論協助自殺及自願積極安樂死的合法化—倫理學與法政策的討論

本文試圖找出協助自殺及自願積極安樂死在台灣合法化之可能進路，其論述可分為四個部分。第一部分，本文先建構協助自殺及自願積極安樂死之道德基礎，即證成協助自殺及自願積極安樂死符合道德，且自願消極安樂死與自願積極安樂死之間沒有道德差異，而應等同視之。第二部分，在此道德基礎上探究協助自殺及自願積極安樂死之合憲性，分析我國刑法第275條加工自殺罪之正當性、生命權與自主權之價值排序，以及德國聯邦憲法法院於2020年2月26日宣告德國刑法第217條禁止業務協助自殺違憲之判決理由，進而支持協助自殺及自願積極安樂死合憲且應除罪化。第三部分，本文試圖探究台灣醫學界反對協助自殺及自願積極安樂死之根本原因，並透過回應台灣安寧緩和醫學學會〈安樂死及醫師協助自殺立場聲明書〉各項主張，進而反思支持其立場之生命倫理四原則是否合理。第四部分，回到台灣協助自殺及自願積極安樂死合法化進展，介紹及說明筆者起草《尊嚴善終法草案》之立法歷程、目的、理由與條文內容，並回應相關批評。

關鍵字

自願積極安樂死；協助自殺；加工自殺罪；業務協助自殺罪；死亡自決權；醫學倫理四原則；尊嚴善終法草案

並列摘要

This thesis attempts to find a possible approach to the legalization of assisted suicide and voluntary active euthanasia in Taiwan. The discussion can be divided into four parts. In the first part, this thesis constitutes the basis for assisted suicide and voluntary active euthanasia, which proves that assisted suicide and voluntary active euthanasia is morally permissible. Furthermore, there is no moral difference between voluntary passive euthanasia and voluntary active euthanasia. Accordingly, they should be regarded as equivalent. In the second part, on the basis of morality constituted, this thesis examines the constitutionality of assisted suicide and voluntary active euthanasia by discussing the relations between right to life and autonomy; rethinking the legitimacy of Article 275 of the Criminal Code in Taiwan; and comprehending the foundations of German Federal Constitutional Court held that the prohibition of assisted suicide services set out in § 217 of the Criminal Code violated the Basic Law and was void on 26th April 2020. Therefore, those arguments can support that assisted suicide and voluntary active euthanasia is a constitutional right and should be decriminalized. In the third part, this thesis quests the fundamental reasons why Taiwan’s medical communities reject assisted suicide and voluntary active euthanasia, and responds to Taiwan Academy of Hospice Palliative Medicine’ statement as representative. Furthermore, this thesis inspects Principles of Biomedical Ethics for deficiencies. In the fourth part, this thesis concentrates on Taiwan’s progress in legalization of assisted suicide and voluntary active euthanasia, and introduces the "Dignified End of Life Bill" drafted by author, including backgrounds, purposes, contents, arguments and process of the bill. Finally, this thesis concludes that meaning of the "Dignified End of Life Bill " is to make the public have sufficient reflections on these concrete issues, to communicate rationally with others coming from various professional fields, and then to garner consensus of the society. In the end, whether the consensus agrees or not to legalize assisted suicide and voluntary active euthanasia, at least Taiwan’s community have deliberated the option at great length.