安楽死を認める。

THW legalize euthanasia.
(安楽死を合法化する。)

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安楽死…末期がんなど「不治」かつ「末期」で「耐えがたい苦痛」を伴う疾患の患者の求めに応じ、医師などが積極的あるいは消極的手段によって死に至らしめること。
安楽死と尊厳死との違い…安楽死は第三者が注射や毒物投与などの積極的な方法で死期を早めるもの。尊厳死は延命措置を拒否し自然の摂理に経過を任せて死を迎えるもの。
現状…日本では法制化されてはいないが、判例上刑事罰を受けない基準がある。
日本においては安楽死は法的に認めておらず、刑法上殺人罪の対象となる。昭和37年の名古屋高裁の判例により、6つの要件を満たさない場合は違法行為となるとされている（違法性阻却条件）。以下にその6つの要件を列挙する。詳しくは名古屋安楽死事件を参照のこと。

死期が切迫していること
耐え難い肉体的苦痛が存在すること
苦痛の除去・緩和が目的であること
患者が意思表示していること
医師が行うこと

倫理的妥当な方法で行われること
合法化されているオランダでは、毎年3000人以上が安楽死を選択している。

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肯定／否定
Principal
ア） 生命の選択権
肯定…人間には生きる権利がある。権利とは選択できるものだ。だから安楽死は許されるべきである。
Every human being has a right to life, perhaps the most basic and fundamental of all our rights. However, with every right comes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the right to choose to die is implicit in the right to life.
否定…安楽死の選択は取り返しのつかないものである。安楽死を認めることは、逆にその人が将来下すであろうすべての選択を奪うことになる。（！）
There is no comparison between the right to life and other rights. When you choose to remain silent, you may change your mind at a later date; when you choose to die, you have no such second chance. Participating in someone’s death is also to participate in depriving them of all choices they might make in the future, and is therefore immoral.

Practical
イ）死に際しての尊厳
肯定…末期の苦痛を考えると、自分の死に方（尊厳死）を選ぶ権利はある。
Those who are in the late stages of a terminal disease have a horrific future ahead of them: the gradual decline of their body, the failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to ‘control’ their pain will often leave them in a delirious and incapable state. Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and die with dignity.
否定…政府は、そのような人が充実した人生を送れるような支援をするべきだ。
Modern palliative care is immensely flexible and effective, and helps to preserve quality of life as far as is possible. There is no need for terminally ill patients ever to be in pain, even at the very end of the course of their illness. It is always wrong to give up on life. The future that lies ahead for the terminally ill is of course terrifying, but society’s role is to help them live their lives as well as they can. This can take place through counseling, helping patients to come to terms with their condition.

ウ）状況による容認、自殺との対比
肯定…自殺同様に悪いことではない。状況によっては許されるべき。
Society recognizes that suicide is unfortunate but acceptable in some circumstances – those who end their own lives are not seen as evil, nor is it a crime to attempt suicide. The illegality of assisted suicide is therefore particularly cruel for those who are disabled by their disease, and are unable to die without assistance.
否定…モラルの問題として、自殺しようとしている人を見殺しにするべきではない。安楽死にしても然りである。
Those who commit suicide are not evil, and those who attempt to take their own lives are not prosecuted. However, if someone is threatening to kill themselves it is your moral duty to try to stop them. You would not, for example, simply ignore a man standing on a ledge and threatening to jump simply because it is his choice; and you would definitely not assist in his suicide by pushing him. In the same way, you should try to help a person with a terminal illness, not help them to die.

エ）残された人たちへの影響
肯定…家族が気持ちを知れる。
Suicide is a lonely, desperate act, carried out in secrecy and often as a cry for help. The impact on the family who remain can be catastrophic. By legalizing assisted suicide, the process can be brought out into the open. In some cases, families might have been unaware of the true feelings of their loved one; being forced to confront the issue of their illness may do great good, perhaps even allowing them to persuade the patient not to end their life. In other cases, it makes them part of the process: they can understand the reasons behind their decision without feelings of guilt and recrimination, and the terminally ill patient can speak openly to them about their feelings before their death.
否定…別問題としての、安楽死への圧力。（←？？）
Demanding that family take part in such a decision can be an unbearable burden: many may resent a loved one’s decision to die, and would be either emotionally scared or estranged by the prospect of being in any way involved with their death. Assisted suicide also introduces a new danger, that the terminally ill may be pressured into ending their lives by others who are not prepared to support them through their illness. Even the most well regulated system would have no real way to ensure that this did not happen.

オ）医者の役割
肯定…患者との関係が深い医者は安楽死を裏で行っている。合法化したら透明化もできる。
At the moment, doctors are often put into an impossible position. A good doctor will form close bonds with their patients, and will want to give them the best quality of life they can; however, when a patient has lost or is losing their ability to live with dignity and expresses a strong desire to die, they are legally unable to help. To say that modern medicine can totally eradicate pain is a tragic over-simplification of suffering. While physical pain may be alleviated, the emotional pain of a slow and lingering death, of the loss of the ability to live a meaningful life, can be horrific. A doctor’s duty is to address his or her patient’s suffering, be it physical or emotional. As a result, doctors will in fact already help their patients to die – although it is not legal, assisted suicide does take place. It would be far better to recognize this, and bring the process into the open, where it can be regulated. True abuses of the doctor-patient relationship, and incidents of involuntary euthanasia, would then be far easier to limit.
否定…医者は病気の治療だけでも難しい。死ぬか死なないかの判断は無理だ。
It is vital that a doctor’s role not be confused. The guiding principle of medical ethics is to do no harm: a physician must not be involved in deliberately harming their patient. Without this principle, the medical profession would lose a great deal of trust; and admitting that killing is an acceptable part of a doctor’s role would likely increase the danger of involuntary euthanasia, not reduce it. Legalizing assisted suicide also places an unreasonable burden on doctors. The daily decisions made in order to preserve life can be difficult enough; to require them to also carry the immense moral responsibility of deciding who can and cannot die, and the further responsibility of actually killing patients, is unacceptable. This is why the vast majority of medical professionals oppose the legalization of assisted suicide: ending the life of a patient goes against all they stand for.

外国の例〜オランダ
オランダはキリスト教カルヴァン派の国でもあり、個人主義が確立している。また、医者と患者の信頼関係を構築するための訪問医療制度もある。そうであるから安楽死の合法化が世界に先駆けて可能だったのかもしれない。
　一方で、治る見込みのない患者→慢性的な患者→…→精神病患者へと安楽死の適用範囲が広がっている懸念もある。
【出典】ウィキペディア・ディベータベース（URLの貼りつけミスです。）

2009/10/11 hideo akagi