本論文主要討論在安寧緩和醫療下一項合法和廣為接受的醫療措施—「臨終鎮靜」的倫理爭議。並將現行「臨終鎮靜」的醫療倫理問題、支持臨終鎮靜的相關倫理議題做分析，例如「雙重效果原則」和「作為與不作為原則」。有些學者認為臨終鎮靜是醫生為了替病人減輕疼痛，主動施予藥物使病人持續昏迷，意義上與醫助自殺和自願主動安樂死是相同的，因此臨終鎮靜可能是偽裝的安樂死。 而「臨終鎮靜」到底是「自然死」，「醫助自殺」，亦或是緩慢的「自願主動安樂死」?文中除了提出西方許多生命倫理學家和醫療專家的不同理據和看法，也用貝參和查爾德斯的原則主義、儒家生命倫理學、辛格的偏好功利主義等道德原則和理論，對臨終鎮靜、醫助自殺和自願主動安樂死做倫理分析和比較。 最後，本論文嘗試證立臨終鎮靜和自願主動安樂死是合理和合人道的醫療。並希望藉由論文中的討論促使立法機構對「臨終鎮靜」醫療訂定更明確相關法規、支持「有條件的末期命人之自願主動安樂死」，以提供一個良好的緩和醫療讓末期病人替自己做最好的生命決擇。 The purpose of this thesis is to analyse the morality of a legal and widely accepted practice in palliative care—terminal sedation for dying patients. Some underlying issues about terminal sedation are also been analysed, like medical ethics problems while using Terminal Sedation in practice,「Doctrine of Double Effect」, and「Doctrine of Acts and Omissions」 . Some bioethicists or medical professionals with experience of Terminal Sedation think the meaning of Terminal Sedation is the same as Physician-assisted Suicide and Voluntary Active Euthanasia, because it is the doctor who put the patients into coma by actively giving drips for alleviating the pain.That counts for Terminal Sedation may be Euthanasia in Disguise. Is ”Terminal Sedation“ ”Natural Death”, “Physician-assisted Suicide”, or ”Voluntary Active Euthanasia”? There are not only different kinds of views of bioethicists or medical professionals, but some bioethics principles and moral theories, like the Principles of Bioethics, Confucian Ethics, Preference Utilitarianism, for better consideration to discuss and compare ”Terminal Sedation“, ”Natural Death”, “Physician-assisted Suicide”, or ”Voluntary Active Euthanasia”. Consequently, the thesis tries to verify that Terminal Sedation and Voluntary Active Euthanasia are proper and humane choices for incurable and painful dying patients. By this discussion, I wish the legislature would make clearer and more definite laws about terminal sedation, and approve “Voluntary Active Euthanasia under some conditions” to provide a better and effective palliative care for dying patients to make the best life decisions for themselves.
