he Supreme Court’s decisions on physician-assisted suicide carry important implications for how medicine seeks to relieve dying patients of pain and suffering.
Although it ruled that there is no constitutional right to physician-assisted suicide, the Court in effect supported the medical principle of “double effect,” a centuries-old moral principle holding that an action having two effects -- a good one that is intended and a harmful one that is foreseen -- is permissible if the actor intends only the good effect.
Doctors have used that principle in recent years to justify using high doses of morphine to control terminally ill patients’ pain, even though increasing dosages will eventually kill the patient.
Nancy Dubler, director of Montefiore Medical Center, contends that the principle will shield doctors who “until now have very, very strongly insisted that they could not give patients sufficient mediation to control their pain if that might hasten death.”
George Annas, chair of the health law department at Boston University, maintains that, as long as a doctor prescribes a drug for a legitimate medical purpose, the doctor has done nothing illegal even if the patient uses the drug to hasten death. “It’s like surgery,” he says. “We don’t call those deaths homicides because the doctors didn’t intend to kill their patients, although they risked their death. If you’re a physician, you can risk your patient’s suicide as long as you don’t intend their suicide.”
On another level, many in the medical community acknowledge that the assisted-suicide debate has been fueled in part by the despair of patients for whom modern medicine has prolonged the physical agony of dying.
Just three weeks before the Court’s ruling on physician-assisted suicide, the National Academy of Science (NAS) released a two-volume report, Approaching Death: Improving Care at the End of Life. It identifies the undertreatment of pain and the aggressive use of “ineffectual and forced medical procedures that may prolong and even dishonor the period of dying” as the twin problems of end-of-life care.
The profession is taking steps to require young doctors to train in hospices, to test knowledge of aggressive pain management therapies, to develop a Medicare billing code for hospital-based care, and to develop new standards for assessing and treating pain at the end of life.
Annas says lawyers can play a key role in insisting that these well-meaning medical initiatives translate into better care. “Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering,” to the extent that it constitutes “systematic patient abuse.” He says medical licensing boards “must make it clear that painful deaths are presumptively ones that are incompetently managed and should result in license suspension.”
红字翻译过来,应该是"该原则会保护一些医生,这些医生认为如果加大用药剂量会加速死亡的话,他们就不能给病人足够的用药以控制他们的痛苦."
这话什么意思呀???
如果加大剂量会加速死亡,他们就会不能给病人足够用药来控制痛苦,
那如果加大剂量不会加速死亡,医生他们就能给病人足够用药来控制痛苦吗?
该原则会保护医生又从何说起咯?保护医生他们什么了?
该段前后,我都明白,就这段话看我的莫名其妙,纵观全文似乎可以删掉这一段!
本想放过这个疑问,但是真是如鲠在喉,请同学和老师指点! |
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