生命結束的挑戰──Zimowski總主教 網站站長 2010-09-14 12:15:07
安樂死宣言的臨終牧靈關懷〈中英文版〉
〈Zimowski 總主教
pastorat care at the end of life, in the light of
the Declaration on Euthanasia, Taipei. 12 September 2010〉
引 言
週年慶在家庭生活中是很重要的，在天主教的家庭、教會裡也不例外。今年，天主教會慶祝信仰教義聖會有關安樂死問題宣言30週年。這對我來說也很重要，教宗本篤當時是主管那盛會的樞機主教，他那時和現在一樣有巨大的智慧，深刻的信仰及謙遜，能夠與他工作及向他學習是件很歡樂的事。他持續的教導說，人的生命是神聖的，從胎始到自然死亡。這是一個自然法的真理而不是依賴大多數人的意見或者是個人的信仰。生命是一個禮物。任何人不得隨意處置它。
梵蒂岡第二大會在牧法Gaudium et spes裡，已針對侵犯“人的生命”這美好禮物，各種罪行加以譴責。例如任何形式的謀殺、種族滅絕、墮胎、安樂死或故意自殺。(Pastoral constitution et Spes, 27)
1980年5月5日，信仰教義聖會（安樂死的宣言）從基督信仰教義的角度針對安樂死作了詮釋。此文件的第一重點是針對所有那些把信仰和希望寄於基督者。因他通過用自己的生命，死亡和復活，給我們一個新的存在的意義，尤其每一個基督徒死亡的意義。正如聖保祿寫道：“因為我們或者生，是為主而生，或者死，是為主而死；所以我們或生或者死，都是屬於主。” (Rom 14:8)
生命的價值
該文件指出，人的生命，是所有善良的基礎，也是每一個人和所有的社會活動的必要條件與來源。大多數的人認為生命是神聖的，因此任何人不得隨意處置它。但信徒視生命為更偉大， 那就是天主愛的禮物，被委託保存和使它有成果。因此，沒有人可以試圖剝奪一個無辜人的生命而不妨礙上主對那個人的愛，不違反人的基本權利，不犯下極其嚴重的罪行。故意造成自己死亡，或自殺 是等同於謀殺 一樣的錯誤行為。這種行為是被視為拒絕上主的主權和愛心計劃。此外，自殺往往也是一個拒絕愛自己的行為，否定自然求生的本能，逃避執行正義的義務和虧欠愛鄰人、社區或整個社會。雖然，正如普遍承認，人有時因心理因素，而減低甚至完全去除目前的責任。 但是，人必須明確區分自殺跟為了更高的使命而犧牲自己的生命，如為了天主的榮耀，拯救靈魂，或服務同胞而犧牲自己的生命，或處之於危險。(cf.Jn.15:14)
安樂死的意義
安樂死是被理解為一個行動或疏忽，因本身或由意圖造成死亡，使所有的痛苦可能以這種方式被消除。安樂死的條件因此是建立在蓄意與其使用的方法。在這裡有必要重申，沒有人能以任何方式允許殺害無辜的人，無論是胎兒或胚胎，嬰兒或成年人，老年人或一個身患不治之症，或瀕臨死亡的人。這些要點都在教宗若望保祿二世的預言性通諭中Evangelium vitae重申過。我們敬愛的教宗非常關注在當代文化裡，人們的態度是認為他們可以控制生命和把死亡的決定權掌握在他們自己手中。 “實際上真正發生的案例是該人被死亡壓倒和碾碎而剝奪了任何有意義或希望的前景。我們看到這一切悲慘的場景在於安樂死的傳佈-掩飾和祕密的，或公開實施，甚至是合法的。因目睹 病人的痛苦而 誤導錯誤的憐憫為理由，安樂死有時被實利主義者辯解其正當性。其動機是為了避免無任何回報的投資和社會的負擔。因此，建議消滅畸形嬰兒，嚴重殘疾人，老年人，尤其當他們不能自理時，和身患絕症的人“(EV, 15)。
這種行為是不能接受的，天主教會的教義問答書簡潔的指出“無論其動機和手段，直接安樂死，包括結束殘疾、生病、或瀕死者的生命，在道義上是不可接受的。因此， 一個行動或不行動，因本身或由意圖造成死亡以消除痛苦，是已構成謀殺，且嚴重的違反人的尊嚴，及生命的創造者，生活的天主應得的尊嚴”。
苦痛及止痛藥的使用對基督徒的意義
依據宣言，苦痛就基督宗教的教誨而言，特別是在生命最後的那一剎那，在天主的救贖計劃中佔有特別的地位。苦痛其實是分享耶穌的熱情及結合祂遵循天父的旨意所做的犧牲救贖(Cfr. Salvific Doloris, 18-24) 。因此，不用驚奇有些基督徒自我節制止痛藥的使用，而自願接受部份苦痛藉此有意識的參與基督為了人類被釘在十字架上的痛苦(cf. Mt. 27:34)。然而將此英勇行為化為常規是不智的。相反的，人們及基督徒審慎的建議部分病人可用藥物來減緩痛苦，即使藥物副作用可能會使病人的神智混淆及降低意志清晰。就那群無法表達自我的病人來說，我們可以合理的假設他們希望在醫師的建議下服用止痛藥物。但重劑量的止痛藥物使用並非沒有問題-如同教義信仰部的文件所申明的-成癮現象常會造成病患必須增加藥物的劑量來維持相同的效力。就這點而言，安樂死宣言在教宗碧岳十二世當時所宣導。那時，一群醫師提問：醫師及病人使用會抑制疼痛及降低意識的麻醉劑是否被宗教及道德規範所允許，（即使是病人已正邁向死亡或是預期使用麻醉劑會減短生命）。教宗回答道：若沒有其他的方法，在特殊的情境下，使用麻醉劑若不妨礙其他宗教或道義的話：是被允許的。〔ADDRESS of February 24,1957:AAS 49(1957), P. 147.〕在這種情境下，即使使用麻醉劑有合理的的危險性，死亡並非是刻意造成或是追求的，使用止痛藥的目的是要有效的緩解疼痛，但是對於那些會造成昏迷的止痛藥則需要特別的考量。身為人除了要盡到道德責任及家庭義務外，他還必須完全清醒的準備好自己，去見主耶穌。依此教宗警告：在缺乏正當的理由下，剝奪瀕死的人的神智是不對的。〔 Pius XII, Ibid, p. 145;cf. ADDRESS of September 9,1958: AAS 50(1958)., p.694〕〕.
結論
三十年前所發表的安樂死宣言中的原則對現代人仍很切題，不論他們是否信徒。他們被感召，真誠的渴望，依造物主的計畫而服務人群。生命是上主賜給我們的禮物，但另一方面死亡是無可避免的，且重要的是我們不能催促生命的結束，而是要負責的、有尊嚴的面對它。沒有錯死亡代表我們在地球上存在的一個結束，但同時它也為永生開啟了另一扇門。因此就生命的價值來說，每個人都應該準備迎接死亡，身為基督信徒更應為如此。
