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以安樂死合法化國家為中心之系統性文獻回顧（一）
Identifying Practical Clinical Problems in Active Euthanasia: A Systematic Literature Review of the Findings in Countries Where Euthanasia Is Legal (I)
Identifying Practical Clinical Problems in Active Euthanasia: A Systematic Literature Review of the Findings in Countries Where Euthanasia Is Legal (I)
This article primarily explores the clinical practice issues of euthanasia in countries where it has been legalized, with a particular focus on those nations. Through a systematic literature review analyzing 140 documents, including articles and regulations, the authors identified several significant issues: vague execution standards, insufficient assurance of voluntary choice, challenges in addressing requests for euthanasia due to psychological distress, moral dilemmas, and physician non-compliance. These problems reflect the challenges faced by countries legalizing euthanasia in practice. The Netherlands, as one of the earliest countries to practice euthanasia, has rich experience in this field; however, physicians still encounter various pressures and concerns. Additionally, some countries that have not legalized euthanasia have experienced instances of clandestine euthanasia, indicating an immature understanding of euthanasia. This study aims to provide a reference for countries discussing euthanasia legalization by summarizing legal requirements and implementation issues across nations. The article discusses the specific situations of euthanasia in legalized countries, including the Netherlands, Belgium, Luxembourg, Canada, Colombia, Spain, and New Zealand. In these nations, there are differences in euthanasia laws and practices. The Netherlands, Belgium, Luxembourg, Canada, Spain, and New Zealand all have clear euthanasia laws, while Colombia, although not legislated, has legalized euthanasia.
Here are the key points regarding euthanasia in these countries:
● Netherlands: The euthanasia law was passed in 2002, applicable to individuals aged 12 and above, allowing euthanasia for psychological distress.
● Belgium: The euthanasia law was passed in 2002, applicable to individuals of all ages, allowing euthanasia for psychological distress.
● Luxembourg: The euthanasia law was implemented in 2009, applicable to individuals aged 18 and above, allowing euthanasia for psychological distress.
● Belgium: The euthanasia law was passed in 2002, applicable to individuals of all ages, allowing euthanasia for psychological distress.
● Luxembourg: The euthanasia law was implemented in 2009, applicable to individuals aged 18 and above, allowing euthanasia for psychological distress.
● Canada: The law, effective since 2016, applies to individuals aged 18 and above; until March 2023, euthanasia was only allowed for suffering caused by physical illnesses.
● Colombia: The euthanasia law was passed in 2015, applicable to individuals aged 18 and above, with specific execution details yet to be clarified.
● Spain: The euthanasia law began implementation in 2021, applicable to individuals aged 18 and above, allowing euthanasia for psychological distress.
● New Zealand: The euthanasia law began implementation in 2021, applicable to individuals aged 18 and above; currently, euthanasia is only allowed for suffering caused by physical illnesses.
Furthermore, the article analyzes and lists eight important criteria for euthanasia execution:
1. Age range of the target population
2. Expected lifespan under legalized euthanasia
3. Methods and timeframe for expressing euthanasia intentions
4. Consultation with an independent physician
5. Post-reporting system
6. Euthanasia for psychological distress
7. Advance directives for euthanasia
8. Right to object based on moral grounds
2. Expected lifespan under legalized euthanasia
3. Methods and timeframe for expressing euthanasia intentions
4. Consultation with an independent physician
5. Post-reporting system
6. Euthanasia for psychological distress
7. Advance directives for euthanasia
8. Right to object based on moral grounds
These points highlight some key issues in the implementation of euthanasia laws, including age restrictions, reasons for euthanasia, execution procedures, and moral considerations. Overall, countries legalizing euthanasia face a series of challenges in balancing individual rights and societal moral values.
