Definition
Like other terms borrowed from history, "euthanasia" has had different meanings depending on usage. The first apparent usage of the term "euthanasia" belongs to the historian Suetonius, who described how the Emperor Augustus, "dying quickly and without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished for."[9] The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body." Bacon referred to an "outward euthanasia"—the term "outward" he used to distinguish from a spiritual concept—the euthanasia "which regards the preparation of the soul."[10]
In current usage, euthanasia has been defined as the "painless inducement of a quick death".[11] However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional.[12][13]
Another approach incorporates the notion of suffering into the definition.[12] The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with "the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma",[14] This approach is included in Marvin Khol and Paul Kurtz's definition of it as "a mode or act of inducing or permitting death painlessly as a relief from suffering".[15] Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as Tom Beauchamp and Arnold Davidson have argued that doing so would constitute "murder simpliciter" rather than euthanasia.[12]
The third element incorporated into many definitions is that of intentionality – the death must be intended, rather than being accidental, and the intent of the action must be a "merciful death".[12] Michael Wreen argued that "the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned."[16] Similarly, Heather Draper speaks to the importance of motive, arguing that "the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end."[13] Definitions such as that offered by the House of Lords Select Committee on Medical Ethics take this path, where euthanasia is defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering."[2] Beauchamp and Davidson also highlight Baruch Brody's "an act of euthanasia is one in which one person ... (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed".[17]
Draper argued that any definition of euthanasia must incorporate four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Based on this, she offered a definition incorporating those elements, stating that euthanasia "must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies."[18] Prior to Draper, Beauchamp and Davidson had also offered a definition that includes these elements. Their definition specifically discounts fetuses in order to distinguish between abortions and euthanasia:[19]
"In summary, we have argued ... that the death of a human being, A, is an instance of euthanasia if and only if (1) A's death is intended by at least one other human being, B, where B is either the cause of death or a causally relevant feature of the event resulting in death (whether by action or by omission); (2) there is either sufficient current evidence for B to believe that A is acutely suffering or irreversibly comatose, or there is sufficient current evidence related to A's present condition such that one or more known causal laws supports B's belief that A will be in a condition of acute suffering or irreversible comatoseness; (3) (a) B's primary reason for intending A's death is cessation of A's (actual or predicted future) suffering or irreversible comatoseness, where B does not intend A's death for a different primary reason, though there may be other relevant reasons, and (b) there is sufficient current evidence for either A or B that causal means to A's death will not produce any more suffering than would be produced for A if B were not to intervene; (4) the causal means to the event of A's death are chosen by A or B to be as painless as possible, unless either A or B has an overriding reason for a more painful causal means, where the reason for choosing the latter causal means does not conflict with the evidence in 3b; (5) A is a nonfetal organism."[20]
Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition:
"Person A committed an act of euthanasia if and only if (1) A killed B or let her die; (2) A intended to kill B; (3) the intention specified in (2) was at least partial cause of the action specified in (1); (4) the causal journey from the intention specified in (2) to the action specified in (1) is more or less in accordance with A's plan of action; (5) A's killing of B is a voluntary action; (6) the motive for the action specified in (1), the motive standing behind the intention specified in (2), is the good of the person killed."[21]
Wreen also considered a seventh requirement: "(7) The good specified in (6) is, or at least includes, the avoidance of evil", although as Wreen noted in the paper, he was not convinced that the restriction was required.[22]
In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject's "right to life". In response, Wreen argued that euthanasia has to be voluntary, and that "involuntary euthanasia is, as such, a great wrong".[22] Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: "Medicalized killing of a person without the person's consent, whether nonvoluntary (where the person in unable to consent) or involuntary (against the person's will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only."[23] Although the EPAC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.[22]
