患者の自己決定権と医師の倫理的統合性(第7回日本生命倫理学会年次大会ワークショップ「医療と生命倫理」発表原著)

概要

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In recent years, there exists worldwide tendency to stress patient's autonomy instead of doctor's paternalism in daily medical practice. This tendency must be appreciated as'every human being of adult years and sound mind has a right to determine what shall be done with his own body'. But this autonomy sometimes conflicts with the doctor's personal integrity which is essencially pro-life one. In informed consent or refusal, the procedures are suggested from doctors, but the active requests from patient's side sometimes call difficulty. In some western countries, such a request from autonomy is legally admitted even in life-shortening procedures such as an abortion or euthanasia in the terminally ill patients. In 1994,Japanese scientific council made a report concerning'death with dignity'and declared that the withdrawal of foods from PVS patients should be proceeded under his or his supposed will. And in a criminal case decision in 1995,criteria for the active euthanasia in the terminal patients are proposed. In both situations, the actor, they say, should be a doctor. These life-shortening procedures might be appreciated for the autonomy of patient and be legally permitted. But conscientious refusal of doctor against proceeding these acts from patient's request must be also admitted, as the philosophy of each doctor about the sanctity of terminal life is different from doctor to doctor as in lay persons.
1996-06-30