lesson4
自己選擇死亡方式
Lesson Four Die as You Choose
制定關(guān)于安樂死的法律已經(jīng)到了不能再回避的地步。
The need for laws on euthanasia cannot be dodged for much longer.
在世界上某個較小的國家里，安樂死被醫(yī)療機(jī)構(gòu)普遍接受，每年都有數(shù)千例公開實施。
In one of the world's smaller countries， mercy-killing is accepted by the medical establishment and openly practiced a few thousand times each year.
而在某個世界大國，安樂死雖然經(jīng)常受到醫(yī)療機(jī)構(gòu)的公開譴責(zé)，每年卻以數(shù)倍于此的次數(shù)秘密實施，且從未公之于眾。
In one of the world's biggest countries， euthanasia is condemned by the medical establishment， secretly practiced many times more often， and almost never comes to light.
但是，在上述那個國家有醫(yī)生因為實施安樂死而在監(jiān)獄里服刑呢？
Which of these countries has a mercy-killing doctor now languishing in its jails？
是在小國荷蘭。荷蘭制定了有關(guān)安樂死的法律，能有效地管理它。
It is the small one， Holland， which has rules for euthanasia and so can police it effectively.
那位荷蘭的醫(yī)生違反了他國家的規(guī)定。
The Dutch doctor broke his country's rules.
有關(guān)安樂死的問題在所有國家都存在，決不僅出現(xiàn)在美國這個禁止安樂死的大國。
There is a moral here for all the countries， and not just for the big death-forbidding country， America.
目前美國正再次展開有關(guān)安樂死的辯論。
Right now it is going over the arguments about euthanasia once again.
美國醫(yī)學(xué)協(xié)會會刊1月份發(fā)表了一封非同尋常的來信。一位醫(yī)生在信中宣稱自己按照病人的意愿，殺死了一位身患癌癥的20歲女孩。
In January the Journal of the American Medical Association published a bizarre letter， in which an anonymous doctor claimed to have killed a 20-year-old cancer patient at her own request.
這件事引起了一場辯論，而這場辯論將轟轟烈烈地持續(xù)到秋季，那時加利福尼亞州可能會就一項使安樂死合法化的法律進(jìn)行投票表決。
This started a debate that will rumble on into the autumn， when Californians may vote on a proposed law legalizing euthanasia.
這封信可能是為了起到引發(fā)爭論的效果，內(nèi)容并不可信。
The letter was probably written for polemical impact. It is scarcely credible.
是作者自己在信中聲稱他（或她）第一次與那位得了癌癥的病人見面，聽到病人說出5個字——“讓我去死吧”——然后就殺了她。
It's author claims that he met the cancer patient for the first time， heard five words from her – “Let's get this over with” – then killer her.
即使是極端的安樂死支持者也不贊成在這種情況下采取如此做法。
Even the most extreme proponents of euthanasia do not support such an action in those circumstances.
然而，醫(yī)療上出現(xiàn)的可怕事件如洪水猛獸一般，并不比安樂死的情況更好。它們無疑會在英美以及其他國家中繼續(xù)肆虐，幾乎成了令人恐怖的常規(guī)。
Yet medical monstrosities that are hardly any better undoubtedly continue， almost as a matter of macabre routine， in America， Britain and many other countries.
一些醫(yī)生私下透露他們有時會故意殺死病人，這樣的情況非常普遍，令人擔(dān)憂。
It is disturbingly easy to find doctors who will say， in private， that they sometimes kill patients on purpose.
多數(shù)醫(yī)生說他們知道其他醫(yī)生也有同樣的行為，但是因為即使在病人乞求他們的時候，醫(yī)生也幾乎不能與病人公開討論安樂死，因此醫(yī)生往往傾向于僅在要死的人處于垂危昏迷之際而無法表達(dá)是否同意安樂死時，才結(jié)束其生命。
Most say that know somebody else who does. But because they can rarely discuss euthanasia openly with patients – even when those patients beg them for it – doctors tend to kill only when the dying are too far gone to consent.
由于自愿要求安樂死受到禁止，就只能由醫(yī)生自行作出決定了，病人會在夜間受到藥物注射而非自愿地離開人世。
Thus， because voluntary euthanasia is taboo， a doctor makes the decision himself – and the patient is killed involuntarily in the night with a syringe.
