Unit Five
第五单元
Text
课文
Is it ever proper for a medical doctor to lie to his patient?
体格检查的医生对病人撒谎是对的吗?
Should he tell a patient he is dying?
医生是否应该告诉病人他将要死了呢?
These questions seem simple enough,
这些问题看起来似乎很简单,
but it is not so simple to give a satisfactory answer to them.
但是却不容易给一个令人满意的回答。
Now a new light is shed on them.
现在一线新的曙光来了!
TO LIE OR NOT TO LIE -THE DOCTOR'S DILEMMA
撒谎还是不撒谎??医生左右为难
Sissela Book
摘自Sissela的书。
Should doctors ever lie to benefit their patients-
医生到底该不该撒谎?为了对病人有好处??
to speed recovery or to conceal the approach of death?
为了加快病人康复或不让病人知道死亡的来临,
In medicine as in law, government,
医疗行业与法律、政府
and other lines of work,
主其它行业一样,
the requirements of honesty often seem dwarfed by greater needs:
往往显得对诚实与否的问题不那么看重,
the need to shelter from brutal news or to uphold a promise of secrecy;
要紧的倒是另外一些事情,譬如,应设法避免可怕的消息造成的打击,或是应考虑恪守保密的诺言。
to expose corruption or to promote the public interest.
或是需要揭露腐败行为或促进公众利益等。
What should doctors say, for example,
这时,医生该怎么对他讲呢?举例说吧,
to a 46-year-old man coming in for a routine physical checkup just before going on vacation with his family who,
一个46岁的男子,在与家人外出度假之前进行常规体格检查,
though he feels in perfect health,
虽然他自我感觉良好,
is found to have a form of cancer that will cause him to die within six months?
但医生发现他患了某种癌症,6个月内就会死去。
Is it best to tell him the truth?
是不最好对他讲实话?
If he asks, should the doctors deny that he is ill,
要是他问起检查结果,医生该不该当否认他得了病?
or minimize the gravity of the illness?
该不该将病情的严重性缩小到最低限度?
Should they at least conceal the truth until after the family vacation?
该不该将真情至少隐瞒到他全家度假之后?
Doctors confront such choices often and urgently.
医生们常常面临这样的非常紧迫的选择。
At times, they see important reasons to lie for the patient's own sake;
他们不时认为,为了病人自身的利益,撒谎很有必要,
in their eyes, such lies differ sharply from self-serving ones.
在他们看来,这种谎言与利己的谎言截然不同。
Studies show that most doctors sincerely believe that the seriously ill do not want to know the truth about their condition,
研究结果表明,大多数医生深信身患重病的人不想知道他们的真实病情,如果将真情相告,
and that informing them risks destroying their hope,
则有可能使他们完全失去希望,
so that they may recover more slowly,
结果使他们恢复得更慢,
or deteriorate faster,
或恶化得更快,
perhaps even commit suicide.
甚至会自寻短见。
As one physician wrote:
正如一位内科医生写道:
"Ours is a profession which traditionally has been guided by a precept that transcends the virtue of uttering the truth for truth's sake,
“我们这个职业,传统上恪守一条信条,这一信条胜过为讲真话而讲真话的美德。
and that is 'as far as possible do no harm.' "
“那就是:‘尽可能不造成伤害’。
Armed with such a precept,
有了这样一个指导原则,
a number of doctors may slip into deceptive practices that they assume will "do no harm" and may well help their patients.
一些医生可能渐渐习惯于采用他们认为对病人很可能有益而“无害”的骗人做法。
They may prescribe innumerable placebos,
他们可能开出无数贴安慰剂,
sound more encouraging than the facts warrant,
说一些没有事实根据的打气的话,
and distort grave news,
并歪曲严重的病情,
especially to the incurably ill and the dying.
对那些患有不治不症和濒临死亡的病人,则尤其如此。
But the illusory nature of the benefits such deception is meant to produce is now coming to be documented.
