扩大使用持续镇静至死和医生协助自杀。

IF 1.3 3区 哲学 Q3 ETHICS Journal of Medicine and Philosophy Pub Date : 2024-04-20 DOI:10.1093/jmp/jhae009
Samuel H LiPuma, Joseph P Demarco
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引用次数: 0

摘要

关于持续镇静至死(CSD)和医生协助自杀/安乐死(PAS/E)等同性的争议为关注持续镇静至死的重要扩展应用提供了一个机会。持续镇静至死(CSD)和医生协助自杀/安乐死(PAS/E)的等同性所暗示的这种扩展旨在促进生命末期患者的更多自主权。塞缪尔-利普马(Samuel LiPuma)在其文章《持续镇静至死作为医生协助自杀/安乐死:概念分析》中声称持续镇静至死与死亡等同;他的论文在等同性辩论中具有开创性意义。批评者认为,镇静剂遵循相称性协议,而 LiPuma 的论文并没有充分说明这一点。此外,镇静剂可能不会消除意识,因此 LiPuma 关于 CSD 等同于新皮质死亡的论点值得怀疑。我们不仅要为等效论进行辩护,还要将其扩展到更多的道德考量。首先,我们解释等同论。随后,我们针对五种批评意见为该论点进行辩护。第三部分对目前使用的 CSD 进行了批评。最后,我们提出了两项建议,如果这些建议被采纳,将会扩大 PAS/E 和 CSD 的使用范围,从而增加生命末期的选择。
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Expanding the Use of Continuous Sedation Until Death and Physician-Assisted Suicide.

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, "Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis" claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows proportionality protocols for which LiPuma's thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma's contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life.

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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
30
期刊介绍: This bimonthly publication explores the shared themes and concerns of philosophy and the medical sciences. Central issues in medical research and practice have important philosophical dimensions, for, in treating disease and promoting health, medicine involves presuppositions about human goals and values. Conversely, the concerns of philosophy often significantly relate to those of medicine, as philosophers seek to understand the nature of medical knowledge and the human condition in the modern world. In addition, recent developments in medical technology and treatment create moral problems that raise important philosophical questions. The Journal of Medicine and Philosophy aims to provide an ongoing forum for the discussion of such themes and issues.
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