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12. Euthanasia and Forgoing Life-sustaining Treatment in the Chinese Context
- Hong Kong University Press, HKU
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12 Euthanasia and Forgoing Life-sustaining Treatment in the Chinese Context ChunYanTSE and Samantha Mei ChePANG Introduction Euthanasia i s derived fro m th e Gree k euthanatos, whic h mean s a goo d o r peaceful death. 1 Ther e hav e bee n man y definition s o f the term , an d man y forms o f euthanasia have been described , including active euthanasia, passiv e euthanasia, voluntary euthanasia , non-voluntar y euthanasi a an d involuntar y euthanasia. Whe n use d withou t qualification , th e ter m euthanasia usuall y signifies "voluntar y active euthanasia". 2 Euthanasia i s illegal in mos t parts o f the world , excep t i n th e Netherland s an d Belgium , wher e euthanasi a wa s legalized i n Apri l an d Ma y 200 2 respectively . Physician-assiste d suicid e i s similarly illegal i n mos t part s of th e world, thoug h i t was legalized (bu t no t euthanasia) i n th e US state of Oregon i n 1997 . Forgoing futile life-sustainin g treatmen t i n th e terminall y ill, however, is a widely accepte d practic e i n medicall y advance d countries . As a resul t o f advances i n medica l technolog y t o prolon g life , ther e ar e situation s whe n further life-sustainin g treatmen t only prolongs the dying process and become s a burden o n the patient. A decision needs to be made on whether to forgoin g such life-sustainin g treatmen t tha t i s not in th e bes t interests o f the patient . Such a decisio n i s not eas y and involve s medical, psychosocia l an d ethica l considerations. Professional bodie s in many medically advanced countries like the US, the UK, and Canada, while opposing euthanasia, support the forgoin g of life-sustainin g treatmen t tha t i s not i n th e bes t interest s o f th e patient . Detailed guideline s hav e bee n publishe d o n this. 3 "5 Recently, th e Hospita l Authority of Hong Kong has also issued a set of guidelines on th e subject. 6 There is still controversy surrounding the above two issues. Public opinio n differs widel y o n whethe r euthanasi a shoul d b e legalize d o r not . Wha t constitutes futile treatmen t an d thu s can be forgone, an d what constitutes a proper decision-making process is also hotly debated. The controversy is often compounded b y the different interpretation s of the terms used. In biomedica l ethics literatur e an d i n publi c debates , th e ter m "passiv e euthanasia " i s 170Chun Yan TSEandSamanthaMeiChe PANG sometimes used to describe forging life-sustaining treatment . However, the use of this term is often considere d inappropriat e i n the medical and legal fields, because forgoin g life-sustainin g treatmen t i s considere d differen t fro m euthanasia. Th e Hous e o f Lords Selec t Committee o n Medica l Ethic s state d that the term is "misleading".7 The Hospital Authority of Hong Kong listed i n an appendix of its guidelines why the term should not be used (Appendi x 1) . The Hospital Authority Guidelines concluded that avoidance of this misleading term would facilitat e publi c discussio n o n th e topi c and discussio n wit h th e patients and thei r family i n individual cases . This chapter contain s two parts. The first part examines the controversie s regarding th e legalizatio n o f euthanasi a i n China . Drawin g o n traditiona l Chinese thought s o n deat h an d dying , the author s argu e tha t th e confusio n in term s and concept s shoul d b e disentangle d an d palliativ e car e shoul d b e promoted, befor e th e debat e o n euthanasi a i n Chin a ca n continu e i n a healthier way. The secon d part of this chapter the n examine s how a decision on forgoing life-sustainin g treatmen t coul d be made...