然而,现在开始有人提出证据,说明这种欺骗旨在给病人带来好处的说法是虚幻的。
Studies show that,
研究结果表明,
contrary to the belief of many physicians,
与许多医生的想法相反,
an overwhelming majority of patients do want to be told the truth,
绝大多数病人确实想知道真实情况,
even about grave illness,
甚至是严重的病情。
and feel betrayed when they learn that they have been misled.
当他们了解到医生没有对他们讲真话的时候,他们感到自己被玩弄了。
We are also learning that truthful information,
我们还获悉,将真实情况
humanely conveyed,
妥当地告诉病人,
helps patients cope with illness: helps them tolerate pain better,
能帮助他们与病魔作斗争,有助于他们更好地忍受疼痛,
need less medicine,
减少用药,
and even recover faster after surgery.
甚至在手术后更快地康复。
Not only do lies not provide the "help" hoped for by advocates of benevolent deception;
谎言不仅不能提供鼓吹“仁慈”欺骗的人们所希望的那种“帮助”,
they invade the autonomy of patients and render them unable to make informed choices concerning their own health,
它还侵犯了病人的个人自由,使他们不能对有关自己健康的问题作出明达的选择,
including the choice of whether to be a patient in the first place.
包括要不要就医这一首要的选择。
We are becoming increasingly aware of all that can befall patients in the course of their illness when information is denied or distorted.
我们越来越意识到,病人发病期间,在不知病情或未被如实地告知病情的情况下,他们会遭到什么样的不幸。
Dying patients especially-
特别是濒临死亡的病人??
who are easiest to mislead and most often kept in the dark -
他们最易受骗也最会被人蒙在鼓里??
can then not make decisions about the end of life;
因此而不能作出临终前的种种有关抉择:
about whether or not they should enter a hospital, or have surgery;
是否要住进医院,或进行手术,
about where and with whom they should spend their remaining time;
在何处与何人度过所剩下的一点时间,
about how they should bring their affairs to a close and take leave.
以及如何处理完自己的事务而后与世长辞。
Lies also do harm to those who tell them:
谎言也伤害说谎的人,
harm to their integrity and, in the long run,
损害他们的诚实,并最终,
to their credibility.
损害他们的信誉。
Lies hurt their colleagues as well.
谎言还伤害他们的同事。
The suspicion of deceit undercuts the work of the many doctors who are scrupulously honest with their patients;
由于病人怀疑有欺骗行为,许多对病人十分开诚布公的医生的工作也因此受到影响。
it contributes to the spiral of lawsuits and of "defensive medicine,"
病人的不信任使医疗诉讼案增多,造成医生避免风险“防御性诊治”增多,
and thus it injures, in turn, the entire medical profession.
而这些又进而有损于整个医疗事业。
Sharp conflicts are now arising.
剧烈的冲突正在出现。
Patients are learning to press for answers.
病人开始学会催问真实情况,
Patients' bills of rights require that they be informed about their condition and alternatives for treatment.
根据病人应享有的权利的规定,医生应将病情和可供选择的治疗方案通知病人。
Many doctors go to great lengths to provide such information.
许多医生尽可能向病人提供这些情况。
Yet even in hospitals with the most eloquent bill of rights,
然而,即使在对病人的权益考虑得最周到的医院里,
believers in benevolent deception continue their age-old practices.
信奉“仁慈”欺骗的医生们也还在继续他们传统的古老做法。
Colleagues may disapprove but refrain from objecting.
同事们也许不赞同,但避免公开表示反对。
Nurses may bitterly resent having to take part,
护士们也许深恶痛绝,
day after day, in deceiving patients,
对不得不日复一日地参与欺骗病人的做法,
but feel powerless to take a stand.
但要抵制却感到无能为力。
There is urgent need to debate this issue openly.
及时对这个问题进行公开辩论非常必要。
Not only in medicine,
不仅在医疗业,
but in other professions as well,
而且在其它行业,
practitioners may find themselves repeatedly in difficulty where serious consequences seem avoidable only through deception.
