文化冲突与价值碰撞:安乐死问题根源探究——兼及反思国内安乐死问题之讨论

20世纪80年代国内学术界及公众对安乐死问题的关注与讨论日渐升温,但总体上对安乐死作为问题的理解和把握仍显不足.安乐死作为一种临终生命处置方式而被争论不止,其缘起于西方文化系统中内在的冲突与价值碰撞,集中表现在:宗教文化、医学职业文化和政治文化领域.这三种文化各自内在的价值冲突与不同文化之间的相互碰撞造就了安乐死问题.     

安乐死与中国传统文化

安乐死虽是一个历史久远的事实,但至今仍然存在着不少问题。在国内作为一个医学伦理学的问题明确提出来,还是近几年的事。它已经引起社会各阶层的广泛关注,可以说是议论纷纷,莫衷一是,这是很自然的。笔者认为在安乐死的道德理论的探讨和实践中,一个非常重要的问题是安乐死与中国传统文化的冲突问题。本文就这一问题谈些粗浅的看法。 一、不同文化层次对安乐死意向调查引起的思考 对安乐死的看法,与不同地区、不同民族的风俗习惯、文化水平等因素有关。现就我们对100人的调查情况分析如下:     

法哲学视域中的安乐死合法化问题

安乐死合法化问题 ,牵涉甚多复杂的利益价值和思想观念 ,自法哲学层面而言 ,其中最主要者有 :其一 ,当下现实提出合法化要求的安乐死 ,是一种国家权力 ,还是一种公民权利 ?其二 ,安乐死合法化问题是一个宗教、信仰问题 ,还是一个世俗权利问题 ?其三 ,安乐死合法化问题的判定标准为何 :是实定法 ,还是超实定法 ?兹分别探讨如下。1　作为公民权利的安乐死与作为国家权力的安乐死荷兰安乐死法案获通过后 ,有观点认为 ,这一法案与纳粹德国有计划屠杀残疾成人和儿童的政策并无区别 ,它们的理论基础是相同的。无独有偶 ,在中国和其他一些国家的安…     

从我国现行法律看安乐死的实施

安乐死作为自然人在特殊情况下对自己生命自主选择的权利,涉及人的生命权益,有关生命权立法是安乐死问题的关键.安乐死的实施与我国现行法律对生命权的严格维护产生冲突,需要我国用法律的形式肯定安乐死,并对现行法律做出适当调整,为安乐死立法留下法律空间.     

从我国现行法律看安乐死的实施

安乐死作为自然人在特殊情况下对自己生命自主选择的权利,涉及人的生命权益,有关生命权立法是安乐死问题的关键。安乐死的实施与我国现行法律对生命权的严格维护产生冲突,需要我国用法律的形式肯定安乐死,并对现行法律做出适当调整,为安乐死立法留下法律空间。     

安乐死的对象及其伦理问题

何种安乐死请求能得到伦理支持?不同对象的安乐死存在哪些伦理问题?讨论了存在较大分歧的几个焦点问题:是否必须存在痛苦以及何种痛苦;是否必须濒临死亡;处于持续性植物状态的病人、重残新生儿能否作为安乐死对象,即非自愿安乐死存在的伦理问题.     

西方宗教视阈下的安乐死透视

安乐死作为一种非自然结束生命的方式,在世界范围备受争议。西方宗教是安乐死的主要反对力量。依据《圣经》信仰,安乐死在理论和实践上都存在严重错误。生命是上帝的恩赐,痛苦有积极的意义,死亡是生命的转变,真正的临终关怀之道是信仰与爱。在今天看来,虽然西方宗教反对安乐死的论点有些拘囿与过时,但其对终极价值和意义世界的思考,确保了对生命最根本的敬畏。安乐死是西方理性主义发展到极致的产物,从宗教的视角看,理性并不能解决人类实践领域中的一切问题,人的生命只有一次,一旦结束便不会复回,对待生命应该始终保持敬畏。     

