突然「不想死」錯了嗎？──從尊重自主原則到尊重自主死亡權利的道德疑慮

Is temporary change of mind “do not want to die” wrong? -- Moral doubts from the principle of autonomy to respecting the right to death

2016年4月，世界第一個安樂死合法化的國家—荷蘭，發生一起震驚社會且嚴重衝擊死亡醫生們為病人最佳利益考量的堅定信念的悲劇。一名患有阿茲海默症的74歲婦人，在執行安樂死的過程中，突然強力反抗，然而，最後負責執行的醫師在家屬的協助下，不顧當事人反抗，仍然被完成藥劑注射，隨後死亡。該案件於2018年11月9日，由荷蘭公共檢察官以越權的理由公訴起訴負責執行安樂死的女醫師，這起案例不僅撼動了擁有17年安樂死合法化的荷蘭，也強烈地動搖世界各國死亡醫師們的意願，同時，病人自主意願的前後不一致所衍生的問題也將更深層地被檢討。本文首先藉由荷蘭老婦人被強制完成安樂死的案例做為開端，提出3個關於尊重自主的疑惑，其次藉由分析相關案例來點出這些疑惑背後所隱藏的爭議，最後提出本文對於自主前後不一致該如何理解的幾個觀點與建議。

In April 2016, a tragedy occurred in the Netherlands, the country where the world's first euthanasia was legalized. This tragedy shocked the whole society and seriously affected the beliefs of doctors who were willing to assist in the execution of euthanasia. A 74-year-old woman with Alzheimer's disease suddenly reacted strongly during the euthanasia. However, with the assistance of the family physician who was ultimately responsible for the implementation, regardless of the party's resistance, the drug was still injected and subsequently died. On November 9, 2018, the Dutch public prosecutor prosecuted the female physician responsible for the euthanasia on the grounds of overpower. This case strongly shakes the will of the death physicians from all over the world. Meanwhile, if the patient's autonomy is inconsistent before and after, how should we respond? It will be reviewed more deeply. This article begins with the case of the old woman who is forced to complete euthanasia in the Netherlands, proposes three doubts about respecting autonomy, and secondly analyzes the relevant cases to point out the controversies behind these doubts. Finally, this paper puts forward the viewpoints and suggestions.