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Файл:США. Этические проблемы. Учебное пособие на английском языке.pdf
the intent and the knowledge are left deliberately ambiguous.” Only a
few, like Dr. Jack Kevorkian, have defied this conspiracy of silence.
But now that legal prohibitions against assisted suicide may be
crumbling, doctors all over the U.S. could soon be as up front as
Kevorkian — a prospect that has always disturbed many of them. For
one thing doctors may become more vulnerable to lawsuits because
they will suddenly be open to scrutiny by family members and
attorneys. If health professionals are going to be held accountable,
says Dr. Howard Grossman, one of the three doctors who successfully
challenged the New York law, “there must be clear guidelines of what
constitutes a terminally ill patient.”
Many physicians also fear that making the practice legal will lead
to ill-considered decisions to terminate life. Some doctors believe —
though have not proved — that a 1993 Dutch decision to legalize
euthanasia has resulted in some cases of mercy killing without the
patient’s explicit consent. Clinical depression can often be the reason
behind a terminal patient’s death wish; so can unremitting, intense
pain. Says Dr. William Wood, clinical director of the Winship Cancer
Center at Emory University in Atlanta: “If we treat their depression
and we treat their pain, I’ve never had a patient who wanted to die.”
Even those who believe assisted suicide is ethically sound agree that it
should not be undertaken lightly. Benjamin, whose car sports a
bumper sticker reading GOOD LIFE, GOOD DEATH, gets one or two
request a month for help in dying but talks most of his patients out of
it. Says he: “You don’t want to give pills to someone you think
decided to commit suicide on Tuesday and on Wednesday would have
changed his mind.”
Is that a good argument for keeping the practice illegal? No, says
Crossman: “It’s incredibly arrogant to say nobody’s going to be
careful so we shouldn’t let patients make this decision for
themselves.”
What doctors do need is a set of standards that make clear the role
a physician should play in letting a patient go. How imminent should
death be? How do physicians make sure a patient is mentally
competent and really wants to die? What alternatives should be
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suggested? What sort of counseling is appropriate? The American
Medical Association presently frowns upon doctors who participate in
patient suicide. Now it has announced plans to revisit the matter.
ADDITIONAL VOCABULARY
suicide (n) — the act of killing oneself: to commit suicide; assisted
suicide
to forbid (v) (forbade, forbidden) — 1. to tell someone that they are
not allowed to do something, or that something is not allowed: He
was forbidden to leave the house, as a punishment. The law strictly
forbids racial or sexual discrimination. 2. fml to make it
impossible for someone to do something; prevent: Lack of space
forbids listing the names of all those who contributed.
Synonyms: to ban, to prohibit, to bar somebody from doing
something
God/Heaven forbid — (spoken) used to emphasize that you hope
that something will not happen: ‘Supposing I had an accident.’ —
‘God forbid!’
to prohibit (v) — to say that an action is illegal or not allowed; ban,
forbid: Smoking is strictly prohibited inside the factory. They are
prohibited from revealing details about the candidates.
prohibition (n) — 1. the act of saying that something is illegal: the
prohibition of the sale of firearms. 2. an order stopping something:
prohibition on/against, a prohibition on Sunday trading
to withhold (v) — to refuse to give someone something: I withheld
payment until they had completed the work. Jim was accused of
withholding vital information from the police.
to withdraw (v) — 1. to stop taking part in an activity, belonging to
an organization, etc., or to make someone do this: A knee injury
forced her to withdraw from the competition. 2. to stop giving
support or money to someone or something, especially as the result
of an official decision: One of the minority parties had withdrawn
its support for Chancellor Kohl. 3. if you withdraw a threat, offer,
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request, etc., you say that you no longer will do what you said:
After much persuasion he agreed to withdraw his resignation. 4. to
take money out of a bank account: I’d like to withdraw £500 from
my current account. 5. to become quieter, less friendly, and only
concerned about your own thoughts: Ralph has withdrawn from the
other kids. Many depressed people just withdraw into themselves.
conscience (n) — 1. the part of your mind that tells you whether what
you are doing is morally right or wrong: Well, at least I can face
them all with a clear conscience. 2. a guilty feeling that you have
about something bad you have done
twinge/pang of conscience: Sam felt a pang of conscience at
having misjudged her.
on one’s conscience: He didn’t want somebody’s death on his
conscience.
not in (all/good) conscience (fml): I couldn’t in all conscience tell
him that his job was safe.
to terminate (v, fml) — to end: The court ruled that the contract must
be terminated. The woman made a decision not to terminate her
pregnancy
terminal (adj) — of an illness that cannot be cured and will cause
death: terminal cancer; a terminal patient
lethal (adj) — causing death, or able to cause death; fatal: a lethal
dose of heroin; a lethal weapon; death by lethal injection; a lethal
cocktail of drink and pills. These chemicals are lethal to fish.