這是不使安樂死公開的代價。
That is one price of keeping euthanasia secret.
如果所有形式的安樂死都是錯誤的，那就應(yīng)該統(tǒng)統(tǒng)列入禁止之列。
If all forms of mercy-killing are wrong， they should remain taboo.
可情況果真如此嗎？
But are they？
許多人都認(rèn)為依靠醫(yī)學(xué)技術(shù)來延續(xù)生命帶給人的痛苦是令人悲哀、可憎可惡的，完全不顧人的尊嚴(yán)，因此被動的安樂死——讓病人自行死亡——被人們普遍接受。
Because many people accept that it is sad， undignified and gruesome to prolong the throes of death will all the might of medical technology， passive euthanasia – letting patients die – is widely accepted.
美國大多數(shù)州都有關(guān)于“活遺囑”的法規(guī)，為醫(yī)生提供保護(hù)。如果醫(yī)生沒有盡力救助曾聲明不想延續(xù)生命的病人，不會為此受到起訴。
Most American states have “l(fā)iving – will” legislation that protects doctors from prosecution if they do not try to save someone who has said he does not want life prolonged.
主動的安樂死——殺死病人——卻依然爭論頗多。
Active euthanasia – killing – remains controversial.
將人殺死與讓人死亡之間的界線還能維持多久呢？
How long can the distinction between killing and letting die hold out？
正如因未履行某種職責(zé)受到處罰一樣，人也可能因干了某事而不受責(zé)難。
Just as there can be culpable omissions， so too can there be blameless acts.
讓我們從道德倫理著作中舉例說明。假定一個人會從某個孩子的死亡中獲益，當(dāng)這個孩子在浴缸中撞傷頭部而失去知覺時，那個人視而不見，任其溺水身亡。
Suppose – to take an example from the moral philosophy books – that a man stands to gain from the death of a certain child. The child strikes his head in the bath and falls unconscious. The man sits down and watches him drown.
雖然這個人什么都沒有做，但他并不能因此開脫罪責(zé)。
The fact that the man has performed no action does not excuse him.
同樣，再假設(shè)為了縮短而不是延長死亡到來的時間，醫(yī)生終止某種治療是無可指責(zé)的做法，那么如果這位醫(yī)生使用足夠的鎮(zhèn)痛劑致使病人死亡，他就一定大錯特錯嗎？
Similarly， suppose that a doctor does no wrong by withholding some treatment in order that death should come sooner rather than later. Is he then necessarily wrong if he administers enough painkillers to kill？
這位醫(yī)生采取了某種行動，而不是未盡某種職責(zé)，這會使他有罪嗎？
Does the fact that the doctor performed an action， rather than an omission， condemn him？
許多醫(yī)生一直在為解除病人臨終前的痛苦而奮斗著。他們認(rèn)為在病人請求安樂死時，根本無法截然區(qū)分被動與主動的安樂死。
Many doctors working on the battlefield of terminal suffering think that only squeamishness demands a firm difference between passive and active euthanasia on request.
他們贊成醫(yī)生殺死病人的理由是：醫(yī)生的職責(zé)之一就是使病人免遭痛苦，這是醫(yī)生所做的全部事情，而殺死病人則是做到這一點的惟一辦法。
Their argument for killing goes like this： one of a doctor's duties is to prevent suffering； sometimes that is all there is left for him to do， and killing is the only way to do it.
這個觀點并不新穎。當(dāng)希波克拉底為醫(yī)生制定信條的時候，曾明確禁止安樂死，而多數(shù)其他希臘醫(yī)生和思想家都不贊成這一禁令。
There is nothing new in this view. When Hippocrates formulated his oath for doctors， which explicitly rules out active killing， most other Greek doctors and thinkers disagreed with his ban.
前事不忘，后事之師。
Let the past be a guide.
有人認(rèn)為死亡的時間是上帝安排的，任何人不得縮短他人的生命，然而假如一位病人的人生觀使其接受安樂死，那么人們不禁要問：為什么其他人還要用不同的宗教觀念去干預(yù)其死亡呢？
Some people believe that the time of death is appointed by God and that no man should put the clock back on another. Yet if a patient's philosophical views embrace euthanasia， it is not clear why the religious objections of others should intrude on his death.
