「積極安樂死」與「消極安樂死」之道德差異與許可性

張智皓(Jhih-Hao Jhang)

指導教授 ： 張忠宏

國立中正大學/文學院/哲學系/碩士(2014年)

摘要

安樂死的道德爭議，在於醫生是否可以基於解除病患痛苦的考慮，提早結束病患生命？如果可以，那麼醫生採取怎麼樣的手段來結束病患生命，在道德上是可被許可的？一般而言，醫生結束病患生命的手段大概有兩種，一種是對病患投放致命毒藥（此種手段普遍稱為「積極安樂死」）；另外一種是關閉病患的維生器材（此種手段普遍稱為「消極安樂死」）。許多人認為這兩種行為有道德差異，而其道德差異源自於這兩種行為分別歸屬於「殺死他人」與「任他人死亡」這兩類行為。積極安樂死涉及「殺死他人」，這在道德上容易讓人感到不安；消極安樂死涉及「任他人死亡」，這在道德上似乎較容易被證成。
　　本篇文章有兩個目標：（1）消除「積極安樂死」與「消極安樂死」的道德差異：我會透過因果基礎、權利基礎以及意圖基礎之分析，說明這兩種行為不會分別歸屬於「殺死他人」及「任他人死亡」，而是同樣歸屬於其中一邊，「殺死他人」與「任他人死亡」之間的道德差異在此議題中是不相干的。（2）論述安樂死的道德許可性：當我們透過上述三種基礎的分析，消除了這兩種安樂死的道德差異之後，我會接著說明，在患者明確表達死亡意願的情況下，這些基礎可以幫助我們證成醫生結束患者的生命是道德上許可的行為。

關鍵字

道德差異 ； 積極安樂死 ； 消極安樂死 ； 道德許可性

並列摘要

The ethical dispute on euthanasia lies in whether doctors are permitted to terminate a patient’s life for the sake of relieving pain. If they are, then what method of termination is morally permissible? In general, doctors have two ways of ending a patient’s life: one is to give the patient a lethal injection (It is generally called “active euthanasia.”); another is to withdraw the patient’s life-support system (It is generally called “passive euthanasia.”). Many believe that there is a moral difference between these two acts and that it is due to their categorical difference: the former belongs to killing and the latter belongs to letting die. Active euthanasia involves killing, which is more morally disturbing; passive euthanasia involves letting die, which seems more easily to be justified.
This paper has two goals. First, to eliminate the moral difference between active and passive euthanasia: By analyzing the issue from different perspectives (i.e., causal, right-based, and intention-based), I will explain why passive and active euthanasia do not belong to killing and letting die respectively, rather, they belong to the same category. The moral difference between killing and letting die is irrelevant. Second, to expound the moral permissibility of euthanasia: After eliminating the moral difference between passive and active euthanasia by the three analyses, I will elaborate on the claim that under the condition of the patient’s explicit demonstration of willingness to die, the termination of the patient's life can be justified with the help of those analyses.

並列關鍵字

moral difference ； passive euthanasia ； active euthanasia ； moral permissibility

參考文獻

Bennett, J. (1987). Event Causation: The Counterfactual Analysis. Philosophical Perspectives(1), pp. 367-386.

Donagan, A. (1979). The Theory of Morality. Chicago: University of Chicago Press.

Dworkin, R. (2000). Sovereign Virtue: the Theory and Practice of Equality. London: Harvard University Press.

Hume, D. (1975). Enquiries concerning the human understanding and concerning the principles of morals. (L. Selby-Bigge, & P. H. Nidditch, Eds.) Oxford: Clarendon Press.

Kamm, F. M. (2006). Intricate Ethics : Rights, Responsibilities, and Permissible Harm: Rights, Responsibilities, and Permissible Harm. New York: Oxford University Press.