复旦研究生英语Unit Seven
- 格式:docx
- 大小:30.51 KB
- 文档页数:5
Doctor’s Dilemma: Treat or Let Die?Medical advances in wonder drugs, daring surgical procedures, radiation therapies, and intensive-care units have brought new life to thousands of people. Yet to many of them, modern medicine has become a double-edged sword.特效药、冒险的手术、放疗以及重症监护等方面医学进步使成千上万人获得了新生。
然而,对于多数人来说,现代医学成了一把双刃剑。
Doctor’s power to treat with an array of space-age techniques has outstripped the body’s capacity to heal. More medical problems can be treated, but for many patients, there is little hope of recovery. Even the fundamental distinction between life and death has been blurred.医生可以用各式各样的太空时代的医疗技术治疗疾病,而病人康复的能力与之相比却相形见绌。
可以治疗的疾病越来越多,而对于许多病人而言,康复的希望非常渺茫。
甚至生死之间的界限也变得模糊不清了。
Many Americans are caught in medical limbo, as was the South Korean boxer Duk Koo Kim, who was kept alive by artificial means after he had been knocked unconscious in a fight and his brain ceased to function. With the permission of his family, doctors in Las Vegas disconnected the life-support machines and death quickly followed.许多美国人像韩国拳击手金得九一样身陷医学困境。
金得九在一次比赛中遭到重击,不省人事,大脑停止运转,仅靠人工方法延续生命。
后经家人同意,拉斯维加斯的医生中断维持生命的医疗器械,死神接踵而至。
In the wake of technology’s advances in medicine, a heated debate is taking place in hospitals and nursing homes across the country--- over whether survival or quality of life isthe paramount goal of medicine.医学的最终目标是生存呢?还是生命的质量?在医学技术取得进步的背景下,全国的医院和养老院围绕这个问题展开了一场激烈的辩论。
“It gets down to what medicine is all about,” says Daniel Callahan, director of the Institute of Society, Ethics, and the Life Sciences in Hastings-on-Hudson, New York. “Is it really to save a life? Or is the larger goal the welfare of the patient?”“这个问题归根结底在于医学的本质是什么。
”位于纽约哈得孙河畔黑斯挺斯的社会、伦理及生命科学研究所的所长丹尼尔卡拉汉说。
“是挽救生命呢?还是为了病人的幸福?”Doctors, patients, relatives, and often the courts are being forced to make hard choices in medicine. Most often it is at the two extremes of life that these difficulty ethical questions arise --- at the beginning for the very sick newborn and at the end for the dying patient.医生、病人和亲戚,通常还有法庭都不得不做出艰难的医疗选择。
这些艰难的伦理问题通常出现于生命的两个顶端:处于生命开端的重病新生儿以及处于生命末端的临终病人。
The dilemma posed by modern medical technology has created the growing new discipline or bioethics. Many of the country’s 127 medical schools now offer courses in medical ethics, a field virtually ignored only a decade ago. Many hospitals have chaplains, philosophers, psychiatrists, and social workers on the staff to help patients make crucial decisions, and one in twenty institutions has a special ethics committee to resolve difficult cases.这种现代医学技术带来的两难问题催生了一个不断成长的新学科:生物伦理学。
在全国127 家医学院中,有许多现在已经开设了医学伦理学课程。
而仅仅在10 年前,这个领域实际上是被忽视的。
许多医院员工队伍中都出现了牧师、哲学家、心理专家以及社会工作者来帮助病人做出重要的决定。
二十个机构中就有一家成立特别伦理委员会来帮助解决棘手的确案例。
Death and Dying死亡与垂危Of all the patients in intensive-care units who are at risk of dying, some 20 percent present difficult ethical choices--- whether to keep trying to save the life or to pull back andlet the patient die. In many units, decisions regarding life-sustaining care are made about three times a week.在所有重症监护病房的生命垂危的病人中,大约有20% 需要艰难的伦理抉择:是继续挽救生命呢?还是放手不管听天由命?在癌症病房,每周涉及到生死抉择的病例多达三次。
Even the definition of death has been changed. Now that the heart-lung machine can take over the functions of breathing and pumping blood, death no longer always comes with the patient’s “last gasp” or when the heart stops beating. Thirty-one states and the District of Columbia have passed brain-death statutes that identify death as when the whole brain ceases to function.就连死亡的定义都已经发生了变化。
由于人工心肺机可以取代心肺的呼吸和泵血功能,因而死亡也不再是“最后一口气”或心脏停止跳动。
三十一个州和哥伦比亚特区已经通过脑死34超过12 个州承认“前遗嘱”。
More than a dozen states recognize “living wills” in which the patients leave instructions to doctors not to prolong life by feeding them intravenously or by other methods if their illness becomes hopeless. A survey of California doctors showed that 20 to 30 percent were following instructions of such wills. Meanwhile, the hospice movement, with its emphasis on providing comfort --- not cure --- to the dying patient, has gained momentum in many areas.病人“生前遗嘱”要求医生在疾病治愈无望的情况下不要通过静脉注射或其他方法延长生命。
1979 年对加利福尼亚的医生所做的调查显示,当年有20%到 30%的医生遵从了病人的生前遗嘱。
与此同时,一项强调为临终病人提供安适生活而不是医疗服务的临终安养运动在许多地区得到了蓬勃发展。
Despite progress in society’s understanding of death and dying, theory issues remain. Example: A woman, 87, afflicted by the nervous-system disorder of Parkinson’s disease, has a massive stroke and is found unconscious by her family. Their choices are to put her in a nursing home until she dies or to send her to a medical center for diagnosis and possible treatment. The family opts for a teaching hospital in New York city. Tests show the woman’s stroke resulted from a blood clot that is curable with surgery. After the operation, she says to her family: “Why did you bring me back to this agony?” Her health continues to worsen, and two years later she dies.尽管社会对于死亡及生命垂危的理解取得了巨大进步,但是棘手的问题仍然迟迟不能解决。