對醫療工作者而言，此份聲明表示：他們應該絕不忽視提供他們的專業技能，給生病者及瀕死者，同時也要記住，更重要的是給予他們無限的仁慈及衷心的仁愛。服侍人如同服侍主耶穌，如同主耶穌所說的: 「凡你們對我這些最小兄弟中的一個所做的，就是對我做」 。(Mt. 25:24)
親愛的朋友：
我們必須尊敬安樂死宣言中的原則，以期建立起一個熱情與正義的社會。讓我們記得病患所需要的，除了醫療照顧外，還有愛。人的愛與主的愛，應溫馨的環繞著病人、家屬、醫師與護士，及所有醫療照護的人。
謝謝大家的聆聽！
From: Archbishop Zimowski
President of the Pontifical Council
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〈英文版〉
Pastoral care at the End of Life, in the Light of the Declaration on Euthanasia
By Archbishop Zimowski
President of the Pontifical Council
9/12/2010
Introduction
•
• Anniversaries are important in the life of any family. In the church, which is the family of God, this is no exception. This year, we in the Catholic Church celebrate the 30th anniversary of the important of the congregation for the Doctrine of the Faith on the problem of euthanasia. It’s important to me as well in a personal way, because this document (Doctrine of the Faith on the problem of euthanasia) was published by the Congregation for the Doctrine of the Faith only about 2 years before I arrived there to begin my work for the then Perfect of the Congregation, Joseph Ratzinger. My memories of those years are filled with pleasant recollections. As Cardinal Perfect of the “Holy Office”, Pope Benedict was as he is now – a man of such great intelligence, profound faith & humility that it is always a great pleasure to work with, and to learn from him. He continues to teach that human life is sacred, from conception to natural death This is a truth of the natural law, and not dependent on the opinion of the majority or any personal belief. Life is a gift. No one may dispose of it at will
•
• Already the Second Vatican Council in the Pastoral Constitution, Gaudium et spes, had condemned different crimes against the beautiful gift of human life: crimes such as “any type of murder, genocide, abortion, euthanasia, or willful suicide” (Pastoral Constitution Gaudium et Spes, 27)
•
• On May 5, 1980, the Congregation for the Doctrine of the Faith addressed the specific problem of euthanasia (Declaration on Euthanasia) from the perspective of Christian doctrine
• The considerations set forth in this document were directed in the first place to all those who place their faith and hope in Christ, who, through His life, death and resurrection, has given a new meaning to our existence and especially to the death of every Christian
• As Saint Paul writes: “If we live, we live to the Lord, and if we die, we die to the Lord” (Rom 14:8)
The Value of Human Life
