euthanasiaWord格式.docx
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Contents
▪1Definition
2Classificationofeuthanasia
▪2.1Voluntaryeuthanasia
▪2.2Non-voluntaryeuthanasia
▪2.3Involuntaryeuthanasia
▪2.4Passiveandactiveeuthanasia
3History
▪3.1Beginningsofthecontemporaryeuthanasiadebate
▪3.2EarlyeuthanasiamovementintheUnitedStates
▪3.31930sinBritain
▪3.4NaziEuthanasiaProgram(ActionT4)
▪4Euthanasiadebate
▪5Legalstatus
▪6Physiciansentiment
▪7Seealso
▪8References
▪9Externallinks
▪10Furtherreading
Definition
Likeothertermsborrowedfromhistory,"
euthanasia"
hashaddifferentmeaningsdependingonusage.Thefirstapparentusageoftheterm"
belongstothehistorianSuetoniuswhodescribedhowtheEmperorAugustus,"
dyingquicklyandwithoutsufferinginthearmsofhiswife,Livia,experiencedthe'
euthanasia'
hehadwishedfor."
[5]Theword"
wasfirstusedinamedicalcontextbyFrancisBaconinthe17thcentury,torefertoaneasy,painless,happydeath,duringwhichitwasa"
physician'
sresponsibilitytoalleviatethe'
physicalsufferings'
ofthebody."
Baconreferredtoan"
outwardeuthanasia"
—theterm"
outward"
heusedtodistinguishfromaspiritualconcept—theeuthanasia"
whichregardsthepreparationofthesoul."
[6]
Incurrentusage,oneapproachtodefiningeuthanasiahasbeentomirrorSuetonius,regardingitasthe"
painlessinducementofaquickdeath"
.[7]However,itisarguedthatthisapproachfailstoproperlydefineeuthanasia,asitleavesopenanumberofpossibleactionswhichwouldmeettherequirementsofthedefinition,butwouldnotbeseenaseuthanasia.Inparticular,theseincludesituationswhereapersonkillsanother,painlessly,butfornoreasonbeyondthatofpersonalgain;
oraccidentaldeathswhicharequickandpainless,butnotintentional.[8][9]
Thusanotherapproachistoincorporatethenotionofsufferingintothedefinition.[8]ThedefinitionofferedbytheOxfordEnglishDictionaryincorporatessufferingasanecessarycondition,with"
thepainlesskillingofapatientsufferingfromanincurableandpainfuldiseaseorinanirreversiblecoma"
[10]andthisapproachcanbeseenasapartofotherworks,suchasMarvinKholandPaulKurtz'
s"
amodeoractofinducingorpermittingdeathpainlesslyasarelieffromsuffering"
.[11]However,focusingonthisapproachtodefiningeuthanasiamayalsoleadtocounterexamples:
suchdefinitionsmayencompasskillingapersonsufferingfromanincurablediseaseforpersonalgain(suchastoclaimaninheritance),andcommentatorssuchasTomBeauchamp&
ArnoldDavidsonhavearguedthatdoingsuchwouldconstitute"
murdersimpliciter"
ratherthaneuthanasia.[8]
Thethirdelementincorporatedintomanydefinitionsisthatofintentionality–thedeathmustbeintended,ratherthanbeingaccidental,andtheintentoftheactionmustbea"
mercifuldeath"
.[8]MichaelWreenarguedthat"
theprincipalthingthatdistinguisheseuthanasiafromintentionalkillingsimpliciteristheagent'
smotive:
itmustbeagoodmotiveinsofarasthegoodofthepersonkilledisconcerned"
[12]aviewmirroredbyHeatherDraper,whoalsospoketotheimportanceofmotive,arguingthat"
themotiveformsacrucialpartofargumentsforeuthanasia,becauseitmustbeinthebestinterestsofthepersononthereceivingend."
[9]DefinitionssuchasthatofferedbytheHouseofLordsSelectCommitteeonMedicalEthicstakethispath,whereeuthanasiaisdefinedas"
adeliberateinterventionundertakenwiththeexpressintentionofendingalife,torelieveintractablesuffering."
[1]Beauchamp&
DavidsonalsohighlightBaruchBrody'
anactofeuthanasiaisoneinwhichoneperson...(A)killsanotherperson(B)forthebenefitofthesecondperson,whoactuallydoesbenefitfrombeingkilled"
.[13]
Draperarguedthatanydefinitionofeuthanasiamustincorporatefourelements:
anagentandasubject;
anintention;
acausalproximity,suchthattheactionsoftheagentleadtotheoutcome;
andanoutcome.Basedonthis,sheofferedadefinitionincorporatingthoseelements,statingthateuthanasia"
mustbedefinedasdeaththatresultsfromtheintentionofonepersontokillanotherperson,usingthemostgentleandpainlessmeanspossible,thatismotivatedsolelybythebestinterestsofthepersonwhodies."
