研究生英语视听说教程

Discussions on controversial topics such as euthanasia, physician-assisted suicide, and the withdrawal or withholding of medical treatment are commonly held within our homes, workplaces, and governments. The last several decades have seen an increase in right-to-die activist movement groups across the nation. This is in part a result of many people being afraid that the tremendous advances in medical therapy available may expose them to unnecessary and extraordinary treatment, which would serve only to prolong their suffering in the face of death. Society’s beliefs about end-of-life care and the right to make personal choices are changing. At one time, it was considered immoral and unethical to assist or aid a person to escape from pain and suffering of a terminal illness by means of murder or suicide. Many people now feel they have the right to choose voluntary death in the terminal stages of their illnesses when they are no longer able to cope. Our nation is under great pressure by citizens and activist groups to legalize euthanasia. I believe that the legalization of euthanasia would lead to abuse of that legislation. Once legalized, euthanasia would become a commonplace method of dealing with serious and terminal illnesses. One of the reasons for this is that medical and technical advances in palliative care and pain control would be threatened with the sanctioning of euthanasia as a method for relieving pain and suffering. We would see an eventual decline in available funds and resources for palliative care. In the state of Oregon1, where euthanasia has been legalized, there has been a reduction of funds allocated to those essential services required for the care of the terminally ill. The same has been found in the Netherlands, where euthanasia is also a legal option. Post-implementation studies have shown that terminally ill patients are presented with fewer options for community-based, end-of-life care. Because supportive services in the Netherlands have been reduced, people tend to seek out end-of-life options. An important point to consider is that when given options, most people will not exercise their option of euthanasia when they have adequate pain control and end-of-life care. Another point to consider is that it is entirely feasible that our government
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1 Oregon: a state in the northwest United States, on the Pacific coast. 俄勒冈州
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may choose the least expensive route of care in dealing with the terminally ill. Members of the International Anti-Euthanasia Task Force2 have addressed their fears that legalized euthanasia might be abused: “The cost effectiveness of hastened death is undeniable. The earlier a patient dies, the less costly is his or her care”. It has been shown that in the Netherlands, medical treatment options are frequently withheld from those who require palliative treatment. They are left to seek out the services of physicians who will assist them in succumbing to an early death. In Oregon, health management organizations (HMOs) are planning to cover the cost of assisted suicide and, as stated earlier, have reduced funding available for palliative care. Not only do our governments hold a significant amount of authority in determining how our health-care needs are met, but physicians possess incredible power as well. Barney Sneiderman, a professor in the Faculty of Law at the University of Manitoba, is concerned that physicians have the potential to abuse guidelines when they take on the role of judge and jury. Legalization would enhance the power of control for doctors, not the patients where the control is intended. Where there is legislation approving euthanasia, there are no guarantees to safeguard against possible abuse. The Netherlands model of euthanasia is one we should be watching closely when determining possibilities of abuse after legalization. Explicit guidelines were set up in that model, but those guidelines are not being followed in the fashion intended. There is nothing in place to protect citizens from abuse. That country has found that there has been a progression from the people for whom euthanasia was initially intended to those who are receiving it now. Initially, the terminally ill were the only recipients of physician-assisted suicide or euthanasia. There has been a rapid progression to include those who are chronically ill, those with psychological afflictions, and finally those who are unable to make or communicate decisions for themselves. There are on average 130 000 deaths per year in the Netherlands, 1000 of which a doctor actively caused or hastened without the patients’ request. Rather than requests for euthanasia being initiated by the patient, as the guidelines require, requests in the Netherlands most commonly come from family members of patients. Families become exhausted with caregiving, as there are few resources available for assistance. Given the option, many people choose to have their loved ones put to death instead of continuing the burden of caregiving. If euthanasia is legalized in Canada, the requests for assistance in dying should come voluntarily from individuals when they feel they can no longer cope with the burdens of the dying process. As seen in the Netherlands model, however, many will request assistance when they see themselves as burdens or nuisances. The next step is that requests for euthanasia will come from family or friends, as the patient is increasingly perceived as a burden on them. The reduced value placed on a life in our society and reduced available resources would play a role in this progression. In 1997, the Hemlock Society
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Useful Expressions • Terminal Sedation essentially places a patient under anesthesia while they are dying. • Terminal Sedation is also known as palliative sedation, or sedation for intractable distress while the patient is dying. • Terminal Sedation is tantamount to euthanasia, or a kind of slow euthanasia. • Euthanasia is illegal in most countries. Do you think it should be legalized in our country? • Life must always be considered as the ultimate human value. • The quality of life is more important than the value of life itself. • The question of euthanasia raises serious moral and ethical issues. • Terminal Sedation is usually presented as an ethical “choice” rationally made by people who are dying.
Unit Three
Euthanasia Reconsidered
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Euthanasia Reconsidered
By Gail Deagle
Gail Deagle is the Patient Care Director in ICU/Medicine/Respiratory (ICU = intensive care unit), Queen Elizabeth II Hospital. At the time she wrote this paper, Deagle was a part-time nursing student living in Grande Prairie, Alberta, Canada.
Unit Three
Euthanasia Reconsidered
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Unit Three Euthanasia Reconsidered
Preparing to Read
Task 1 Define euthanasia You may have heard of the word “euthanasia”, which is also called mercy killing. Write a clear definition for this medical term. You can consult an English dictionary or find the definition in the text. Then discuss the definition with your classmates. Euthanasia: ______________________________________________________________________ _______________________________________________________________________________ _ Task 2 Decide who needs Terminal Sedation. Look at the picture and discuss its implications in small groups. The candles represent different groups of people, and Terminal Sedation (TS) indicates the ending of a life.