從佛教與當代倫理學的對談看佛教對醫助自殺的回應與轉變

Revisiting Buddhist Ethics in the Context of Physician-Assisted Suicide: Insights from the Buddhist and the Ethicist

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

本文以釋昭慧與彼得．辛格的對話為線索，探討佛教倫理對醫助自殺與自願安樂死的回應與轉變。佛教傳統上反對主動終結生命，但在面對不可逆的病痛與個體苦難時，釋昭慧提出應以慈悲為原則，謹慎對待安樂死，並宣導安寧療護等替代方案。她強調臨終“識”的清明對來世影響深遠，且主張在極端情況下，若病人在清明狀態下自願求死，應與一般自殺區分。文章揭示佛教倫理在現代醫療背景下的調適趨勢，提供了新的思考路徑。

This paper, framed by the dialogue between Ven. Shih Chao-hwei and Peter Singer, explores the evolution of Buddhist ethics concerning physician-assisted suicide and voluntary euthanasia. While traditional Buddhism opposes the active termination of life, Ven. Shih Chao-hwei, when faced with irreversible illness and individual suffering, proposed that euthanasia should be approached cautiously, guided by the principle of compassion (karuṇā). She also advocated for alternative solutions such as hospice and palliative care. She emphasised the profound impact on others’ lives of maintaining a lucid consciousness (vijñāna) at the moment of death. In extreme circumstances, she argued, a request for death voluntarily made by a patient in a lucid state should be distinguished from ordinary suicide. This article reveals an adaptive trend in Buddhist ethics within the context of modern medicine, offering new paths for consideration.