คำจำกัดความเงื่อนไขอื่น ๆ เช่นยืมจากประวัติ "การุณยฆาต" มีความหมายแตกต่างกันขึ้นอยู่กับการใช้งาน ใช้ชัดเจนครั้งแรกคำว่า "การุณยฆาต" เป็นนักประวัติศาสตร์ซูโทเนียส ซึ่งอธิบายไว้ว่า จักรพรรดิ Augustus "ตายอย่างรวดเร็ว และไม่ มีความทุกข์ในแผ่นดินของภรรยา ลิเวีย ประสบการณ์ 'การุณยฆาต' เขามีปรารถนาสำหรับการ" [9] คำว่า "การุณยฆาต" ก่อนใช้ในบริบททางการแพทย์ โดยเบคอน Francis ในศตวรรษที่ 17 อ้างถึงการง่าย เจ็บปวด ความสุขตาย ซึ่งมันเป็นความ "แพทย์รับผิดชอบเพื่อบรรเทา 'ทุกข์มีอยู่จริง' ของร่างกาย" เบคอนที่เรียกว่าการ "ภายนอกการุณยฆาต" ซึ่งคำ "ภายนอก" เขาเคยแยกจากแนวคิดทางจิตวิญญาณ — การการุณยฆาต "ซึ่งพิจารณาการเตรียมจิตวิญญาณ" [10]ในการใช้งานปัจจุบัน การุณยฆาตได้ถูกกำหนดเป็นแบบ "inducement ที่เจ็บปวดของการเสียชีวิตอย่างรวดเร็ว" [11] อย่างไรก็ตาม มันจะโต้เถียงว่า วิธีการนี้ไม่ถูกต้องกำหนดการุณยฆาต เป็นมันใบเปิดหมายเลขของการดำเนินการเป็นไปได้ที่จะตอบสนองความต้องการของคำนิยาม แต่จะไม่เห็นเป็นการุณยฆาต โดยเฉพาะอย่างยิ่ง รวมถึงสถานการณ์ที่บุคคลฆ่าอีก สามารถ แต่ไม่มีเหตุผลนอกเหนือจากนั้นประโยชน์ส่วนตัว หรือเสียชีวิตโดยบังเอิญที่รวดเร็ว และเจ็บปวด แต่ไม่ตก [12] [13]วิธีอื่นประกอบด้วยแนวคิดของความทุกข์เป็นคำนิยาม [12] ทุกข์เป็นเงื่อนไขจำเป็น มี "ที่เจ็บปวดฆ่าผู้ป่วยทุกข์ทรมาน จากโรคนี้ และเจ็บตัว หรือมีอาการสาหัสให้" ประกอบด้วยคำนิยามจากพจนานุกรมอังกฤษออกซ์ฟอร์ด [14] วิธีการนี้จะรวมอยู่ใน Marvin โขและ Paul Kurtz คำจำกัดความของ "โหมดหรือกระทำ inducing หรืออนุญาตให้ตายสามารถเป็นบรรเทาจากทุกข์" [15] สามารถกำหนด counterexamples: คำนิยามดังกล่าวอาจรอบฆ่าผู้ที่ทุกข์ทรมานจากโรคนี้เป็นในประโยชน์ส่วนตัว (เช่นการอ้างสิทธิการสืบทอด), และแสดง Beauchamp ทอมและอาร์โนลด์ Davidson ได้โต้เถียงว่า ทำดังนั้นจะถือเป็นการ "ฆ่า simpliciter" แทนการุณยฆาตได้ [12]The third element incorporated into many definitions is that of intentionality – the death must be intended, rather than being accidental, and the intent of the action must be a "merciful death".[12] Michael Wreen argued that "the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned."[16] Similarly, Heather Draper speaks to the importance of motive, arguing that "the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end."[13] Definitions such as that offered by the House of Lords Select Committee on Medical Ethics take this path, where euthanasia is defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering."[2] Beauchamp and Davidson also highlight Baruch Brody's "an act of euthanasia is one in which one person ... (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed".[17]Draper โต้เถียงว่า ข้อกำหนดใด ๆ ของการุณยฆาตต้องรวมองค์ประกอบที่ 4: ตัวแทนและหัวข้อ ความตั้งใจ แห่งสาเหตุ เช่นที่การกระทำของตัวแทนนำไปสู่ผลลัพธ์ และผล ตามนี้ เธอให้คำนิยามองค์ประกอบเหล่านั้น เพจระบุว่า การุณยฆาต "ต้องกำหนดเป็นความตายที่สุด ที่เป็นแรงจูงใจแต่เพียงผู้เดียวของบุคคลที่ตาย หมายถึง ผลลัพธ์จากความตั้งใจของคนฆ่าผู้อื่น ใช้อย่างอ่อนโยนที่สุด และเจ็บปวด" [18] ก่อนอยู่กับ Draper, Beauchamp และ Davidson ได้ยังให้คำจำกัดความที่รวมองค์ประกอบเหล่านี้ คำนิยามของส่วนลด fetuses เฉพาะเพื่อแยกระหว่างแท้งและการุณยฆาต: [19]"In summary, we have argued ... that the death of a human being, A, is an instance of euthanasia if and only if (1) A's death is intended by at least one other human being, B, where B is either the cause of death or a causally relevant feature of the event resulting in death (whether by action or by omission); (2) there is either sufficient current evidence for B to believe that A is acutely suffering or irreversibly comatose, or there is sufficient current evidence related to A's present condition such that one or more known causal laws supports B's belief that A will be in a condition of acute suffering or irreversible comatoseness; (3) (a) B's primary reason for intending A's death is cessation of A's (actual or predicted future) suffering or irreversible comatoseness, where B does not intend A's death for a different primary reason, though there may be other relevant reasons, and (b) there is sufficient current evidence for either A or B that causal means to A's death will not produce any more suffering than would be produced for A if B were not to intervene; (4) the causal means to the event of A's death are chosen by A or B to be as painless as possible, unless either A or B has an overriding reason for a more painful causal means, where the reason for choosing the latter causal means does not conflict with the evidence in 3b; (5) A is a nonfetal organism."[20]Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition:"Person A committed an act of euthanasia if and only if (1) A killed B or let her die; (2) A intended to kill B; (3) the intention specified in (2) was at least partial cause of the action specified in (1); (4) the causal journey from the intention specified in (2) to the action specified in (1) is more or less in accordance with A's plan of action; (5) A's killing of B is a voluntary action; (6) the motive for the action specified in (1), the motive standing behind the intention specified in (2), is the good of the person killed."[21]Wreen also considered a seventh requirement: "(7) The good specified in (6) is, or at least includes, the avoidance of evil", although as Wreen noted in the paper, he was not convinced that the restriction was required.[22]In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject's "right to life". In response, Wreen argued that euthanasia has to be voluntary, and that "involuntary euthanasia is, as such, a great wrong".[22] Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: "Medicalized killing of a person without the person's consent, whether nonvoluntary (where the person in unable to consent) or involuntary (against the person's will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only."[23] Although the EPAC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.[22]
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