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1、Unit 4 Active and Passive EuthanasiaU8Additional lnformation for the Teachers Reference Text Active and Passive EuthanasiaWarm-up ActivitiesFurther ReadingWriting SkillsAdditional WorkUnit 4 Active and Passive EuthanasiaWarm-up Activities1.Try to give a definition of euthanasia.2.Brainstorm about th
2、e pros and cons of euthanasia.3.Collect references to this issue and take down notes.4.Order information and work out your own opinion.Warm-up 1.1Unit 4 Active and Passive Euthanasia James Rachels was an American professor of moral philosophy and medical ethics who was particularly concerned with et
3、hical issues.Born in Columbus,Georgia,he earned degrees at Mercer University and the University of California before joining the University of Alabama,Birmingham Department of Philosophy faculty in 1977.The popularity of his groundbreaking textbook anthology Moral Problems(1971),which sold 100,000 c
4、opies,influenced American universities to move away from more traditional philosophically oriented undergraduate moral philosophy courses toward more practical undergraduate courses in ethics.AIFTTR1.1Additional lnformation for the Teachers Reference1.James Rachels(1941-2003)Unit 4 Active and Passiv
5、e EuthanasiaAIFTTR2.12.EuthanasiaEuthanasia is a practice of mercifully ending a persons life in order to release the person from an incurable disease,intolerable suffering,or undignified death.The word euthanasia derives from the Greek for“good death”and originally referred to intentional mercy kil
6、ling.Proponents of euthanasia believe that unnecessarily prolonging life in terminally ill patients causes suffering to the patients and their family members.Many societies now permit passive euthanasia,which allows physicians to withhold or withdraw life-sustaining treatment when directed to do so
7、by the patient or an authorized representative.Unit 4 Active and Passive EuthanasiaAIFTTR2.2 Euthanasia differs from assisted suicide,in which a patient voluntarily brings about his or her own death with the assistance of another person,typically a physician.In this case,the act is a suicide(intenti
8、onal self-inflicted death),because the patient actually causes his or her own death.A.Related Laws As laws have evolved from their traditional religious underpinnings,certain forms of euthanasia have been legally accepted.In general,laws attempt to draw a line between passive euthanasia(generally as
9、sociated with allowing a person to die)and active euthanasia(generally associated with killing a person).While laws commonly permit passive euthanasia,active euthanasia is typically prohibited.Unit 4 Active and Passive EuthanasiaAIFTTR2.3 Laws in the United States and Canada maintain the distinction
10、 between passive and active euthanasia.While active euthanasia is prohibited,courts in both countries have ruled that physicians should not be legally punished if they withhold or withdraw a life-sustaining treatment at the request of a patient or the patients authorized representative.These decisio
11、ns are based on increasing acceptance of the doctrine that patients possess a right to refuse treatment.Until the late 1970s,whether or not patients possessed a legal right of refusal was highly disputed.One factor that may have contributed to growing acceptance of this right is the ability to keep
12、individuals alive for long periods of time even when they are permanently unconscious or severely brain-damaged.Proponents jets Unit 4 Active and Passive EuthanasiaAIFTTR2.4of legalized euthanasia believe that prolonging life through the use of modern technological advances,such as respirators and k
13、idney machines,may cause unwarranted suffering to the patient and the family.As technology has advanced,the legal rights of the patient to forgo such technological intervention have expanded.Every U.S.state has adopted laws that authorize legally competent individuals to make advanced directives,oft
14、en referred to as living wills.Such documents allow individuals to control some features of the time and manner of their deaths.In particular,these directives empower and instruct doctors to withhold life-support systems if the individuals become terminally ill.Furthermore,the federal Patient Self-D
15、etermination Act,which became effective in 1991,requires federally certified health-care betUnit 4 Active and Passive EuthanasiaAIFTTR2.5facilities to notify competent adult patients of their right to accept or refuse medical treatment.The facilities must also inform such patients of their rights un
16、der the applicable state law to formulate an advanced directive.Patients in Canada have similar rights to refuse life-sustaining treatments and formulate advanced directives.As of mid-1999,only one U.S.state,Oregon,had enacted a law allowing physicians to actively assist patients who wish to end the
