自願積極安樂死之合法化—以末期病人為中心

Abstract

從世界各國關於安樂死的立法趨勢上，安樂死問題於法律上之重要性日漸顯著。隨著國內相關社會事件的浮現，縱使爭議不斷，此議題在我國亦日益受到關注與重視。本文之核心問題意識在於，末期病人實行自願積極安樂死之法理基礎與正當性，研究末期病人對於生命可能之自主決定權限，以及於我國法上的容許性。首先，對於安樂死之諸多型態進行定性、分類與解析，釐清其內涵與類型，強調安樂死概念的中性性質。次者，參考外國立法例與判決，針對荷蘭、美國奧瑞岡州與日本的法律與案例作主要研究對象，並觀察我國實務與學說對於安樂死合法化之不同見解。 再次，反思安樂死所涉及之哲學、倫理等問題，從家父長主義、自由主義與國家權力運作，以及醫學倫理等角度進行研析。另外，回到我國法體系上，從憲法學視角尋找自願積極安樂死的正當化基礎，探討生命權、人性尊嚴與個人自主決定權等基本權利的內涵與彼此間的關係。又在我國現行法律下，試圖破除刑法加工自殺罪的處罰依據，以求除罪化之可能性；退步言之，縱保留該條，入罪範圍應加以限縮，抑制國家刑罰權的發動，個人於特殊情形下對於生命法益之處分應為有效，肯認自願積極安樂死之實行，行為人可阻卻違法而不成立犯罪；並提出實質與程序之合法化要件，以及修正建議與未來可能的發展。 本文亦冀能藉由對於安樂死議題之討論與淺析，激發國內社會對於該議題之青睞與關切，進一步喚醒相關問題意識，並進行更深層的探究，期許我國相關法制上，對於人民之權利保障能更加完善。

Following the euthanasia legislation trend all around the world, the importance of euthanasia topics is more prominent than before. Although there are still a lot of controversies, people concern about these topics worldwide. The issues on euthanasia are valued recently in Taiwan as well, while Hospice-Palliative Care Act has come into force for many years, and Patient's Self-determination Right Act has been passed in 2016. The purpose of this thesis is to discuss legalization of voluntary active euthanasia in Taiwanese laws and related criminal issues. The central issue in this thesis is whether terminally ill patients have rights to choose voluntary active euthanasia without any interference or not. First of all, this thesis explains the concept and classification of euthanasia. Secondly, this thesis reviews criminal regulations, judicial judgments, and scholarly papers, and other research on this issue in Netherland, Oregon (a state of the U.S.), Japan, and Taiwan. Then, this thesis develops several philosophical and ethical arguments about euthanasia from different aspects, including paternalism, liberalism, the operation of power of governance as well as medical ethics. Besides, this thesis discovers legalization foundations from the perspective of Constitution of the Republic of China (Taiwan), including right to life, human dignity and individual autonomy. From this viewpoint, the power of national penalty should be limited. Even though article 275 of the Criminal Code of the Republic of China cannot be abolished, this thesis still makes efforts to seek some possible solutions. This thesis deeply agrees that voluntary active euthanasia must be approved in exceptional cases, especially in such circumstances of terminally ill patients. Moreover, this thesis attempts to propose the legitimate conditions and procedure of voluntary active euthanasia. Last but not least, for the sake of protecting and improving individual rights, this thesis provides some solutions to this dilemma and hopes that there will be more research in these issues in the future.