scholarly journals 道德生死觀下的臨終關懷辨析

Author(s):  
Ping DONG ◽  
Xiaoyan WANG

LANGUAGE NOTE | Document text in Chinese; abstract also in English.戀生懼死是人之常情。對於一個瀕臨死亡的人來說,其最大的悲劇莫過於沉浸於對死亡的心理焦慮之中。因此,臨終關懷的重要價值指向應是最大限度地減輕瀕死者的心理痛苦。人生的態度與死亡的觀點息息相闕,瀕死者的悲哀正在於死亡焦慮中的生死困惑。道家文化倡導出生入死、道法自然、無為處世。它以低音悠揚但可震憾現代人心曲的生死吟唱,可以引導臨終者走出死亡焦慮的心理誤區,消解悲苦於無形。安樂死是臨終關懷的應有之意。道家生死論尚自然,法自然,主張人為要與自然之序相協調,不應違反自然而強做妄為。道家反對用過枉之舉去擾亂人的生死變化,認為在死亡來臨時,順其自然,享其“安樂”,尊嚴而歸是不失為善終的。因此,在道家生死觀下,“被動安樂死”(即放棄治療)實為良策,而各種形式的“主動安樂死”(包括醫助致死)均與道家生死論主旨相悖。In confronting death there are differences among people regarding their deep concerns. A survey shows that most Chinese Catholics are worried about what will happen to them after death, whereas most other Chinese are concerned about unfinished life plans, unfulfilled familial obligations, and so on. However, most Western and Chinese authors agree that a great number of terminally ill patients suffer from anxiety, sadness, and depression. And no one denies that unease, puzzle, solitude, and even anger are often experienced by many dying patients. Against this background, this essay argues that the mental sufferings of terminally ill patients can appropriately be healed by taking the Daoist perspective over life and death. Moreover, the essay demonstrates that the Daoist position sheds light on the debate around the issue of passive and active euthanasia.According to the Daoist, the Dao is the way of nature. Nature is a universal process of constant change, binding all things together into a vast and natural harmony. Humans should live freely, naturally, and spontaneously in accord with the Dao. From the Daoist perspective, life and death can be analogized as day and night. They constitute two complementary aspects of nature. Where there is life, there is death. Everything living dies, and death implies new life. In short, just as the ceaseless transformation of four seasons in nature, life and death constitute a balanced knot in the harmonious chain of constant natural changes. Therefore, humans should take death naturally, just as they take life naturally. Humans should not have unnatural worry or anxiety on death in their mind.As there are the natural rules of the Dao, one should follow these rules rather than create artificial human laws. For the Daoist, one artificial expectation for humans is to gain an eternal life without death (here the classical philosophical Daoism remarkably differs from the subsequent religious Daoism which pursues immortality). The other unnatural concerns include mental inseparability from the benefits, utilities, and complicated human relations offered in the living world. The Daoist believes that life and death should be identified as one process and that humans and nature should be taken as a unity.Concerning the issue of euthanasia, we believe that the Dao as following nature is consistent with the position of so-called passive euthanasia. Passive euthanasia allows the terminally ill patient naturally to accept death by foregoing aggressive medical procedures when such procedures cannot do more benefit than harm to the patient. Peaceably accepting death when it naturally comes is the human action performed in accord with the Dao. Launching extra human efforts against natural processes is against the Dao.However, the Daoist cannot advocate any type of active euthanasia or physician assisted suicide. On the one hand, the Daoist admires the man who does not use unnatural instruments to prolong the period of dying in the natural process of death. On the other hand, however, to take active means to kill the patient is to act against the Dao. Indeed, actively to kill the patient is on purpose to destroy the natural mechanism and process of human life. It is to intervene with the spontaneous way of nature in the worst sense. Therefore, the Daoist cannot consider it good to take human life with the help of medical tools.DOWNLOAD HISTORY | This article has been downloaded 44 times in Digital Commons before migrating into this platform.

2020 ◽  
pp. 002436392092731
Author(s):  
Ethan M. Schimmoeller

Christ has fashioned a remedy for the human condition out of mortality, making death the paradoxical means of salvation. Thus, the early Church saw martyrdom as the best kind of death, epitomized in the story of St. Ignatius of Antioch. He saw his death in Christ to be a birth into eternal life. Yet martyrdom and suicide can be conflated under crafty definitions and novel terminology, leading inevitably to calls to soften prohibitions against physician-assisted suicide. Whereas martyrdom locates death within the Christian lived experience of the Paschal mystery, suicide transfers the sovereignty of God over life and death to the individual, necessarily denying the goodness of creation in the process. I point to a liturgical foundation for bioethics as a better starting point for understanding martyrdom and suicide. Entering Christ’s sacrifice, Christians receive divine life and new vision to locate suffering, death, and health care within the Christian salvation narrative. Summary: Confusing martyrdom and suicide locates ethics outside the Church by bending language around the 5th commandment. St. Ignatius of Antioch's martyrdom clarifies the role of the Christian bioethicist to situate health care in the Church's life-giving liturgical experience.


