The modern art of dying: The history of euthanasia in America.

摘要

This is a study of the history of euthanasia in the United States. The medical hastening of death was first proposed as a public policy in the late 19th century, long before the technical advances commonly associated with it. The question this dissertation raises is: how did euthanasia emerge as a modern way of dying?;The emergence of euthanasia proceeded from a radical transformation in the way we die, by which care of the dying moved from the domain of religion, through medicine, to the jurisdiction of positive law and public policy. This movement may be seen as an aspect of the rise of technique and the decline of art in our world.;First, with the rise of the Protestant ethic, dying lost its earlier Christian character as a moment of transition between this world and the world to come, and holy dying became an art of holy living culminating in the last hours of life. Second, the position of the priest as minister of salvation at the deathbed was taken over by the physician as minister of medical hope. The physician, who had the duty to care for the dying patient but lacked the means to do so, turned to euthanasia to overcome the hopeless suffering of the dying. Third, to prevent the medical profession from abusing its power, positive law, in the form of state law, assumed the role of regulating medical euthanasia. At the same time, in the first decades of the 20th century, euthanasia came to be seen as an instrument of public policy, part of a range of means by which the State would undertake to manage its biological resources; its reach then extended not only to the dying but also to the "physically disabled" and the "mentally handicapped." The routinization of medically-hastened death and the turn of dying from art to technique, reached a high point, when "lethal dosing"---the administration of sedatives with the intention of relieving pain but with the well-known outcome of hastening death---became widely practiced and not even considered an act of taking life.