17、ir lives.However,Oregons law concerns assisted suicide rather than active euthanasia.It authorizes physicians to prescribe lethal amounts of medication that patients then administer themselves.In response to modern medical technology,physicians and lawmakers are slowly developing new professional an
18、d legal definitions of death.Additionally,experts are formulating rules to batUnit 4 Active and Passive EuthanasiaAIFTTR2.6implement these definitions in clinical situations,for example,when procuring organs for transplantation.The majority of states have accepted a definition of brain death the poi
19、nt when certain parts of the brain cease to function as the time when it is legal to turn off a patients life-support system,with permission from the family.In 1995 the Northern Territory of Australia became the first jurisdiction to explicitly legalize voluntary active euthanasia.However,the federa
20、l parliament of Australia overturned the law in 1997.In 2001 The Netherlands became the first country to legalize active euthanasia and assisted suicide,formalizing medical practices that the government had tolerated for years.Under the Dutch law,euthanasia is justified(not legally punishable)if the
21、 mustUnit 4 Active and Passive EuthanasiaAIFTTR2.7physician follows strict guidelines.Justified euthanasia occurs if(1)the patient makes a voluntary,informed,and stable request;(2)the patient is suffering unbearably with no prospect of improvement;(3)the physician consults with another physician,who
22、 in turn concurs with the decision to help the patient die;and(4)the physician performing the euthanasia procedure carefully reviews the patients condition.Officials estimate that about 2 percent of all deaths in The Netherlands each year occur as a result of euthanasia.B.Prevalence Although establi
23、shing the actual prevalence of active euthanasia is difficult,studies suggest that the practice is not common in the United States.In a study published in 1998 in the New England Journal of Medicine,only about 6 percent of basketballUnit 4 Active and Passive Euthanasiaphysicians surveyed reported th
24、at they had helped a patient hasten his or her own death by administering a lethal injection or prescribing a fatal dose of medication.(Eighteen percent of the responding physicians indicated that they had received requests for such assistance.)However,one-fifth of the physicians surveyed indicated
25、that they would be willing to assist patients if it were legal to do so.No comparable data are available for Canada.However,in 1998 the Canadian Medical Association(CMA)proposed that a study of euthanasia and physician-assisted suicide be undertaken due to poor information on the subject.C.Ethical C
26、oncerns The issue of euthanasia raises ethical questions for physicians and other health-care providers.The ethical code of physicians in theAIFTTR2.8Unit 4 Active and Passive EuthanasiaAIFTTR2.9United States has long been based in part on the Hippocratic Oath,which requires physicians to do no harm
27、.However,medical ethics are refined over time as definitions of harm change.Prior to the 1970s,the right of patients to refuse life-sustaining treatment(passive euthanasia)was controversial.As a result of various court cases,this right is nearly universally acknowledged today,even among conservative
28、 bioethicists(see Medical Ethics).The controversy over active euthanasia remains intense,in part because of opposition from religious groups and many members of the legal and medical professions.Opponents of voluntary active euthanasia emphasize that health-care providers have professional obligatio
29、ns that prohibit killing.These opponents maintain that active euthanasia is inconsistent with the roles of nursing,basketballUnit 4 Active and Passive EuthanasiaAIFTTR2.10caregiving,and healing.Opponents also argue that permitting physicians to engage in active euthanasia creates intolerable risks o
30、f abuse and misuse of the power over life and death.They acknowledge that particular instances of active euthanasia may sometimes be morally justified.However,opponents argue that sanctioning the practice of killing would,on balance,cause more harm than benefit.Supporters of voluntary active euthana
31、sia maintain that,in certain cases,relief from suffering(rather than preserving life)should be the primary objective of health-care providers.They argue that society is obligated to acknowledge the rights of patients and to respect the decisions of those who elect euthanasia.Supporters of active eut
32、hanasia contend that since society has mutualUnit 4 Active and Passive EuthanasiaAIFTTR2.11acknowledged a patients right to passive euthanasia(for example,by legally recognizing refusal of life-sustaining treatment),active euthanasia should similarly be permitted.When arguing on behalf of legalizing
33、 active euthanasia,proponents emphasize circumstances in which a condition has become overwhelmingly burdensome for a patient,pain management for the patient is inadequate,and only a physician seems capable of bringing relief.They also point out that almost any individual freedom involves some risk