Author(s):  
John Keown

This chapter identifies several respects in which medical law in England and Wales suffers from a lack of ethical coherence in relation to its protection of human life. It argues that it is philosophically incoherent for the law to calibrate its protection of human life according to arbitrary stages of human development such as birth, viability, the fourteenth day after fertilization, and implantation. To the extent that the law permits life-sustaining treatment to be withheld or withdrawn from incompetent patients on the ground that their ‘quality of life’ is insufficient, and even with an intent to hasten death, it again displays ethical incoherence. If legislators or judges were to make it lawful for physicians to intentionally assist suicidal refusals of treatment, or to endorse a right to physician-assisted suicide for the ‘terminally ill’, the law's ethical incoherence would be seriously aggravated.


2002 ◽  
Vol 95 (8) ◽  
pp. 386-390 ◽  
Author(s):  
E Tiernan ◽  
P Casey ◽  
C O'Boyle ◽  
G Birkbeck ◽  
M Mangan ◽  
...  

Some patients with advanced cancer express the wish for an early death. This may be associated with depression. We examined the relations between depressive symptoms and desire for early death (natural or by euthanasia or physician-assisted suicide) in 142 terminally ill patients with cancer being cared for by a specialist palliative care team. They completed the Hospital Anxiety and Depression Scale questionnaire and answered four supplementary questions on desire for early death. Only 2 patients expressed a strong wish for death by some form of suicide or euthanasia. 120 denied that they ever wished for early release. The desire for early death correlated with depression scores. Depressive symptoms were common in the whole group but few were on antidepressant therapy. Better recognition and treatment of depression might improve the lives of people with terminal illness and so lessen desire for early death, whether natural or by suicide.


Death Studies ◽  
2007 ◽  
Vol 31 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Jean-Jacques Georges ◽  
Bregje D. Onwuteaka-Philipsen ◽  
Martien T. Muller ◽  
Gerrit van der Wal ◽  
Agnes van der Heide ◽  
...  

2000 ◽  
Vol 160 (16) ◽  
pp. 2454 ◽  
Author(s):  
Keith G. Wilson ◽  
John F. Scott ◽  
Ian D. Graham ◽  
Jean F. Kozak ◽  
Susan Chater ◽  
...  

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 122-122
Author(s):  
Andrea Martani ◽  
◽  
◽  

"In the last few years, the debate whether terminally ill patients should have access to experimental treatments without governmental supervision has intensified. The so-called “Right-to-Try” (RTT) doctrine has become popular especially in the United States, where the federal parliament passed a bill allowing such practices. As many other policies concerning patients’ autonomy in end-of-life circumstances, the appropriateness of RTT has often been challenged. In this context, some authors recently put forward the argument that states where it is allowed to request physician assisted suicide (PAS) should also necessarily recognize a RTT. In the authors’ own words: “if states can give a terminally ill patient the right to die using medications with 100% probability of being unsafe and ineffective against his/her disease [i.e. the substances used for PAS], they should also be able to grant terminally ill patients a right to try medications with less than 100% probability of being unsafe and ineffective [i.e. ET]”. In this contribution, I will question this argument by underlying three flaws in the authors’ comparison of RTT and PAS. First, there is a fundamental distinction in the nature of the choices between the two situations concerning the (un)certainty of their outcomes. Second, the number of actors (and their potential conflicting interests) involved in these two situations is different. Third, the authors’ understanding of the object of patients’ rights in PAS is partially incorrect. I will conclude by arguing that, although reasons might exist to support RTT, such comparison with PAS is not one of them. "


Author(s):  
Yu Jung Kim

No studies have explicitly addressed the attitudes and desires of terminally ill patients on euthanasia and physician-assisted suicide (PAS). In this prospective cohort study, 988 terminally ill patients and 893 caregivers were surveyed. A total of 60.2% patients supported euthanasia or PAS in a standard poll question, but only 10.6% seriously considered these interventions for themselves. Patients with depressive symptoms, moderate to severe pain, and significant care needs were more likely to consider euthanasia and PAS. Half of the patients who initially considered euthanasia or PAS changed their minds at the follow-up interview, and an almost equal number newly considered these interventions. Patients with depressive symptoms and dyspnea were more likely to change their minds over time. According to the caregivers of 256 deceased patients, 5.6% of patients discussed euthanasia or PAS in the last month of life, 2.5% hoarded drugs for suicide, and 0.4% died by PAS.


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