另一個令人擔(dān)憂問題是，有關(guān)安樂死的法律體系允許醫(yī)生在規(guī)定的情況下按照垂死病人的請求實施安樂死，就可能為殺人首開先例，從而危害社會。
Another worry is that a legal framework for euthanasia， permitting a doctor to comply with a dying man's request in a prescribed set of circumstances， might pose dangers for society by setting a precedent for killing.
這個問題取決于社會。
That depends on the society.
盡管有不同意見，荷蘭對建立這樣的法律體系已經(jīng)準(zhǔn)備就緒。
Holland， arguably， is ready for it.
當(dāng)年就是荷蘭醫(yī)生英勇無比地頂住了壓力，拒絕參與使安樂死聲名狼藉的納粹用人體進(jìn)行醫(yī)學(xué)實驗的暴行，這恐怕不是巧合。
It is probably no coincidence that it was Dutch doctors who most heroically resisted pressure to join in the Nazi medical atrocities that have given euthanasia its worst name.
這些醫(yī)生對個人自由堅定不移的尊重使他們沒有殺害渴望活下去的健康人。今天正是同樣的精神又使他們?nèi)椭辉富钕氯サ拇刮２∪恕?BR> The same tenacious respect for individual liberty that stopped them killing healthy people， who did not want to die， now lets them help dying people who do.
與之相反，西德在未來相當(dāng)長的時間里都無法使任何形式的安樂死合法化。
West Germany， by contrast， will not be able to legalize any form of euthanasia for a long time to come.
由于歷史的陰影反對安樂死的力量異常強(qiáng)大，在那些近年來自由意志的傳統(tǒng)未受任何干擾的國家里，為自愿安樂死制定有限的規(guī)定并不會使人們產(chǎn)生太多的恐懼。
Opposition is too fierce， because of the shadow of the past. Countries with an uninterrupted recent libertarian tradition have less to fear from setting some limited rules for voluntary euthanasia.
拒絕討論這個問題會使情況更加糟糕。
By refusing to discuss it， they usher in something worse.
自己選擇死亡方式
Lesson Four Die as You Choose
制定關(guān)于安樂死的法律已經(jīng)到了不能再回避的地步。
The need for laws on euthanasia cannot be dodged for much longer.
在世界上某個較小的國家里，安樂死被醫(yī)療機(jī)構(gòu)普遍接受，每年都有數(shù)千例公開實施。
In one of the world's smaller countries， mercy-killing is accepted by the medical establishment and openly practiced a few thousand times each year.
而在某個世界大國，安樂死雖然經(jīng)常受到醫(yī)療機(jī)構(gòu)的公開譴責(zé)，每年卻以數(shù)倍于此的次數(shù)秘密實施，且從未公之于眾。
In one of the world's biggest countries， euthanasia is condemned by the medical establishment， secretly practiced many times more often， and almost never comes to light.
但是，在上述那個國家有醫(yī)生因為實施安樂死而在監(jiān)獄里服刑呢？
Which of these countries has a mercy-killing doctor now languishing in its jails？
是在小國荷蘭。荷蘭制定了有關(guān)安樂死的法律，能有效地管理它。
It is the small one， Holland， which has rules for euthanasia and so can police it effectively.
那位荷蘭的醫(yī)生違反了他國家的規(guī)定。
The Dutch doctor broke his country's rules.
有關(guān)安樂死的問題在所有國家都存在，決不僅出現(xiàn)在美國這個禁止安樂死的大國。
There is a moral here for all the countries， and not just for the big death-forbidding country， America.
目前美國正再次展開有關(guān)安樂死的辯論。
Right now it is going over the arguments about euthanasia once again.
美國醫(yī)學(xué)協(xié)會會刊1月份發(fā)表了一封非同尋常的來信。一位醫(yī)生在信中宣稱自己按照病人的意愿，殺死了一位身患癌癥的20歲女孩。
In January the Journal of the American Medical Association published a bizarre letter， in which an anonymous doctor claimed to have killed a 20-year-old cancer patient at her own request.