The document states that human life is the basis of all goods, and is the necessary source and condition of every human activity and of all society. Most people regard life as something sacred and hold that no one may dispose of it at will, but believers see in life something greater, namely, a gift of God’s love, which they are called upon to preserve and make fruitful. Therefore no one can make an attempt on the life of an innocent person without opposing God’s love for that person, without violating a fundamental right, and therefore without committing a crime of the utmost gravity. To intentionally cause one’s own death, or suicide, is therefore as equally wrong as murder; such an action on the part of a person is to be considered as a rejection of God’s sovereignty and loving plan. Furthermore, suicide is also often a refusal of love for self, the denial of a natural instinct of live, a flight from the duties of justice and charity owed to one’s neighbor, to various communities or to the whole of society – although, as is generally recognized, at times there are psychological factors present that can diminish responsibility or even completely remove it. However, one must clearly distinguish suicide from that sacrifice of one’s life whereby for a higher cause, such as God’s glory, the salvation of souls or the service of one’s brethren, a person offers his or her own life or puts it in danger (cf.Jn. 15:14).
The Meaning of Euthanasia
By euthanasia, therefore, is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Authanasi’s terms of reference, therefore, are to be found in the intention of the will and in the methods used. It is necessary to repeat once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.
These points were all reiterated by Pope John Paul II in his prophetic Encyclical Evangelium vitae. Our beloved Pope was very concerned by what the attitude he saw in contemporary culture which leads people to think that they can control life and death by talking the decisions about them into their own hands. “What really happens in this case is that the individual is overcome and crushed by a death deprived of any prospect of meaning or hope. We see a tragic expression of all this in the spread of euthanasia – disquised and surreptitious, or practiced openly and even legally. As well as for reasons of a misguided pity at the sight of the patient’s suffering, euthanasia is sometimes justified by the utilitarian motive of avoiding costs which bring no return and which weight heavily on society. Thus it is proposed to eliminate malformed babies, the severely handicapped, the disabled, the elderly, especially when they are not self-sufficient, and the terminally ill” (EV, 15).
The unacceptability of these actions is stated very succinctly in the Catechism of the Catholic Church (N. 2277): “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.”
