善终服务的法律调整模式及选择逻辑  

Law and Logic of the“Good Death”Service

作　　者：汪志刚[1] Wang Zhigang

机构地区：[1]江西财经大学

出　　处：《中外法学》2022年第4期924-943,共20页Peking University Law Journal

基　　金：2019年度国家社会科学基金一般项目“我国安宁疗护法律制度体系的构建研究”(项目编号:19BFX138)的阶段性研究成果。

摘　　要：善终服务立法在比较法上经历了从安乐死立法整体受挫,到自然死和安宁疗护立法获得成功,再到向协助自杀和安乐死合法化渐次拓展的过程。这种发展根源于死亡的医学化和多元化的世俗死亡观间的相互作用,根本任务是要衡平生命保护和个体自决。善终服务立法已经形成了以医疗自主权为基础的,自然死立法与安宁疗护立法或合一、或分离的自然死服务立法模式以及以事实上的死亡自由和医疗援助为基础的不具有医疗性质的速死服务立法模式,后者包含协助自杀模式和安乐死模式。我国法不应承认所谓的死亡权。未来我国立法应采安宁疗护与自然死立法合一模式,在承认末期患者有权拒绝维生医疗、预立医疗指示和获得安宁疗护的基础上,对安宁疗护的服务对象、意愿表达和实施程序等作出明确规定。The development of legislation on“good death”service in comparative law has experienced aprocess from the avoiding euthanasia legislation in many countries to the success of natural death and palliative legislation in many countries,and then to the gradual expansion to the legality of assisted suicide and euthanasia in a few countries This development is rooted in the interaction between the medicalization of death and the pluralistic secular view of death,and its fundamental goal is to balance life protection and patient self-determination Different legislative models have formed,including the model of separation or integration of natural death and palliative legislation based on patients right to medical selfdetermination,the assisted suicide model and euthanasia model based on de facto freedom of death and medical assistance.In China,refusing to recognize the legality of assisted suicide and euthanasia does not constitute a violation of the PRC Constitution.In the future,China's legislation should focus on palliative care,adopt the legislative model of integrating palliative care and natural death legislation,and makes clear provisions on the service objects,expression of will,implementation procedures while recognizing the terminally ill patients have the right to refuse life support medical treatment and obtain palliative care.

关 键 词：善终服务 安乐死 自然死 安宁疗护 协助自杀 

分 类 号：D912.1[政治法律—宪法学与行政法学]