34、of abuse and argue that such risks can be kept to a minimum by using proper legal safeguards.Unit 4 Active and Passive EuthanasiaAIFTTR3.13.American Medical Association The American Medical Association(AMA),founded in 1847 and incorporated 1897,is the largest association of physicians and medical st
35、udents in the United States.It is a nonprofit professional association of physicians,including all medical specialties.The AMAs purpose is to promote the art and science of medicine for the betterment of the public health,to advance the interests of physicians and their patients,to promote public he
36、alth,to lobby for legislation favorable to physicians and patients,to raise money for medical education and to serve as an advocate for the advancement of the profession.The Association also publishes the Journal of the American Medical Association(JAMA),which has the largest circulation of any week
37、ly medical journal in the world.The AMA also publishes a list of Physician Specialty Codes which are a standard method in the U.S.for identifying physician and practice specialties.Unit 4 Active and Passive EuthanasiaText Active and Passive EuthanasiaNotesIntroduction to the Author and the ArticlePh
38、rases and ExpressionsExercisesMain Idea of the Text Unit 4 Active and Passive EuthanasiaMain Idea of the Text 1Main Idea of the Text Rachelsessay“Active and Passive Euthanasia”first appeared in the New England Journal of Medicine in 1975.In it,Rachels argues that killing is not morally worse than le
39、tting a person die of natural causes,when done for humanitarian reasons.Therefore,active euthanasia is not any worse than passive euthanasia,and in cases where a patient is spared needless pain,arguably better.Unit 4 Active and Passive Euthanasia James Rachels(1941 2003)was an American professor of
40、moral philosophy and medical ethics who was particularly concerned with ethical issues.Born in Columbus,Georgia,he earned degrees at Mercer University and the University of California before joining the University of Alabama,Birmingham Department of Philosophy faculty in 1977.The popularity of his g
41、roundbreaking textbook anthology Moral Problems(1971),which sold 100,000 copies,influenced American universities to move away from more traditional philosophically oriented undergraduate moral philosophy courses toward more practical undergraduate courses in ethics.Introduction to the Author and the
42、 articleIntroduction to the Author and the ArticleUnit 4 Active and Passive EuthanasiaRachelsessay“Active and Passive Euthanasia”first appeared in the New England Journal of Medicine in 1975.In it,Rachels argues that killing is not morally worse than letting a person die of natural causes,when done
43、for humanitarian reasons.Therefore,active euthanasia is not any worse than passive euthanasia,and in cases where a patient is spared needless pain,arguably better.Introduction to the Author and the articleUnit 4 Active and Passive EuthanasiaPart2_T1 The distinction between active and passive euthana
44、sia is thought to be crucial for medical ethics.The idea is that it is permissible,at least in some cases,to withhold treatment and allow a patient to die,but it is never permissible to take any direct action designed to kill the patient.This doctrine seems to be accepted by most doctors,and it is e
45、ndorsed in a statement adopted by the American Medical Association on December 4,1973:James RachelsActive and Passive EuthanasiaTextUnit 4 Active and Passive Euthanasia The intentional termination of the life of one human being by another mercy killing is contrary to that for which the medical profe
46、ssion stands and is contrary to the policy of the American Medical Association.The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient and/or his immediate family.The ad
47、vice and judgment of the physician should be freely available to the patient and/or his immediate family.Part2_T2Unit 4 Active and Passive Euthanasia However,a strong case can be made against this doctrine.In what follows I will set out some of the relevant arguments,and urge doctors to reconsider t
48、heir views on this matter.To begin with a familiar type of situation,a patient who is dying of incurable cancer of the throat is in terrible pain,which can no longer be satisfactorily alleviated.He is certain to die within a few days,even if present treatment is continued,but he does not want to go
49、on living for those days since the pain is unbearable.So he asks the doctor for an end to it,and his family joins in the request.Part2_T3Unit 4 Active and Passive Euthanasia Suppose the doctor agrees to withhold treatment,as the conventional doctrine says he may.The justification for his doing so is
50、 that the patient is in terrible agony,and since he is going to die anyway,it would be wrong to prolong his suffering needlessly.But now notice this.If one simply withholds treatment,it may take the patient longer to die,and so he may suffer more than he would if more direct action were taken and a