A morally justified policy for assisted euthanasia

[摘要] ENGLISH ABSTRACT:This study was undertaken to evaluate whether a mentally competent maturehuman being, who is suffering an intolerable, irremediable existence resultingfrom an incurable agonising or devastating paralysing disease; has a moral,personal and civic right to end that life or have it ended by requesting assistancein meeting death in a humane, compassionate and dignified manner.~ The righteousness of such assistance can only be gauged if it follows therepeated and voluntary request of someone who is presently not suffering fromany psychiatric disorder, is presently mentally competent or had made such awritten or verbal witnessed advance directive while mentally competent to do so.~ This study will not deal with assistance in dying either active or passive which isperformed on severely mentally and physically handicapped new-born babieswith scant prospect of survival; nor with euthanasia for the relief of malignant orparalysing disease in those with life-long [anoxic, congenital, inflammatory ortraumatic] mental incompetencies who have never had decision-making capacity.~ This study will not address issues of aid-in-dying for mentally incompetentpersons suffering from senile dementia, Alzheimer's disease, or permanentvegetative states due to brain pathology following anoxic, circulatory, infective,malignant or traumatic events, who have not made advance directives and whohad never stated preferences concerning assisted euthanasia. The aim of this study is to outline the moral case advanced by those in favour oflegalising Voluntary Assisted Euthanasia [VAE] also called Assisted Euthanasia[AE] and to develop ethically sound and practical proposals for policy and actionscontributing towards the resolution of the moral dilemma faced daily by doctorswhen asked by mentally competent patients suffering from irremediablemalignant or paralysing diseases or the agonising symptoms of end-stageAcquired Immune Deficiency Syndrome (AIDS) for assistance to end their lives.}ii> This study will cover and discuss the more important objections of those opposedto the legalising of assisted suicide for mentally-competent terminal patients whoare irremediably suffering in their bodies or from dehumanising incurable endstageparalysing diseases and are near to an inevitable death.}ii> The insights of philosophers, theologians, physicians and sociologists on thesubject of suicide and aid-in-dying, have been researched in the extensiveliterature that exists (both in print and in cyberspace) on these subjects and arepresented with the study.}ii> The study tries to show that a competent adult in certain grim circumstancesshould have an inalienable human right, if not a constitutional one, to requestassisted euthanasia or aid-in-dying or assistance in ending their lives.}ii> Such assistance must be subject to peer review, after careful assessment by amultidisciplinary team in the healing [both physical and spiritual] professionsThis paper will try to determine whether the actionalisation of voluntary assistedsuicide or assisted euthanasia is murder or an act of compassion and empathyperformed out of respect for a fellow human being's autonomy and in deferenceto their right to self-determination and self-realisation.~ The relevance of this situation is that aid-in-dying is becoming one of the major,moral, religious, philosophical and bio-medical dilemmas at this time.~ The author's position is that it is neither just nor ethical to prevent a mentallycompetenthuman being, who is tormented by agonising, incurable terminalphysical or irremediable paralysing disease, from deciding to chose to die whenhe/she can no longer bear the torment and asking for professional assistance toeffect this. This relief should be given not only to those who are able to make anenduring, informed contemporaneous decision, but also to those who [when theystill had decision-making capacity] had previously made a considered informedadvance directive about the use of ordinary and extraordinary medical methods ofsustaining a life that had become merely an existence.

[发布机构] Stellenbosch University