Euthanasia and Assisted Suicide: Realization or Abandonment of Self-determination?

Axel W Bauer
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Abstract

There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. Being unable to die can be worse than death, one might say or think. But until we ourselves have crossed that frontier, we do not know this for certain. To die could be worse than not being able to die. One case is difficult to distinguish from the other. But we pretend we can distinguish them if we praise assisted suicide and euthanasia as solutions to a problem that we not only do not solve, but make worse. Do we need assisted suicide in the face of non-dying skills? The author's answer is no: we do not need euthanasia, neither in that nor in any other case. The logic of euthanasia itself decrees that it cannot be restricted to exceptional cases, based as it is on the idea that the patient's autonomy is to be valued more highly than their actual illness. But if autonomy were of absolute value, it could not be limited to cases of severe disease. The reasons which supporters of euthanasia cite for limiting assisted suicide to the most serious cases of illness, therefore, speak against euthanasia in general. Once the first step has been taken, the application can no longer be limited if, on the one hand, the 'autonomous' desire for death is superior to any counter-argument, and on the other hand, no state of illness is conceivable that could call into question the alleged autonomy.

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安乐死与协助自杀:自我决定的实现还是放弃?
毫无疑问,有些病人遭受了巨大的痛苦,当然这是不应该的。没有一个患有不治之症的癌症的病人会遭受数月或数年的折磨,以至于他们只想死,却没有办法这样做。人们可能会说或认为,不能死可能比死亡更糟糕。但在我们自己跨过这条边界之前,我们无法确定这一点。死可能比不能死更糟糕。一种情况很难与另一种情况区分开来。但是,如果我们称赞协助自杀和安乐死是解决问题的办法,我们就假装可以区分它们,而我们不仅没有解决问题,反而使问题变得更糟。面对非死亡技能,我们需要辅助自杀吗?作者的回答是否定的:我们不需要安乐死,无论是在这种情况下还是在其他任何情况下。安乐死的逻辑本身决定了它不能被限制在特殊情况下,因为它是基于病人的自主权比他们实际的疾病更有价值的想法。但是,如果自主权具有绝对价值,它就不可能局限于严重疾病的情况。因此,支持安乐死的人将协助自杀限制在最严重的疾病情况下的理由,是反对安乐死的。一旦采取了第一步,如果一方面,对死亡的"自主"愿望优于任何反对论点,另一方面,没有可以想象的疾病状态可能会对所谓的自主性提出质疑,则适用不再受到限制。
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