當代生物科技與醫療的快速進步，使人類生活產生了重大改變。例如民國40年台灣婦女平均壽命是56.33歲，104年已延長至83.62歲。或者又如在二十世紀前半葉，美國人若去世多半發生在家中，但是1987年美國的死亡人口中，有75%是在醫院或長照中心往生，而如今就更多了。
活得更久、直到臨終都不乏醫療照護，聽起來很吸引人，但是這些改變是好的嗎？「有位老校長7、8年來靠呼吸器維生，飽受無效醫療的折磨，子女為領校長18%利息的退休俸，活愈久領愈多，硬是不讓老人安寧善終...」看來，若我們沒有權利拒絕醫療，活得久未必是件好事。再來，考慮這段報導 : 「前日6位死囚伏法，其中一位希望「捐出器官」贖罪，但法務部在記者會上正式聲明，未來都不會再讓死刑犯器捐，此話一出引發醫界反彈...」若摘除器官時我們還不能確定囚犯已經腦死，進行死囚器捐手術的醫院就有活摘人體器官之嫌。但是拒絕死囚器捐，看在搶救病患生命的醫生和盼望活下去的病人眼裡，真的不是很好受。
人都有面臨生死關頭的一天，你有沒有想過自己或家人某天也可能遇到這些問題？生物科技與醫療的進步給人「能夠繼續活下去」的希望，卻也產生許多倫理和法律上的爭議。除了臨終前的決定、器官捐贈，醫學倫理還包括了這些議題 : 墮胎、安樂死、醫療抉擇遺囑、醫療資源分配、人體生物基因資料庫之建立等。這門課將介紹這些議題為何有爭議性、不同的立場有什麼樣的蘊含、哲學家如何針對這些立場做分析、這些分析有沒有道理。我們將從個人角度，例如身為病患或醫護人員，以及社會政策層面，來看這些問題。透過這門課，你也可以好好思考這些悠關個人生死和國家政策的重要問題 : 你應該採取什麼樣的立場？你有什麼理由支持你的主張？

The rapid progress of contemporary biotechnology and medical treatment has brought about major changes in human life. For example, in the 40 years of the Republic of China, the average life expectancy of Taiwanese women was 56.33 years, which has been extended to 83.62 years in 104 years. Or another example: In the first half of the 20th century, most deaths in the United States occurred at home. However, in 1987, 75% of deaths in the United States occurred in hospitals or long-term care centers. Today, even more deaths occur.
Living longer and having medical care until the end of life sounds appealing, but are these changes good? "There is an old principal who has lived on a respirator for 7 or 8 years and suffered from ineffective medical treatment. His children are receiving the principal's retirement salary with 18% interest. The longer they live, the more they receive. They insist on not letting the old man die in peace..." It seems that if we have no right to refuse medical treatment, living a long life may not be a good thing. Next, consider this report: "The day before yesterday, six death row inmates were sentenced to death. One of them wanted to "donate his organs" to atone for his sins. However, the Ministry of Justice officially stated at a press conference that it would no longer allow death row inmates to donate organs in the future. This statement triggered a backlash from the medical community..." If we are not sure that the prisoner is brain-dead when the organs are removed, the hospital that performs organ donation surgery on death row inmates is suspected of harvesting human organs from alive. But refusing to donate organs from death row inmates is really not a good feeling in the eyes of the doctors who save the patients' lives and the patients who want to live.
Everyone will face a life or death crisis one day. Have you ever thought that you or your family may encounter these problems one day? Advances in biotechnology and medical treatment have given people hope of "continuing to live," but they have also given rise to many ethical and legal controversies. In addition to end-of-life decisions and organ donation, medical ethics also includes these issues: abortion, euthanasia, medical decision-making wills, allocation of medical resources, establishment of human biological genetic database, etc. This course will introduce why these issues are controversial, what are the implications of different positions, how philosophers analyze these positions, and whether these analyzes are reasonable. We will look at these issues from a personal perspective, as a patient or healthcare worker, as well as from a social policy perspective. Through this course, you can also think carefully about these important issues related to personal life and death and national policy: What position should you take? What reasons do you have to support your claim?

The Blackwell Guide to Medical Ethics, edited by Rosamond Rhodes, Leslie P. Francis, and Anita Silvers. Blackwell Publishing (2007).

The Blackwell Guide to Medical Ethics, edited by Rosamond Rhodes, Leslie P. Francis, and Anita Silvers. Blackwell Publishing (2007).