国外医学伦理学中的安乐死问题

苏联学者·察列戈系罗夫在“哲学问题”1984年第12期发表《国外医学伦理学中的安乐死问题》一文,对当前西方社会所争论的安乐死问题作了详细介绍并对赞成安乐死的种种观点进行了分析批判。赞成安乐死的论点不外是解除病人痛苦,减轻家庭和社会的负担,有利于可医治的病人就医。     

安乐死非犯罪化问题的法理探究

安乐死概念提出后,围绕其争论就从未停止过,安乐死已不仅是一个医学问题,而是一个社会问题。通过分析安乐死的正当性、合法性,从刑事理性的角度论证了在我国现实境况下解决安乐死问题的可行途径。从安乐死事实上的非犯罪化,进而提出对安乐死案件审查的司法措施。     

安乐死与中国传统文化

安乐死与中国传统文化上海社会科学院（２０００３１）沈铭贤安乐死涉及死亡这一极为敏感的领域,因而也关系到文化的深层底蕴。生死观向来是文化的重要内涵和表现之一。中国传统文化重视人文关怀,留下了丰富和宝贵的生死文化遗产。儒道释三家的生死观,都有与安乐死相通...     

安乐死立法为什么这样难

关于安乐死的争论由来已久,虽然目前全世界仅有荷兰等极少数国家通过了有关安乐死的法案,但安乐死实际已经在许多国家悄悄实施,越来越多的人对安乐死持肯定态度已成为不争的事实.贵州省贵阳市一个体行医者赵某还声称自己实施过几例"安乐死".我们实在不知道这种"违规"操作在现实中究竟有多少?这些事实提醒我们不应再就安乐死问题采取回避和视而不见的态度,而应正视它,并尽快制定出明确的法规,在认可安乐死的同时,规范安乐死的实施,作出符合人类理性的选择和符合人类法的精神决断.     

Assisted Suicide,Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience

What impact would legalization of assisted suicide and euthanasia have on our ability to treat suicidal patients and to prevent suicide? Information from a study of the Dutch experience illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and euthanasia and encourages patients and doctors to see choosing death as a preferred way of dealing with serious or terminal illness. The extension of the right to euthanasia to those who are not physically ill further complicates the problem. So too does the tendency of doctors in such a culture to begin to feel that they can make decisions about ending the life of competent terminally ill patients without consulting the patient. “Normalizing” suicide as a medical option lays the groundwork for a society that turns euthanasia into a “cure” for suicidal depression.     

Different relational models underlie prototypical left and right positions on social issues

Social issues are important dividing lines in the “culture wars” between the political left and right. Despite much research into social issue stance and ideology, little research has explored these with Relational Models Theory (RMT). RMT proposes four distinct models that people use to construe social relations, each entailing distinct moral considerations. In two studies, participants read summaries of the models, rated how relevant each was to their positions on several social issues (e.g., capital punishment), and expressed issue positions. In Study 1, Communal Sharing and Equality Matching construals predicted prototypical liberal positions across a range of issues; Authority Ranking and Market Pricing construals predicted prototypical conservative positions. By using multilevel modelling in Study 2, individual differences in average Communal Sharing and Authority Ranking construals predicted prototypical liberal and conservative positions, respectively, independent of several factors known to predict social issue stance. In issue‐specific analyses (e.g., focusing on euthanasia), all models showed effects independent of self‐reported ideology, while for certain issues (same‐sex marriage, animal testing, gun control, and flag burning), issue construal using different models predicted opposing positions, implicating relational models in moral disagreement. This paper provides novel tests of Relationship Regulation Theory and suggests that RMT is relevant in understanding political ideology, social issue stance, and moral judgement. Copyright © 2014 John Wiley & Sons, Ltd.     

Suicide and euthanasia--special types of partner relationships

Euthanasia is a controversial and important issue in West Germany, especially given the Nazis' killing of minorities during World War II. This paper concentrates on the joint issues of suicide and euthanasia in the context of the doctor-patient relationship. A new evaluation of suicide prevention and euthanasia, especially as they relate to the training of medical students and doctors, is advocated.     

