/

(problem oriented) v.

19451945

Bioethics ()

vs.vs.vs.()()(universal)(global)()

/

/(Dilemmas)v./v.

DNA

Nonmaleficence Beneficence Respect Justice

/Above all, do no harm

//(1)(2)(3)(4)/(paternalism)

(distributive justice) (formal) (substantial)(retributive justice)

1TarasoffTarasoff

2Z45L25ZL

319981013RG50302

Outline PVS

PVS

1 211975414 120705.23MA1 7

7313 21Medicare450PVS 912

201976691985

1.Human Being 2.Person 1. 2. 3.

Human Being: Person 1. 2. 3.

person Homo Sapiens

Human Being Person

/X1969

219851110541Pelle LindberghPelle LindberghLindbergh,Lindbergh5

3Highland2817383

1959coma depassebeyond coma1968H. Beecher

Presidents Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research12

ICU, Intensive Care Unit

PVS

PVS PVS

Persistent Vegetative State PVS Jennett Plum

PVSPVSPVS

123

1 5430199312199498

2 198519937199413115

1

123

4193991275,000

2

3 Euthanasia the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy.

4Tom Beauchamp

Tom Beauchamp

Euthanasia eu--; thanasia---

12345

A

1. BA

A

2. BAA

A

3. AAA

4. ABBA

A

5. A

1 BWA2 BAA3AAA.4ABBA5A5

natural deathaccident deathsuicide deathhomicide deatheuthanasia

---- ---- Aryan supremacy----

1.

2

beneficence ( autonomy ) ( justice)

beneficenceBeneficence----;

----

----

XY 1. Y 2 . X 3. X 4 . XX 5. YX

(autonomy )Autonomy----autos ( self ) nomos ( rule, governance, law

----

(justice) John Rawls

Quinlan person human beingperson H. Tristram Engelhardt human being self-reflexivity 1 Homo Sapiens23Engelhardtperson 2 PVS 3xuninteractionPVS Homo Sapiens

1 person

3

/19684424< 32.2oC22X1969

20 19851110541Pelle LindberghPelle LindberghLindberghPelle Lindbergh5 Pelle Lindbergh

1959coma depassebeyond coma H. Beecher1968 Presidents Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death :Medical ,Legal and Ethical Issues in the Determination of Death, Washington: Government Printing Office, July 1981.

ICU, Intensive Care Unit

197010 ICU, letting diett1,3 PVSpersistent vegetative state PVS

1968PVS

PVS Jennett Plum1972 Jennett PlumvegetatevegetativeJennett Plum brain-stem199643 1 1persistent vegetative state1permanent vegetative state

20 8729process of dying 80030199696.53885.9287811.01%32.8 2000

123 15430199312199498

2 198519937199413115

1 2 3 193991275,000500

Euthanasia the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy.

Tom Beauchamp

Euthanasia

A 1. BA

ABAAAB A 2. BAABA

living willadvanced directiveA

3. AAA

killingmurdercausing death 4. ABBA

ABB

A 5. A

1 BWA2 BAA3AAA.4ABBA5A 5

natural deathaccident deathsuicide deathhomicide death

euthanasia program 19381942500 clinical context volkvolkAryan supremacy

. withholding or withdrawing life-support measures

1212 Daniel CallahanThe Goals of Medicine: Setting New Priorities1234

4 . slippery slope argumentsLeo Alexanderz

1. ABABAB731 2.ABAB

volk

1.

2.

4 1. 2. 3. 4

----beneficencebeneficencebeneficence 1234 XY 1. Y2 . X3. X4 . XX5. YX

(autonomy )autonomyautos ( self ) nomos ( rule, governance, law )self-rule

(justice) desertJohn Rawls //// Roe vs. WadeRoe vs. WadeReinhardt797