| While human dignity is an issue much discussed in philosophy and ethics, the dignity at the final stage of a human life, that is, the death with dignity is scarcely mentioned in the academic community in China. Human dignity is a core element of the world civilization, and the death with dignity is also an important symbol of human civilization. Through the construction of the dignity theory in the context of modern scientific and technological culture and the study of death against the backdrop of modern medicine, this paper attempts to discuss the basic theories of death with dignity against the background of modern medicine and, depending on this, investigates the current situation of the death with dignity of terminal patients.The theoretical significance of this study lies in the fact that by focusing the study of human dignity at the final stage of a human life, it specifies the theoretical discussions in the research of human dignity and fills the gap in the research of dignity in China. The practical significance is to urge the medical community and the society at large to pay attention to the terminal stage of dying patients and give them the death with dignity and also to provide humanistic guidelines and reference for the medical institutions that treat terminal patients with medical interference. In terms of research methodology, the paper uses humanistic medicine approaches including literature analysis, conference seminar and case interview and etc.There is no doubt that dignity is one of the important values pursued by human beings. The word "dignity" is frequently used in people's daily lives. However, there are many arguments about what dignity really is, not only in our day-to-day life but also in strict academic researches, particularly when it comes to phrases like "the death with dignity", the meaning of which needs to be carefully analyzed and clarified. To this end, the first chapter takes a brief review over the developments of the thoughts about human dignity in history. In the eastern and western cultural traditions, there is no lack of mediations on dignity, only in different expressions and ways of thinking. In the western culture, the idea of dignity is often entangled with religious theology, where human characteristics are associated with rationality, while the idea of dignity in the Chinese culture is secular and, more often than not, appeals to humanism. In the course of the development of the thinking on human dignity, the most influential is the teleological dignity proposed by Immanuel Kant, who uses three theoretical pillars, i.e. universal legislation, autonomy of will and "humanity as an end in itself", to prove one of his most famous points, "only morality and the humanity that is compatible with such morality are the things with dignity." From then on, human dignity no longer depends on the benediction of God; instead, it can find a place inside the human beings themselves. Kant's thought on dignity has become one the three most important sources of German ideas about human dignity and one of the origins of the contemporary constitutional dignity.With the development of modern science and technology, modern civilization has had a tremendous impact on human dignity. On the one hand, in modern medical science and technology, the concept of "dignity" is often used to demonstrate the acceptability of technologies and almost all kinds of discussions on ethics of applying modern medical technologies are related with dignity. On the other hand, in order to share the technological advancement, people may compromise in the face of the technologies that threaten human dignity. In its effort to analyze and explore this impact with seriousness, this article constructs new theories for the concept of "dignity" in the context of modern culture of medical science and technology. This task is important not only because it is necessary for addressing the issue in question, but also because it responds to the abandonment of "dignity" advocated by some moralists, who claim that the concept of "dignity" contains no more meanings than the respect for humans or human autonomy and therefore should be discarded. This has triggered debates in the academic community. The paper maintains that the concept of "dignity" has three important values in that it 1) reflects some important values indescribable with human languages,2) remains the core value of bioethics, and 3) represents the endeavor that human beings make in fighting the abuse of instrumental rationality and preventing the alienation of human nature. However, this analysis is made in the sense of logics. A better response to counter the point presented by those moralists would be the clarification of the concept of "dignity". The paper holds that in the context of modern science and technology, the connotation and denotation of "dignity" are crystal clear:Dignity refers to the combination of self-esteem and other-esteem, the respect and care by oneself and others, whose essence is the social relationship that marks the subject's identity attributes. Social relationship refers to the treatment that the subject receives in certain social relations as a result of his or her status and also includes his or her own attitude or behavior towards him- or herself. Social relationship reflects the nature of the subject's social relations with others, as well as other people's attitude and behavior towards the subject. The interpretation of dignity as essentially the "social relationship that signifies the subject's identity attributes" is an original idea both in philosophy and ethics. This definition differentiates "the dignity that one should have" from "the meaning of dignity", which