這件事引起了一場辯論，而這場辯論將轟轟烈烈地持續(xù)到秋季，那時加利福尼亞州可能會就一項使安樂死合法化的法律進(jìn)行投票表決。
This started a debate that will rumble on into the autumn， when Californians may vote on a proposed law legalizing euthanasia.
這封信可能是為了起到引發(fā)爭論的效果，內(nèi)容并不可信。
The letter was probably written for polemical impact. It is scarcely credible.
是作者自己在信中聲稱他（或她）第一次與那位得了癌癥的病人見面，聽到病人說出5個字——“讓我去死吧”——然后就殺了她。
It's author claims that he met the cancer patient for the first time， heard five words from her – “Let's get this over with” – then killer her.
即使是極端的安樂死支持者也不贊成在這種情況下采取如此做法。
Even the most extreme proponents of euthanasia do not support such an action in those circumstances.
然而，醫(yī)療上出現(xiàn)的可怕事件如洪水猛獸一般，并不比安樂死的情況更好。它們無疑會在英美以及其他國家中繼續(xù)肆虐，幾乎成了令人恐怖的常規(guī)。
Yet medical monstrosities that are hardly any better undoubtedly continue， almost as a matter of macabre routine， in America， Britain and many other countries.
一些醫(yī)生私下透露他們有時會故意殺死病人，這樣的情況非常普遍，令人擔(dān)憂。
It is disturbingly easy to find doctors who will say， in private， that they sometimes kill patients on purpose.
多數(shù)醫(yī)生說他們知道其他醫(yī)生也有同樣的行為，但是因為即使在病人乞求他們的時候，醫(yī)生也幾乎不能與病人公開討論安樂死，因此醫(yī)生往往傾向于僅在要死的人處于垂危昏迷之際而無法表達(dá)是否同意安樂死時，才結(jié)束其生命。
Most say that know somebody else who does. But because they can rarely discuss euthanasia openly with patients – even when those patients beg them for it – doctors tend to kill only when the dying are too far gone to consent.
由于自愿要求安樂死受到禁止，就只能由醫(yī)生自行作出決定了，病人會在夜間受到藥物注射而非自愿地離開人世。
Thus， because voluntary euthanasia is taboo， a doctor makes the decision himself – and the patient is killed involuntarily in the night with a syringe.
這是不使安樂死公開的代價。
That is one price of keeping euthanasia secret.
如果所有形式的安樂死都是錯誤的，那就應(yīng)該統(tǒng)統(tǒng)列入禁止之列。
If all forms of mercy-killing are wrong， they should remain taboo.
可情況果真如此嗎？
But are they？
許多人都認(rèn)為依靠醫(yī)學(xué)技術(shù)來延續(xù)生命帶給人的痛苦是令人悲哀、可憎可惡的，完全不顧人的尊嚴(yán)，因此被動的安樂死——讓病人自行死亡——被人們普遍接受。
Because many people accept that it is sad， undignified and gruesome to prolong the throes of death will all the might of medical technology， passive euthanasia – letting patients die – is widely accepted.
美國大多數(shù)州都有關(guān)于“活遺囑”的法規(guī)，為醫(yī)生提供保護(hù)。如果醫(yī)生沒有盡力救助曾聲明不想延續(xù)生命的病人，不會為此受到起訴。
Most American states have “l(fā)iving – will” legislation that protects doctors from prosecution if they do not try to save someone who has said he does not want life prolonged.
主動的安樂死——殺死病人——卻依然爭論頗多。
Active euthanasia – killing – remains controversial.
將人殺死與讓人死亡之間的界線還能維持多久呢？
How long can the distinction between killing and letting die hold out？
正如因未履行某種職責(zé)受到處罰一樣，人也可能因干了某事而不受責(zé)難。
Just as there can be culpable omissions， so too can there be blameless acts.
讓我們從道德倫理著作中舉例說明。假定一個人會從某個孩子的死亡中獲益，當(dāng)這個孩子在浴缸中撞傷頭部而失去知覺時，那個人視而不見，任其溺水身亡。
Suppose – to take an example from the moral philosophy books – that a man stands to gain from the death of a certain child. The child strikes his head in the bath and falls unconscious. The man sits down and watches him drown.
雖然這個人什么都沒有做，但他并不能因此開脫罪責(zé)。
The fact that the man has performed no action does not excuse him.