从大众传媒看公众对安乐死态度的嬗变

安乐死问题在我国已经历了由精英话语向大众话题的转变.研究传媒的相关报道,可以看出公众对安乐死问题经过认知、态度转变到实践的历程,通过分析传媒对塑形公众观念所起的作用,可以更好地把握当代社会公众接受新生命伦理观的过程.     

‘There is a Time to be Born and a Time to Die’ (Ecclesiastes 3:2a): Jewish Perspectives on Euthanasia

Reviewing the publications of prominent American rabbis who have (extensively) published on Jewish biomedical ethics, this article highlights Orthodox, Conservative and Reform opinions on a most pressing contemporary bioethical issue: euthanasia. Reviewing their opinions against the background of the halachic character of Jewish (biomedical) ethics, this article shows how from one traditional Jewish textual source diverse, even contradictory, opinions emerge through different interpretations. In this way, in the Jewish debate on euthanasia the specific methodology of Jewish (bio)ethical reasoning comes forward as well as a diversity of opinion within Judaism and its branches.     

Sedation before ventilator withdrawal: can it be justified by double effect and called "allowing a patient to die"

...Recognizing that sedation and ventilator withdrawal have a causal impact on a patient's death does not open the door to active euthanasia but helps resist it by showing clearly where the debate centers. The heart of the euthanasia issue is not whether providers play a causal role in patients' deaths. They obviously often do when they withdraw burdensome or futile treatment or provide comfort, and these actions can be morally justified in appropriate circumstances. The key point is whether we can morally justify physicians playing two stronger causal roles: providing drugs and information for suicide and doing something in order to kill their patients. Before we can agree with those ethicists who argue that one can justify assisted suicide and active euthanasia despite the moral tradition that has shunned these causal roles, they must clearly show that the human good -- the good of the professions and of society at large, as well as the good of patients -- will be better served by physicians assisting in suicide and giving lethal injections....     

Autonomy,Euthanasia and the Right to Die with Dignity: A Comparison of Kantian Ethics and Shicite Teachings

This article engages in a conceptual analysis and discussion of the definition of euthanasia, including a number of inherent distinctions, together with a concomitant examination of various value perspectives that are applied to the way the idea of ‘life’ itself is understood, especially the notion of autonomy. Among a number of considerations, the pro-life and pro-choice controversy and its relevance cannot be ignored in the context of a comprehensive discussion of the issue from a Shi^cite point of view. An attempt is made to show that euthanasia is a sophisticated normative subject with different aspects and categories. An outright normative refutation of the act by many Muslim writers and jurists seems to be a kind of oversimplification of this multi-faceted issue.     

Prolonging life or hindering death? An Orthodox perspective on death, dying and euthanasia.

This article addresses death as a biological event and attempts to approach it as a mystery within the light of the Orthodox Christian theology and tradition. First, the value of the last moments of the life of a human being is analyzed; then the state of living is differentiated from the state of surviving that results, in some extreme cases, from the intrusion of technology in medicine. The article elaborates on the sacred and spiritual character of death which, when viewed within the light of the Christ's resurrection, is transformed into a great blessing. The last part of the article focuses on the newly emerged issue of euthanasia and the reasons behind it. It poses certain vital questions that ought to be answered before legalization gets on its way. Finally, the conclusion summarizes the position of the Orthodox Church of Greece on death, dying and euthanasia.     

The sanctity of life: The role of purity in attitudes towards abortion and euthanasia

Although abortion and euthanasia are highly contested issues at the heart of the culture war, the moral foundations underlying ideological differences on these issues are mostly unknown. Given that much of the extant debate is framed around the sanctity of life, we argued that the moral foundation of purity/sanctity—a core moral belief that emphasises adherence to the “natural order”—would mediate the negative relationship between conservatism and support for abortion and euthanasia. As hypothesised, results from a nation-wide random sample of adults in New Zealand (N = 3360) revealed that purity/sanctity mediated the relationship between conservatism and opposition to both policies. These results demonstrate that, rather than being motivated by a desire to reduce harm, conservative opposition to pro-choice and end-of-life decisions is (partly) based on the view that ending a life, even if it is one's own, violates God's natural design and, thus, stains one's spiritual purity.