Translation 中文翻譯
本文主要探討積極安樂死的臨床實務問題，特別聚焦於那些已經合法化安樂死的國家。作者通過系統性文獻回顧的方式，分析了 140 份文件，包括文章和法規。他們發現了幾個重要問題：模糊的執行標準、自願性選擇的保證不足、難以應對因內心痛苦而請求安樂死、道德上的矛盾以及醫師的不遵從行為。這些問題反映了安樂死合法化國家在實踐中所面臨的挑戰。荷蘭作為最早實踐安樂死的國家之一，在此領域有著豐富的經驗，但即便如此，醫師仍然面臨著各種壓力和疑慮。此外，一些沒有合法化安樂死的國家也出現了秘密安樂死的情況，這顯示對安樂死的理解尚未成熟。這篇研究希望透過總結各國的法規要求和執行問題，為正在討論安樂死合法化的國家提供參考。 文章中探討了安樂死在已合法化的國家的具體情況，包括荷蘭、比利時、盧森堡、加拿大、哥倫比亞、西班牙和紐西蘭。在這些國家中，安樂死的法律規定和實踐方式存在一些差異。荷蘭、比利時、盧森堡、加拿大、西班牙和紐西蘭都有明確的安樂死法律，而哥倫比亞雖然未通過立法，但已將安樂死合法化。
以下是這些國家的安樂死要點：
● 荷蘭：於 2002 年通過了安樂死法案，適用於 12 歲以上的個人，並允許因精神痛苦而進行安樂死。
● 比利時：於 2002 年通過了安樂死法案，適用於所有年齡的個人，並允許因精神痛苦而進行安樂死。
● 盧森堡：於 2009 年實施了安樂死法案，適用於 18 歲以上的個人，並允許因精神痛苦而進行安樂死。
● 加拿大：於 2016 年生效的法律規定，適用於 18 歲以上的個人，2023 年 3 月以前僅允許身體疾病造成的痛苦而進行安樂死。
● 哥倫比亞：於 2015 年通過了安樂死法案，適用於 18 歲以上的個人，具體執行細節尚未明確。
● 西班牙：於 2021 年開始實施了安樂死法律，適用於 18 歲以上的個人，並允許因精神痛苦而進行安樂死。
● 紐西蘭：於 2021 年開始實施了安樂死法律，適用於 18 歲以上的個人，目前僅允許身體疾病造成的痛苦而進行安樂死。
● 比利時：於 2002 年通過了安樂死法案，適用於所有年齡的個人，並允許因精神痛苦而進行安樂死。
● 盧森堡：於 2009 年實施了安樂死法案，適用於 18 歲以上的個人，並允許因精神痛苦而進行安樂死。
● 加拿大：於 2016 年生效的法律規定，適用於 18 歲以上的個人，2023 年 3 月以前僅允許身體疾病造成的痛苦而進行安樂死。
● 哥倫比亞：於 2015 年通過了安樂死法案，適用於 18 歲以上的個人，具體執行細節尚未明確。
● 西班牙：於 2021 年開始實施了安樂死法律，適用於 18 歲以上的個人，並允許因精神痛苦而進行安樂死。
● 紐西蘭：於 2021 年開始實施了安樂死法律，適用於 18 歲以上的個人，目前僅允許身體疾病造成的痛苦而進行安樂死。
此外，文中分析列舉了八個重要的安樂死執行要件：
1. 目標族群的年齡範圍
2. 安樂死合法下之預期壽命
3. 安樂死意願表達之方法以及期間規範
4. 與獨立醫生進行諮詢
5. 事後報告系統
6. 因精神痛苦進行安樂死
7. 事先對安樂死進行指示
8. 出於道德反對之權利
2. 安樂死合法下之預期壽命
3. 安樂死意願表達之方法以及期間規範
4. 與獨立醫生進行諮詢
5. 事後報告系統
6. 因精神痛苦進行安樂死
7. 事先對安樂死進行指示
8. 出於道德反對之權利
這些要點突出了安樂死法律實施中的一些關鍵問題，包括年齡限制、安樂死的理由、執行程序和道德考量。總體而言，安樂死合法化國家面臨著一系列挑戰，需要平衡個人權利和社會道德價值觀。
CHECK THIS OUT 學習知識點
‘Additionally, some countries that have not legalized euthanasia have experienced instances of clandestine euthanasia, indicating an immature understanding of euthanasia.’
You can see here the use of the present perfect tense. Here we use the present perfect tense because the meaning is the result in the recent unfinished time. There is no information about an actual time in the sentence, so we need to use present perfect.
「此外，一些沒有合法化安樂死的國家也出現了秘密安樂死的情況，這顯示對安樂死的理解尚未成熟。」
你可以看到這裡現在完成式的使用。這裡我們使用現在完成式是因為意思是最近未完成的時間的結果。句子中沒有關於實際時間的資訊，因此要用現在完成式。
‘Columbia: The euthanasia law was passed in 2015’
Here in this sentence we are using the past simple verb tense because there is a date and the date refers to a finished time. Use these two examples to think about the difference between when to use the present perfect, and when to use the past simple.
「哥倫比亞：於 2015 年通過了安樂死法案」
在這句話中，我們使用過去簡單動詞時態，因為有一個日期，而該日期指的是完成時間。使用這兩個例子來思考何時使用現在完成式和何時使用簡單過去式之間的差異。