[14]PriortoDraper,Beauchamp&
Davidsonhadalsoofferedadefinitionwhichincludestheseelements,althoughtheyofferedasomewhatlongeraccount,andonethatspecificallydiscountsfetusesinordertodistinguishbetweenabortionsandeuthanasia:
[15]
"
Insummary,wehaveargued...thatthedeathofahumanbeing,A,isaninstanceofeuthanasiaifandonlyif
(1)A'
sdeathisintendedbyatleastoneotherhumanbeing,B,whereBiseitherthecauseofdeathoracausallyrelevantfeatureoftheeventresultingindeath(whetherbyactionorbyomission);
(2)thereiseithersufficientcurrentevidenceforBtobelievethatAisacutelysufferingorirreversiblycomatose,orthereissufficientcurrentevidencerelatedtoA'
spresentconditionsuchthatoneormoreknowncausallawssupportsB'
sbeliefthatAwillbeinaconditionofacutesufferingorirreversiblecomatoseness;
(3)(a)B'
sprimaryreasonforintendingA'
sdeathiscessationofA'
s(actualorpredictedfuture)sufferingorirreversiblecomatoseness,whereBdoesnotintendA'
sdeathforadifferentprimaryreason,thoughtheremaybeotherrelevantreasons,and(b)thereissufficientcurrentevidenceforeitherAorBthatcausalmeanstoA'
sdeathwillnotproduceanymoresufferingthanwouldbeproducedforAifBwerenottointervene;
(4)thecausalmeanstotheeventofA'
sdeatharechosenbyAorBtobeaspainlessaspossible,unlesseitherAorBhasanoverridingreasonforamorepainfulcausalmeans,wherethereasonforchoosingthelattercausalmeansdoesnotconflictwiththeevidencein3b;
(5)Aisanonfetalorganism."
[16]
Wreen,inpartrespondingtoBeauchamp&
Davidson,offeredasixpartdefinition:
PersonAcommittedanactofeuthanasiaifandonlyif
(1)AkilledBorletherdie;
(2)AintendedtokillB;
(3)theintentionspecifiedin
(2)wasatleastpartialcauseoftheactionspecifiedin
(1);
(4)thecausaljourneyfromtheintentionspecifiedin
(2)totheactionspecifiedin
(1)ismoreorlessinaccordancewithA'
splanofaction;
(5)A'
skillingofBisavoluntaryaction;
(6)themotivefortheactionspecifiedin
(1),themotivestandingbehindtheintentionspecifiedin
(2),isthegoodofthepersonkilled."
[17]
Wreenalsoconsideredaseventhrequirement:
"
(7)Thegoodspecifiedin(6)is,oratleastincludes,theavoidanceofevil"
althoughasWreennotedinthepaper,hewasnotconvincedthattherestrictionwasrequired.[18]
Indiscussinghisdefinition,Wreennotedthedifficultyofjustifyingeuthanasiawhenfacedwiththenotionofthesubject'
righttolife"
.Inresponse,Wreenarguedthateuthanasiahastobevoluntary,andthat"
involuntaryeuthanasiais,assuch,agreatwrong"
.[18]Othercommentatorsincorporateconsentmoredirectlyintotheirdefinitions.Forexample,inadiscussionofeuthanasiapresentedin2003bytheEuropeanAssociationofPalliativeCare(EPAC)EthicsTaskForce,theauthorsoffered:
Medicalizedkillingofapersonwithouttheperson'
sconsent,whethernonvoluntary(wherethepersoninunabletoconsent)orinvoluntary(againsttheperson'
swill)isnoteuthanasia:
itismurder.Hence,euthanasiacanbevoluntaryonly."
[19]AlthoughtheEPACEthicsTaskForcearguedthatbothnon-voluntaryandinvoluntaryeuthanasiacouldnotbeincludedinthedefinitionofeuthanasia,thereisdiscussionintheliteratureaboutexcludingonebutnottheother.[18]
Classificationofeuthanasia
Euthanasiamaybeclassifiedaccordingtowhetherapersongivesinformedconsentintothreetypes:
voluntary,non-voluntaryandinvoluntary.[20][21]
Thereisadebatewithinthemedicalandbioethicsliteratureaboutwhetherornotthenon-voluntary(andbyextension,involuntary)killingofpatientscanberegardedaseuthanasia,irrespectiveofintentorthepatient'
scircumstances.InthedefinitionsofferedbyBeauchamp&
Davidsonand,later,byWreen,consentonthepartofthepatientwasnotconsideredtobeoneoftheircriteria,althoughitmayhavebeenrequiredtojustifyeuthanasia.[8][22]However,othersseeconsentasessential.
Voluntaryeuthanasia
Mainarticle:
Voluntaryeuthanasia
Seealso:
Righttodie
Euthanasiaconductedwiththeconsentofthepatientistermedvoluntaryeuthanasia.ActivevoluntaryeuthanasiaislegalinBelgium,LuxembourgandtheNetherlands.PassivevoluntaryeuthanasiaislegalthroughouttheU.S.perCruzanv.Director,MissouriDepartmentofHealth.Whenthepatientbringsabouthisorherowndeathwiththeassistanceofaphysician,thetermassistedsu