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題名:在照顧之愛與病痛之苦間擺盪的生死倫理--論天主教有關植物人停止人工餵食餵水的觀點
書刊名:政治與社會哲學評論
作者:孫效智 引用關係
作者(外文):Sun, Hsiao-chih
出版日期:2015
卷期:53
頁次:頁1-55
主題關鍵詞:病人自主權天主教植物人停止餵食餵水安樂死相稱主義Patient's right to autonomyCatholic churchPVSPermanent vegetative stateWithdrawing ANHAssisted/artificial nutrition and hydrationEuthanasiaProportionalism
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天主教反對植物人人工餵食餵水(PVS-ANH)的停止或撤除,堅持為「最弱小的弟兄」爭取生存與被照顧的權利。本文仔細檢視其觀點,探討天主教的論證並提出本文的主張。本文雖認同天主教為弱勢生命發聲的理念,但難以認同其PVS-ANH觀點。天主教主張PVS-ANH在原則上是維護植物人生命的「普通且相稱」(ordinary and proportionate)手段,停止它就是消極安樂死,而安樂死則無論是消極或積極,都是絕對錯誤而必須加以反對者。本文認為這樣的觀點缺乏充分理據,過於絕對而有獨斷之嫌。首先,天主教似乎太過強調「第三人稱倫理觀」,忽略了「第一人稱倫理觀」,以致不夠同理PVS及其家庭之生命困境。其次,過於強調「支持生命」(pro-life),天主教似乎忽略了「支持選擇」(pro-choice)在捍衛人性尊嚴上也能有的價值。所謂「支持選擇」並非支持「只要我喜歡,就沒有什麼不可以」的那種任意抉擇,而是支持PVS在其健康時,經由慎思明辨的道德判斷過程,所做出的負責任的選擇,即使這樣的選擇包含了拒絕PVS-ANH。本文共分五節,第一節是前言,說明問題背景;第二節說明停止或撤除PVS-ANH的爭議脈絡,特別是相關問題涉及到怎樣的倫理學問題意識;第三節則從天主教的官方文件說明天主教反對停止或撤除PVS-ANH的理由;第四節則對這些理由進行分析討論並提出本文的看法,第五節為結論。本文主張:天主教反對植物人停止人工餵食餵水的觀點站不住腳,教會似乎應該思考其立場調整的可能性與必要性。
Advocating the rights of our "weakest brothers" to survival and care, the Roman Catholic Church resolutely objects to the withdrawal of assisted nutrition and hydration for patients in PVS. This article scrutinizes the relevant teachings of the Church, discusses the underlying arguments and then presents its own thesis. Although the advocacy of the Catholic Church for the most vulnerable is reasonable, her view on PVS-ANH as a whole cannot be accepted. She claims that ANH is an "ordinary and proportionate" means of maintaining the life of a PVS and as such its withdrawal is equivalent to passive euthanasia which, together with active euthanasia, is absolutely wrong and thus morally objectionable. However, I argue in this paper that this claim is overly dogmatic and lacking in sufficient rationale. Firstly, with her emphasis on "the third-person-ethicalperspective" the Church ignores "the first-person-ethical-perspective" almost completely and therefore does not show sufficient sympathy for the suffering PVS and their family. Secondly, a biased insistence on "prolife" ideology leads the Church to the point of overlooking the value of "pro-choice" in protecting human dignity. "Pro-choice" does not mean that anyone can arbitrarily do what he or she wants, but that the responsible choice that anyone makes through a process of moral discernment when she or he is competent should be respected even when it includes a refusal of PVS-ANH. This paper is divided into five parts. The first part is introductory. In the second the context of the controversy regarding withdrawal of ANH-PVS is explained, with special attention being paid to questions of ethical significance. Thirdly, the arguments given in the Catholic documents against withdrawing ANH-PVS are expounded in detail, so that they can be dealt with thoroughly and systematically in the fourth part. The last part is the conclusion drawn from the discussions: in objecting to the withdrawal of PVS-ANH the Catholic Church does not make her case and it seems appropriate for the Church to rethink her relevant teachings and even to consider the necessity for a revision.