安樂死宣言的臨終牧靈關懷〈中英文版〉
〈Zimowski 總主教
pastorat care at the end of life, in the light of
the Declaration on Euthanasia, Taipei. 12 September 2010〉
引 言
週年慶在家庭生活中是很重要的，在天主教的家庭、教會裡也不例外。今年，天主教會慶祝信仰教義聖會有關安樂死問題宣言30週年。這對我來說也很重要，教宗本篤當時是主管那盛會的樞機主教，他那時和現在一樣有巨大的智慧，深刻的信仰及謙遜，能夠與他工作及向他學習是件很歡樂的事。他持續的教導說，人的生命是神聖的，從胎始到自然死亡。這是一個自然法的真理而不是依賴大多數人的意見或者是個人的信仰。生命是一個禮物。任何人不得隨意處置它。
梵蒂岡第二大會在牧法Gaudium et spes裡，已針對侵犯“人的生命”這美好禮物，各種罪行加以譴責。例如任何形式的謀殺、種族滅絕、墮胎、安樂死或故意自殺。(Pastoral constitution et Spes, 27)
1980年5月5日，信仰教義聖會（安樂死的宣言）從基督信仰教義的角度針對安樂死作了詮釋。此文件的第一重點是針對所有那些把信仰和希望寄於基督者。因他通過用自己的生命，死亡和復活，給我們一個新的存在的意義，尤其每一個基督徒死亡的意義。正如聖保祿寫道：“因為我們或者生，是為主而生，或者死，是為主而死；所以我們或生或者死，都是屬於主。” (Rom 14:8)
生命的價值
該文件指出，人的生命，是所有善良的基礎，也是每一個人和所有的社會活動的必要條件與來源。大多數的人認為生命是神聖的，因此任何人不得隨意處置它。但信徒視生命為更偉大， 那就是天主愛的禮物，被委託保存和使它有成果。因此，沒有人可以試圖剝奪一個無辜人的生命而不妨礙上主對那個人的愛，不違反人的基本權利，不犯下極其嚴重的罪行。故意造成自己死亡，或自殺 是等同於謀殺 一樣的錯誤行為。這種行為是被視為拒絕上主的主權和愛心計劃。此外，自殺往往也是一個拒絕愛自己的行為，否定自然求生的本能，逃避執行正義的義務和虧欠愛鄰人、社區或整個社會。雖然，正如普遍承認，人有時因心理因素，而減低甚至完全去除目前的責任。 但是，人必須明確區分自殺跟為了更高的使命而犧牲自己的生命，如為了天主的榮耀，拯救靈魂，或服務同胞而犧牲自己的生命，或處之於危險。(cf.Jn.15:14)
安樂死的意義
安樂死是被理解為一個行動或疏忽，因本身或由意圖造成死亡，使所有的痛苦可能以這種方式被消除。安樂死的條件因此是建立在蓄意與其使用的方法。在這裡有必要重申，沒有人能以任何方式允許殺害無辜的人，無論是胎兒或胚胎，嬰兒或成年人，老年人或一個身患不治之症，或瀕臨死亡的人。這些要點都在教宗若望保祿二世的預言性通諭中Evangelium vitae重申過。我們敬愛的教宗非常關注在當代文化裡，人們的態度是認為他們可以控制生命和把死亡的決定權掌握在他們自己手中。 “實際上真正發生的案例是該人被死亡壓倒和碾碎而剝奪了任何有意義或希望的前景。我們看到這一切悲慘的場景在於安樂死的傳佈-掩飾和祕密的，或公開實施，甚至是合法的。因目睹 病人的痛苦而 誤導錯誤的憐憫為理由，安樂死有時被實利主義者辯解其正當性。其動機是為了避免無任何回報的投資和社會的負擔。因此，建議消滅畸形嬰兒，嚴重殘疾人，老年人，尤其當他們不能自理時，和身患絕症的人“(EV, 15)。
這種行為是不能接受的，天主教會的教義問答書簡潔的指出“無論其動機和手段，直接安樂死，包括結束殘疾、生病、或瀕死者的生命，在道義上是不可接受的。因此， 一個行動或不行動，因本身或由意圖造成死亡以消除痛苦，是已構成謀殺，且嚴重的違反人的尊嚴，及生命的創造者，生活的天主應得的尊嚴”。
苦痛及止痛藥的使用對基督徒的意義
依據宣言，苦痛就基督宗教的教誨而言，特別是在生命最後的那一剎那，在天主的救贖計劃中佔有特別的地位。苦痛其實是分享耶穌的熱情及結合祂遵循天父的旨意所做的犧牲救贖(Cfr. Salvific Doloris, 18-24) 。因此，不用驚奇有些基督徒自我節制止痛藥的使用，而自願接受部份苦痛藉此有意識的參與基督為了人類被釘在十字架上的痛苦(cf. Mt. 27:34)。然而將此英勇行為化為常規是不智的。相反的，人們及基督徒審慎的建議部分病人可用藥物來減緩痛苦，即使藥物副作用可能會使病人的神智混淆及降低意志清晰。就那群無法表達自我的病人來說，我們可以合理的假設他們希望在醫師的建議下服用止痛藥物。但重劑量的止痛藥物使用並非沒有問題-如同教義信仰部的文件所申明的-成癮現象常會造成病患必須增加藥物的劑量來維持相同的效力。就這點而言，安樂死宣言在教宗碧岳十二世當時所宣導。那時，一群醫師提問：醫師及病人使用會抑制疼痛及降低意識的麻醉劑是否被宗教及道德規範所允許，（即使是病人已正邁向死亡或是預期使用麻醉劑會減短生命）。教宗回答道：若沒有其他的方法，在特殊的情境下，使用麻醉劑若不妨礙其他宗教或道義的話：是被允許的。〔ADDRESS of February 24,1957:AAS 49(1957), P. 147.〕在這種情境下，即使使用麻醉劑有合理的的危險性，死亡並非是刻意造成或是追求的，使用止痛藥的目的是要有效的緩解疼痛，但是對於那些會造成昏迷的止痛藥則需要特別的考量。身為人除了要盡到道德責任及家庭義務外，他還必須完全清醒的準備好自己，去見主耶穌。依此教宗警告：在缺乏正當的理由下，剝奪瀕死的人的神智是不對的。〔 Pius XII, Ibid, p. 145;cf. ADDRESS of September 9,1958: AAS 50(1958)., p.694〕〕.
結論
三十年前所發表的安樂死宣言中的原則對現代人仍很切題，不論他們是否信徒。他們被感召，真誠的渴望，依造物主的計畫而服務人群。生命是上主賜給我們的禮物，但另一方面死亡是無可避免的，且重要的是我們不能催促生命的結束，而是要負責的、有尊嚴的面對它。沒有錯死亡代表我們在地球上存在的一個結束，但同時它也為永生開啟了另一扇門。因此就生命的價值來說，每個人都應該準備迎接死亡，身為基督信徒更應為如此。
對醫療工作者而言，此份聲明表示：他們應該絕不忽視提供他們的專業技能，給生病者及瀕死者，同時也要記住，更重要的是給予他們無限的仁慈及衷心的仁愛。服侍人如同服侍主耶穌，如同主耶穌所說的: 「凡你們對我這些最小兄弟中的一個所做的，就是對我做」 。(Mt. 25:24)
親愛的朋友：
