slope. When the context of attitudes is examined a number of positive correlates for euthanasia such as age, nursing specialty, and religion appear. In a further analysis of nurses' comments on euthanasia, it is revealed that part of the complexity of nursing attitudes toward euthanasia arises because of the needs of nurses at the levels of clinical practice, communication, emotions, decision making, and ethics.     

医学生对安乐死的认知和态度调查

目的:调查医学生对安乐死的认知和态度,并分析可能的影响因素,为医学伦理教育提供参考依据.方法:采用自行设计的问卷对某医学院校526名本科生进行关于安乐死认知和态度方面的调查.结果:526名被调查者中,安乐死知晓率为63.9%,被调查者表示对安乐死有所了解,但了解的内容和范围有限,94.3%的被调查者认为生命权属于个人,但对于个人是否有权利决定自己生死则表现得较为矛盾.被调查者均承认安乐死属于跨学科、跨领域的争议性问题,63.9%赞成安乐死,63.5%表示安乐死在我国立法是非常必要的.58.7%表示在本人面临是否选择安乐死时要视具体情况而定,64.6%的被调查者在面对亲人选择安乐死时表示不会主动建议,但会支持其决定.结论:多数调查者对安乐死有一定的了解,但是受我国传统思想观念的影响,医学生对于死亡和安乐死的认识有限,被调查者对实施安乐死态度较为严谨,应加强医学生伦理教育和死亡教育,正确引导医学生认识死亡,正确看待安乐死.     

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.     

Medical aspects of euthanasia

The practice of euthanasia in the Netherlands is often cited as an example of progressive social reform. While the Dutch penal code outlaws active euthanasia, the courts have interpreted the law in such a way as to allow doctors to kill their patients under certain conditions, chiefly when the patient has asked to die in preference to enduring unbearable suffering. Current practice in the Netherlands now includes the killing of patients who do not have a terminal disease, the killing of older children without the consent of their parents, and the killing of patients without their consent in circumstances where consent could have been sought. Estimates of the number of euthanasia killings range up to 20,000 per year, but there is no accurate information because of the common medical practice of falsely certifying the cause of death to avoid the need to justify euthanasia. Euthanasia in the Netherlands is now an alarming practice that oversteps ethical bounds and administrative controls, compromising doctors' moral commitment to healing by allowing them to become medical killers.     

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.     

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。     

传统死亡观与安乐死和临终关怀

通过审视安乐死的基本精神，重新思考安乐死在中国的实现途径。安乐死一词与中国的“善终”思想契舍，应结合中国的文化传统和基本国情，重拾安乐死的本意，通过死亡教育树立安乐死亡观，在全方位开展临终关怀事业的基础上，推进中国特色的安乐死进程。     

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。     

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.     

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.