Rethinking the withholding/withdrawing distinction: the cultural construction of "life-support" and the framing of end-of-life decisions

重新思考“停止/撤除”的区别:生命维持的文化建构与临终决策的框架

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Abstract

This paper is a theoretical and empirically informed examination of the naturalist distinction between withholding and withdrawing life-support. Drawing on the history of mechanical ventilation and on a recent Israeli law containing a novel approach to disconnecting life-support at the end of life, it is argued that the design of machines predicates the division line between "active" and "passive" interventions, and that the distinction itself might be morally self-defeating. Informed by insights from moral psychology, behavioral economics and philosophies of technology, the paper warns against the placement of this old distinction at the heart of the moral and legal regulation of life-support at the end of life.

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