我們必須尊敬安樂死宣言中的原則，以期建立起一個熱情與正義的社會。讓我們記得病患所需要的，除了醫療照顧外，還有愛。人的愛與主的愛，應溫馨的環繞著病人、家屬、醫師與護士，及所有醫療照護的人。
謝謝大家的聆聽！
From: Archbishop Zimowski
President of the Pontifical Council
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〈英文版〉
Pastoral care at the End of Life, in the Light of the Declaration on Euthanasia
By Archbishop Zimowski
President of the Pontifical Council
9/12/2010
Introduction
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• Anniversaries are important in the life of any family. In the church, which is the family of God, this is no exception. This year, we in the Catholic Church celebrate the 30th anniversary of the important of the congregation for the Doctrine of the Faith on the problem of euthanasia. It’s important to me as well in a personal way, because this document (Doctrine of the Faith on the problem of euthanasia) was published by the Congregation for the Doctrine of the Faith only about 2 years before I arrived there to begin my work for the then Perfect of the Congregation, Joseph Ratzinger. My memories of those years are filled with pleasant recollections. As Cardinal Perfect of the “Holy Office”, Pope Benedict was as he is now – a man of such great intelligence, profound faith & humility that it is always a great pleasure to work with, and to learn from him. He continues to teach that human life is sacred, from conception to natural death This is a truth of the natural law, and not dependent on the opinion of the majority or any personal belief. Life is a gift. No one may dispose of it at will
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• Already the Second Vatican Council in the Pastoral Constitution, Gaudium et spes, had condemned different crimes against the beautiful gift of human life: crimes such as “any type of murder, genocide, abortion, euthanasia, or willful suicide” (Pastoral Constitution Gaudium et Spes, 27)
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• On May 5, 1980, the Congregation for the Doctrine of the Faith addressed the specific problem of euthanasia (Declaration on Euthanasia) from the perspective of Christian doctrine
• The considerations set forth in this document were directed in the first place to all those who place their faith and hope in Christ, who, through His life, death and resurrection, has given a new meaning to our existence and especially to the death of every Christian
• As Saint Paul writes: “If we live, we live to the Lord, and if we die, we die to the Lord” (Rom 14:8)
The Value of Human Life