从业者不断发现,自己常处于似乎不采用欺骗手段就无法避免严重后果的困难处境。
Yet the public has every reason to be wary of professional deception,
但是公众完全有理由对职业性欺骗保持警惕,
for such practices are peculiarly likely to become deeply rooted,
因为这种做法特别容易变得根深蒂固,
to spread, and to erode trust.
蔓延滋长,并损害信任。
Neither in medicine,
无论医疗界、
nor in law, government,
法律界、政府机构
or the social sciences can there be comfort in the old saying,
还是社会科学界,都不应从一句老话中得到丝毫慰藉。
"What you don't know can't hurt you."
“不知者,不为所害。”
New Words
新单词
dilemma n.
窘境,进退两难
benefit vt.
有益于
recovery n.
痊愈;复得
conceal vt.
隐瞒
line n.
行业
dwarf vt. & n.
使矮小,使相形见绌 矮子;矮小的动(植)物
shelter vi. & vt.
躲避 掩蔽;庇护
brutal a.
残忍的,兽性的
uphold vt.
支撑;维护
secrecy n.
秘密,保密
expose vt.
揭露;暴露
corruption n.
腐化;道德败坏
promote vt.
促进,推进;提升
checkup n.
审查,检查,鉴定,身体检查
minimize vt.
将…减到最少
gravity n.
严重性
confront vt.
(勇敢地)面对;对抗
urgently ad.
紧急地,急迫地
urgent a.
紧急的,急迫的
self-serving a.
利己的
recover vi.
痊愈,复原,胜诉
deteriorate v.
(使)恶化
suicide n.
自杀,自毁,给自己带来伤害或损失的行为
physician n.
内科医生
traditionally ad.
传统上,传说上
precept n.
戒律;格言
transcend vt.
超越
virtue n.
美德;优点
utter vt.
发出,做声,发表,发射,流通
deceptive a.
欺骗性的
innumerable a.
无数的,数不清的
placebo n.
安慰剂
warrant vt.
使有(正当)理由;授权(给);担保
distort vt.
歪曲;弄歪
grave a.
严重的;严肃的
incurably ad.
治不好地,不能矫正地
illusory a.
虚幻的
deception a.
欺骗;诡计
document vt.
用文件证明
contrary a.
相反的;对抗的
overwhelming a.
势不可挡的;压倒之势的
betray vt.
背叛
truthful a.
诚实的,说实话的
humanely ad.
仁爱地;人道地
tolerate vt.
容忍
advocate n.
拥护者,倡导者
benevolent a.
仁慈的
invade vt.
侵犯
autonomy n.
自治(权);自主
render vt.
呈递,归还,着色,汇报,致使,放弃,表演,实施
informed a.
了解情况的;有见识的
concerning prep.
关于
increasingly ad.
日益,愈加
befall vt.
降临到…头上
integrity n.
诚实,正直;完整
credibility n.
可靠性;可信
colleague n.
同事
suspicion n.
怀疑
deceit n.
欺骗
undercut vt.
暗中破坏;削弱
scrupulously ad.
一丝不苟地
spiral n.
螺旋(形);盘旋上升(或下降)
lawsuit n.
诉讼(案件)
injure vt.
损害,伤害
arise vi.
上升;出现
bill n.
法案;议案;账单
alternative n.
抉择;可供选择的东西
treatment n.
治疗;疗法
eloquent a.
雄辩的
disapprove vt.
不赞成
refrain vi.
忍住;戒除
object vi.
反对
objection n.
异议,缺陷,妨碍,拒绝之理由
bitterly ad.
苦苦地,悲痛的,厉害的
deceive vt.
欺骗,行骗
debate vt.
辩论
issue n.
问题;争端
practitioner n.
开业者(尤者医生、律师等)
consequence n.
后果;重要性
avoidable a.
可避免的
wary a.
谨慎的;谨防的
erode vt.
腐蚀
saying n.
格言;谚语
Phrases & Expressions
 

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