篇名

腦死認定後的法律與倫理責任   免費試閱

並列篇名

Legal and Ethical Responsibilities Following Brain Death

作者
中文摘要

持續治療一位腦死病患會帶來什麼樣的法律與倫理上的影響?醫院是否能夠拒絕提供這種治療?近來的兩個案例引發了這些倫理與法律上的問題。在第一個M.Muñoz女士的案例中,治療的醫院基於對於德州當地胚胎保護法的解釋,違背家屬的意願而維持該病人的生命跡象。而在另一個腦死女孩J. McMath的案例中,即便家屬懇求,醫院仍拒絕繼續給予治療。這兩個案例乍看之下,特別是醫院決策不以家屬意願為依歸這點上看似相似,但仔細分析,兩者其實明顯不同。本文首先區分腦死與長期植物人狀態的不同,並主張一旦病人已經腦死,則持續給予治療反而是不合於倫理的做法。死去的人們無法享有法律上或倫理上可識別的利益。本文一方面分析自主權高於其他利益的當代潮流,另一方面也對誤用自主權意義的現象進行討論。筆者主張對於自主權的適當理解,應該是一種避免干涉的權利,而非不論是否有用、是否合於成本效益都能無限制地享有治療之權利。最後本文也討論Muñoz的案例中,該名婦女之自主權與州政府保護胚胎之正當利益兩者間的衝突問題。本文認為,德州法律對於胚胎的保護並不適用於已經死亡的婦女,這點在近來德州地方法院的一項判決上也獲得支持。

英文摘要

What are the legal and ethical implications of continuing to treat a brain dead patient? And may a hospital refuse to provide such treatment? These ethical and legal problems are raised in two recent cases. In the first M. Muñoz, a pregnant woman declared brain dead, was kept on life support against her family’s wishes due to the treating hospital’s interpretation of a Texas fetal protection law. In the other a hospital refused to treat J. McMath, a brain dead girl, despite her family’s entreaties. The cases, at first, appear similar because in each case the hospital was refusing to abide by the family’s wishes. But on closer reflection, they are markedly dissimilar. This opinion piece distinguishes brain death from a persistent vegetative state, arguing that once a person is brain dead it is unethical to continue treatment. Deceased individuals do not possess legally or ethically cognizable interests. The article similarly takes issue with the trend of placing the value of autonomy above all other interests, as well as perverting the meaning of autonomy. I argue that autonomy, properly understood, is the right to avoid unwanted intrusions rather than a right to have any medical treatment, however futile or cost ineffective. Finally, the article considers the competing claims in the Muñoz case — the woman’s right of autonomy on the one hand and the state’s interest in safeguarding her fetus on the other. Here, the article makes the case that the Texas statute protecting fetuses is not applicable to a deceased woman — a claim supported by a recent Texas district court opinion.

起訖頁

066-075

出版單位
DOI

10.3966/241553062018010015005  複製DOI  DOI查詢

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