期刊論文
1.孫效智(20120600)。安寧緩和醫療條例中的末期病患與病人自主權。政治與社會哲學評論,41,45-91。new window  延伸查詢new window
2.楊秀儀(20130600)。論病人之拒絕維生醫療權:法律理論與臨床實踐。生命教育研究,5(1),1-24。new window  延伸查詢new window
3.Shannon, Thomas A.、Walter, James J.(2005)。Assisted Nutrition and Hydration and the Catholic Tradition。Theological Studies,66(3),651-662。  new window
4.Truog, Robert D.(2008)。End-of-Life Decision-Making in the United States。European Journal of Anaesthesiology,25(S42),43-50。  new window
5.Zamperetti, Nereo、Latronico, Nicola(2006)。Nutrition and Hydration of Patients in Vegetative State: A Statement of the Italian National Committee for Bioethics。Intensive Care Medicine,32(5),750-751。  new window
6.Blandford, Janette(2011)。An Examination of the Revisionist Challenge to the Catholic Tradition on Providing Artificial Nutrition and Hydration to Patients in a Persistent Vegetative State。Christian Bioethics,17(2),153-164。  new window
7.Consortium of Jesuit Bioethics Programs(2009)。Undue Burden? The Vatican & Artificial Nutrition & Hydration。Commonweal,136(13)。  new window
8.Fine, Robert L.(2005)。From Quinlan to Schiavo: Medical, Ethical, and Legal Issues in Severe Brain Injury。Proceedings (Baylor University. Medical Center),18(4),303-310。  new window
9.McCormick, Richard A.(1992)。Moral Considerations' Ill Considered。America,166(9),210-214。  new window
圖書
1.Sun, Hsiao-Chih(1994)。Heiligt die gute Absicht ein schlechtes Mittel? Die Kontroverse über Teleologie und Deontologie in der Moralbegründung unter besonderer Berücksichtigung von Josef Fuchs und Robert Spaemann。St. Ottilien:EOS Verlag。  new window
2.United States Conference of Catholic Bishops(2009)。Ethical and Religious Directives for Catholic Health Care Services。  new window
3.羅秉祥、陳強立、張穎(2013)。生命倫理學的中國哲學思考。北京:中國人民大學出版社。  延伸查詢new window
4.Britt, Crystal A.(2012)。Dying in America: A Historical Analysis of Physician-Assisted Suicide and Euthanasia。Long Beach:California State University。  new window
5.Darr, Kurt(2005)。Ethics in Health Services Management。Baltimore:Health Professions Press。  new window
6.Lipp, Volker(2009)。Handbuch der Vorsorgeverfügungen: Vorsorgevollmacht-Patientenverfügung-Betreuungsverfügung。Vahlen。  new window
7.李震山(200902)。人性尊嚴之憲法意義,人性尊嚴與人權保障。臺北:元照出版公司。  延伸查詢new window
8.Paul, John II(1994)。Catechism of the Catholic Church。London:Geoffrey Chapman。  new window
其他
1.Colegrove, Lauren(2013)。Elderly Face Danger of 'Covert Euthanasia,' Pope Says in Book,http://www.catholicnews.com/data/stories/cns/1302007.htm。  new window
2.(2015)。Presentation of the Annuarium Pontificium,http://www.news.va/en/news/presentation-of-the-annuariumpontificium。  new window
3.Congregation for the Doctrine of the Faith(2007)。Responses to Certain Questions of the United States Conference of Catholic Bishops Concerning Artificial Nutrition and Hydration,http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20070801_risposte-usa_en.html。  new window
4.Pope Paul VI(1965)。Dignitatis Humanae,http://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_decl_19651207_dignitatis-humanae_en.html。  new window
5.Pope John Paul II(1995)。Evangelium Vitae,http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_25031995_evangelium-vitae_en.html#-25。  new window
6.Pope Francis(2014)。Message of Pope Francis to Participants in the General Assembly of the Pontifical Academy for Life,https://w2.vatican.va/content/francesco/en/messages/pontmessages/2014/documents/papa-francesco_20140219_messaggio-20-pontificia-accademia-vita.html。  new window
7.Pope Paul VI(19651207)。Gaudium et Spes,Libreria Editrice。,http://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_const_19651207_gaudium-et-spes_en.html。  new window
8.Congregation for the Doctrine of the Faith(1980)。Euthanasia Declaration of the Sacred Congregation for the Doctrine of the Faith,http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19800505_euthanasia_en.html。  new window
9.Pope John Paul II(2004)。Address to the Participants in the International Congress on Life-Sustaining Treatments and the Vegetative State: Scientific Advances and Ethical Dilemmas,http://www.vatican.va/holy_father/john_paul_ii/speeches/2004/march/documents/hf_jp-ii_spe_20040320_congress-fiamc_en.html。  new window
10.Pope Paul VI(1964)。Lumen Gentium,http://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_const_19641121_lumen-gentium_en.html。  new window
11.Pope John Paul II(1993)。Veritatis Splendor,http://www.vatican.va/holy_father/john_paul_ii/encyclicals/documents/hf_jp-ii_enc_06081993_veritatis-splendor_en.html。  new window
12.林昭彰,李易昌,李承穎(2014)。老翁不捨妻遭病折磨病房殺她自殘,http://paper.udn.com/udnpaper/PID0001/265651/web/#8L-5158683L, 2014/10/01。  延伸查詢new window
13.梵蒂岡電臺訊(2014)。法國主教談朗貝爾案:致死的嚴重行為,http://zh.radiovaticana.va/articolo.asp?c=810055, 2014/10/01。  延伸查詢new window
14.梵蒂岡電臺訊(2014)。教宗清晨彌撒:基督徒不做繁瑣法律的奴隸,而要喜樂地遵守愛的法律,http://zh.radiovaticana.va/news/2014/09/05/教宗清晨彌撒:基督徒不做繁瑣法律的奴隸,而要喜樂地遵守愛的法律/1106009, 2014/10/01。  延伸查詢new window
15.Aging with Dignity(2011)。Five Wishes,http://www.agingwithdignity.org/forms/5wishes.pdf。  new window
16.(2008)。AMA Policy on End-of-Life Care (Opinion E-2.21.),http://www.ama-assn.org/ama/pub/physicianresources/medical-ethics/about-ethics-group/ethics-resourcecenter/end-of-life-care/ama-policy-end-of-life-care.page。  new window
17.香港特區政府食物及衛生局(2009)。在香港引入預設醫療指示概念諮詢文件,http://www.gov.hk/tc/residents/government/publication/consultation/docs/2010/AdvanceDirectives.pdf。  延伸查詢new window
圖書論文
1.Moratti, Sofia(2008)。Italy。Euthanasia and Law in Europe。Portland, OR:Hart。  new window
 
 
 
 
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