從「安寧療護」與「病人自主權利」探討「孝德」與「善終」的生命意義

The Study on the Meaning in Life for Filial Piety and Good Death Based on Palliative Care and Patient Autonomy Rights

李春南(Lee, Chun-Nan)

孝德 ； 善終 ； 安寧療護 ； 病人自主權 ； Filial Piety ； Good Death ； Palliative Care ； Patient Autonomy Rights

生死學研究

24期（2024 / 06 / 01）

37 - 63

繁體中文;英文

孝是眾善之始，源起於上古時期人們避禍、祈福與祭祀活動，具有濃厚的原始宗教色彩。道是德的本體，德是道的作用，「孝德」的展現可區分為「生養」和「死祭」兩種，生養大體為指父母健在時，為人子女所給予細膩體貼的照顧，死祭則為父母離世後給予的風光大葬，或者是有尊嚴和溫度的喪禮。學者黃光國提出研究儒家傳統時，必須先進行文化定位，若要理解儒家文化關係的各個層面，則研究的範圍不能僅侷限於儒家，而必須擴及佛教，且須考量儒家倫理的形上學基礎。因此，本文以儒佛會通的角度，從現代「安寧療護」與「病人自主權利」的內涵，探討「孝德」與「善終」的生命意義與終極價值。死亡或是我們人生最大的布施，也是此生最深奧學習的最後一門課，但是為人子女在面臨臨終病患的親人，抉擇是否要採取積極性的搶救與治療時，往往面臨「死孝」與「善終」的決定壓力而身心兩難，因為對每個人而言，如何善終是人生最為重要的功課。因此，對於臨終病患身、心、靈的關懷與醫療，如何減少對親人無意義的侵入性治療，如何尊重親人的生命尊嚴，如何破除「我執」與如何透過「靈性」與「覺性」的照顧，達到此生最後一次生死兩無憾的「安寧解脫」機會，或許從儒佛思想的角度思考，透過「安寧療護」與「病人自主權利」探討「孝德」與「善終」的精神與意義，也是一件自利利他與立德、積德、宏德的人生事業。

Filial piety is the beginning of all goodness. It originates in ancient times when people avoid disasters, pray for blessings and perform rituals, and has a strong primitive religious flavour. The Tao is the essence of virtue, and virtue is the function of the Tao. The manifestation of filial piety can be divided into living and death rites, with living filial piety referring to the delicate and considerate care to their parents when they are still alive, and death filial piety referring to their parents after they have passed away. In order to understand the various aspects of the integration of Confucianism and Buddhism culture, this paper concentrates the study on the meaning in life for filial piety and good death covering the scope of Palliative Care and Patient Autonomy Rights. Death is the greatest donation we can give in life, and it is also the most profound lesson we can learn. However, when we are faced with the decision of whether or not to take active actions to save and treat their loved ones who are dying, they are often faced with the pressure of deciding between "death filial piety" and "a good death", because for everyone, the latter is the most important lesson in life. Therefore, for the care and medical treatment of the body, mind and soul of the terminal patients, how to reduce meaningless invasive treatment of the loved ones, how to respect the dignity of the loved ones' lives, how to break the "ego-grasping" and how to achieve the last chance of "palliative liberation" without regret in life and death through "spiritual" and "conscious" care, perhaps from the perspective of both Confucianism and Buddhism, to explore the spirit and meaning of "filial piety" and "good death" through "palliative care and Patient Autonomy Rights" is also a self-interest and altruistic behavior, as well as to build up virtue, accumulate merit and carry forward virtue.