prevents confusion in using the concept of "dignity" and also tentatively answers the question as to "whether a dying person has dignity".The construction of theories of "dignity" against the backdrop of modern science and technology provides a solid theoretical foundation for the "death with dignity in the context of modern medicine". Nevertheless, the dispute about the death with dignity centers on three aspects,1) the relationship between death and dignity,2) the possibility of objective discussion about the death with dignity, and 3) the impact on the medical staff if the issue of the death with dignity exists at all. Western scholars have carried out some in-depth debates on the three questions, which shows that the problem concerning the death with dignity has already become a serious academic matter in the west. To make a clearer assertion of the importance of this issue, the paper summarizes three significances of the death with dignity:first, the death with dignity is an integral part of the dignity of life; second, from the patient's perspective, death with dignity means good death, the death without pain or insult; finally, from the patient's family's perspective, death with dignity is a soothing and psychological comfort. As for the connotation of the "death with dignity", the paper maintains that, in a strict sense, the death with dignity is a universal philosophy, more than the idea associated with the death of terminal patients in the context of modern medicine. As a philosophy of life, the death with dignity is also a part of the dignity of life. As a daily philosophy in general, the death with dignity is "the respect and care by oneself and others as a result of the death of the subject. Its essence is the social relationship that marks the subject's identity attributes." For better understanding, it is necessary to differentiate "the dignity of the manner of death" from "the dignity of sacrifice", the two very close but different kinds of dignity. Meanwhile, such interpretation reveals that the death with dignity is a value chosen by the subject of his or her own will. In general, other people and the society cannot grant the subject with the death with dignity, but can diminish or protect his or her death with dignity by means of humiliation or the avoidance of it in the course of the subject's death. Therefore, "the death with dignity in the context of modern medicine" can be understood as "the respect and care by oneself or others in the course of one's death, including the dignity that one acquires through one's willpower or others avoiding exerting humiliation. Essentially, it is the social relationship that marks the subject's identity attributes." Based on this definition, we can identify the value of the life-sustaining treatment, understand the difference between delayed death and natural death and their respective significance, recognize the dignity of the patient that depends on life-sustaining treatment, analyze the issue of dignity concerning invasive therapy for terminal patients and take a further step to make the basic proposition of the death with dignity in the context of modern medicine.In the reality of the death with dignity, the patient's pursuit of dignity often takes the form of suicide and euthanasia. However, because of the alienation of modern medicine and familism, the subject position of terminal patients in China is reduced, which means patients have no control over their own destiny, giving rise to a diminished dignity. In this context, the discussion of the relations between the suicide of terminal patients, hospice and euthanasia and the death with dignity is more pertinent. The paper maintains that suicide, hospice and euthanasia can be seen as the three options for terminal patients to assert their dignity. It should be noted that not all patients that kill themselves can acquire the death with dignity. While the suicide that ends the uncontrollable physical and mental pain is the effort to honor the death with dignity, the suicide because of social, familial or financial reasons is yet to be determined as to whether it can result in the death with dignity. Compared with suicide, hospice and euthanasia, in theory, are better options for patients. The two concepts have a lot in common. Although euthanasia is not widely accepted in China due to the traditional mindset and the legislation, both approaches lead to the same goal of maintaining the terminal patient's death with dignity.In the context of modern medicine, the pursuit of the death with dignity is a value that the human beings choose in the face of death under the influence of certain concepts or ideas which will determine the prospect of the death with dignity in the future times. The developments of the death with dignity in the future depend on two important concepts, the "whole person" and the "good death". "Whole person" considers a person an existence of multiple dimensions. "Good death" means peaceful death without pain at the time of dying or any distress that has not been suffered prior to the moment of death, particularly chronicle distress. The significance of the concepts of whole person and good death lies in the care for human existence and the acceptance of death. The future medicine will not only focus on its endeavor for human existence but also the effort in answering the question as to what kind of existence it is. This will make the doctors and the medicine more humane and humanistic. The future medicine will consider death not only an evil, but also a good for a person, if the person's life ceases being productive or meaningful and such existence brings nothing but pain and indignity to the person. |
PDF Full Text Request