The document states that human life is the basis of all goods, and is the necessary source and condition of every human activity and of all society. Most people regard life as something sacred and hold that no one may dispose of it at will, but believers see in life something greater, namely, a gift of God’s love, which they are called upon to preserve and make fruitful. Therefore no one can make an attempt on the life of an innocent person without opposing God’s love for that person, without violating a fundamental right, and therefore without committing a crime of the utmost gravity. To intentionally cause one’s own death, or suicide, is therefore as equally wrong as murder; such an action on the part of a person is to be considered as a rejection of God’s sovereignty and loving plan. Furthermore, suicide is also often a refusal of love for self, the denial of a natural instinct of live, a flight from the duties of justice and charity owed to one’s neighbor, to various communities or to the whole of society – although, as is generally recognized, at times there are psychological factors present that can diminish responsibility or even completely remove it. However, one must clearly distinguish suicide from that sacrifice of one’s life whereby for a higher cause, such as God’s glory, the salvation of souls or the service of one’s brethren, a person offers his or her own life or puts it in danger (cf.Jn. 15:14).
The Meaning of Euthanasia
By euthanasia, therefore, is understood an action or an omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated. Authanasi’s terms of reference, therefore, are to be found in the intention of the will and in the methods used. It is necessary to repeat once more that nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying.
These points were all reiterated by Pope John Paul II in his prophetic Encyclical Evangelium vitae. Our beloved Pope was very concerned by what the attitude he saw in contemporary culture which leads people to think that they can control life and death by talking the decisions about them into their own hands. “What really happens in this case is that the individual is overcome and crushed by a death deprived of any prospect of meaning or hope. We see a tragic expression of all this in the spread of euthanasia – disquised and surreptitious, or practiced openly and even legally. As well as for reasons of a misguided pity at the sight of the patient’s suffering, euthanasia is sometimes justified by the utilitarian motive of avoiding costs which bring no return and which weight heavily on society. Thus it is proposed to eliminate malformed babies, the severely handicapped, the disabled, the elderly, especially when they are not self-sufficient, and the terminally ill” (EV, 15).
The unacceptability of these actions is stated very succinctly in the Catechism of the Catholic Church (N. 2277): “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.”
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