同樣，再假設(shè)為了縮短而不是延長死亡到來的時間，醫(yī)生終止某種治療是無可指責(zé)的做法，那么如果這位醫(yī)生使用足夠的鎮(zhèn)痛劑致使病人死亡，他就一定大錯特錯嗎？
Similarly， suppose that a doctor does no wrong by withholding some treatment in order that death should come sooner rather than later. Is he then necessarily wrong if he administers enough painkillers to kill？
這位醫(yī)生采取了某種行動，而不是未盡某種職責(zé)，這會使他有罪嗎？
Does the fact that the doctor performed an action， rather than an omission， condemn him？
許多醫(yī)生一直在為解除病人臨終前的痛苦而奮斗著。他們認(rèn)為在病人請求安樂死時，根本無法截然區(qū)分被動與主動的安樂死。
Many doctors working on the battlefield of terminal suffering think that only squeamishness demands a firm difference between passive and active euthanasia on request.
他們贊成醫(yī)生殺死病人的理由是：醫(yī)生的職責(zé)之一就是使病人免遭痛苦，這是醫(yī)生所做的全部事情，而殺死病人則是做到這一點的惟一辦法。
Their argument for killing goes like this： one of a doctor's duties is to prevent suffering； sometimes that is all there is left for him to do， and killing is the only way to do it.
這個觀點并不新穎。當(dāng)希波克拉底為醫(yī)生制定信條的時候，曾明確禁止安樂死，而多數(shù)其他希臘醫(yī)生和思想家都不贊成這一禁令。
There is nothing new in this view. When Hippocrates formulated his oath for doctors， which explicitly rules out active killing， most other Greek doctors and thinkers disagreed with his ban.
前事不忘，后事之師。
Let the past be a guide.
有人認(rèn)為死亡的時間是上帝安排的，任何人不得縮短他人的生命，然而假如一位病人的人生觀使其接受安樂死，那么人們不禁要問：為什么其他人還要用不同的宗教觀念去干預(yù)其死亡呢？
Some people believe that the time of death is appointed by God and that no man should put the clock back on another. Yet if a patient's philosophical views embrace euthanasia， it is not clear why the religious objections of others should intrude on his death.
另一個令人擔(dān)憂問題是，有關(guān)安樂死的法律體系允許醫(yī)生在規(guī)定的情況下按照垂死病人的請求實施安樂死，就可能為殺人首開先例，從而危害社會。
Another worry is that a legal framework for euthanasia， permitting a doctor to comply with a dying man's request in a prescribed set of circumstances， might pose dangers for society by setting a precedent for killing.
這個問題取決于社會。
That depends on the society.
盡管有不同意見，荷蘭對建立這樣的法律體系已經(jīng)準(zhǔn)備就緒。
Holland， arguably， is ready for it.
當(dāng)年就是荷蘭醫(yī)生英勇無比地頂住了壓力，拒絕參與使安樂死聲名狼藉的納粹用人體進(jìn)行醫(yī)學(xué)實驗的暴行，這恐怕不是巧合。
It is probably no coincidence that it was Dutch doctors who most heroically resisted pressure to join in the Nazi medical atrocities that have given euthanasia its worst name.
這些醫(yī)生對個人自由堅定不移的尊重使他們沒有殺害渴望活下去的健康人。今天正是同樣的精神又使他們?nèi)椭辉富钕氯サ拇刮２∪恕?BR> The same tenacious respect for individual liberty that stopped them killing healthy people， who did not want to die， now lets them help dying people who do.
與之相反，西德在未來相當(dāng)長的時間里都無法使任何形式的安樂死合法化。
West Germany， by contrast， will not be able to legalize any form of euthanasia for a long time to come.
由于歷史的陰影反對安樂死的力量異常強(qiáng)大，在那些近年來自由意志的傳統(tǒng)未受任何干擾的國家里，為自愿安樂死制定有限的規(guī)定并不會使人們產(chǎn)生太多的恐懼。
Opposition is too fierce， because of the shadow of the past. Countries with an uninterrupted recent libertarian tradition have less to fear from setting some limited rules for voluntary euthanasia.
拒絕討論這個問題會使情況更加糟糕。
By refusing to discuss it， they usher in something worse.