to aid (v) — 1. to help someone do something: an index to aid the
reader; aid somebody in/with (doing) something. Mrs Coxen was
aided in looking after the children by her niece. 2. to make
something happen more quickly or easily: Welfare spending aids
economic development in three ways.
aid (n) — 1. help, such as money or food, given by an organization
or government to a country or to people who are in a difficult
situation: Foreign aid from many countries poured into the famine
area. 2. help that you need to do a particular thing: with/without the
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aid of something; Father Poole walked painfully, with the aid of a
stick. 3. help or advice that is given to someone who needs it:
come/go to somebody’s aid; I didn't speak any French, but a nice
man came to my aid and told me where to go.
sophisticated (adj) — 1. having a lot of experience of life, and good
judgment about socially important things such as art, fashion, etc.:
a sophisticated, witty American; Clarissa’s hair was swept up into
a sophisticated style. 2. (about a machine, system, method, etc.)
very well designed, advanced, and often working in a complicated
way: sophisticated software; a highly sophisticated weapons
system 3. having a lot of knowledge and experience of difficult or
complicated subjects and therefore able to understand them well:
British voters have become much more sophisticated.
up front — (infml) 1. (about money) paid before work is done or
before goods are supplied: We need two hundred pounds up front.
2. direct and clear from the start: He is very up front about his
political views.
vulnerable (adj) — 1. easily harmed or hurt: We work mainly with the
elderly and other vulnerable groups. Children are most vulnerable
to abuse within their own home. He took advantage of me when I
was at my most vulnerable. 2. easy to attack or criticize: The fort
was vulnerable to attack from the north.
scrutiny (n) — careful and thorough examination of someone or
something: Careful scrutiny of the company’s accounts revealed a
whole series of errors.
to scrutinize (v) — to examine someone or something very
carefully: He scrutinized the document closely.
euthanasia (n) — the deliberate killing of a person who is incurably
ill, mercy killing: In the Netherlands euthanasia has already been
legalized. Most doctors are opposed to euthanasia on ethical
grounds.
unremitting (adj, fml) — continuing for a long time and not likely to
stop: unremitting poverty
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imminent (adj) — which is going to happen very soon: imminent
danger/threat/death/ disaster. He was in imminent danger of dying.
He smiled in anticipation of her imminent arrival. A new trade
agreement is imminent.
competent (adj) — having enough skill or knowledge to do
something to a satisfactory standard: A competent mechanic should
be able to fix the problem. She’s a highly competent linguist. I
don’t feel competent to give an opinion at the moment. He is the
only party leader competent enough to govern this country.
EXERCISES
I. Translate the following sentences into Russian paying
attention to the active vocabulary:
1. Barry threatened to commit suicide if she refused to marry
him.
2. More people commit suicide at Christmas than at any other
time.
3. In some states the law forbids the teaching of evolution.
4. His poor eyesight prohibited him from becoming a pilot.
5. Doctors do not have the right to withhold necessary treatment
from a patient.
6. He was accused of withholding vital evidence from the police.
7. Clare had to withdraw from the race after injuring her knee.
8. The drug has been withdrawn from the market for further tests.
9. I withdrew $200 from my savings account.
10. He was capable of making the most ruthless decisions with no
apparent pangs of conscience.
11. Her conscience would not let her take all the credit for their
work.
12. The company had the right to terminate his employment at
any time.
13. Is the disease terminal?
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14. Many of the patients are in the terminal stages of the disease.
15. St. Helen’s Hospice cares for people with terminal illnesses.
16. Death will come by lethal injection, rather than cyanide gas,
since gassing has been challenged in California as unduly cruel.
17. The Red Cross is delivering aid to the refugees.
18. Officers were aided in the search by drug-sniffing dogs.
19. Even experienced and sophisticated readers have been known
to have trouble with his books.
20. Ground floor windows are particularly vulnerable and secure
locks should be fitted.
21. Airlines have increased their scrutiny of the size and amount
of carry-on luggage.
22. Competent skiers should find no difficulty with the course.
23. New students are expected to be competent in mathematics.
24. Tomita is a highly competent translator.
25. We believe the patient was not mentally competent.
26. Some of the buildings were in a state of imminent collapse.
27. Soon it became clear to everyone that war was imminent.
28. The child was in imminent danger of falling into the water.
29. The group faced unremitting hostility from the FBI.
30. Symptoms were chronically severe and unremitting in 17
patients.
II. Translate the following sentences into English paying
attention to the active vocabulary:
1. Родные боялись, что Джон совершит самоубийство, узнав
о своей неизлечимой болезни.
2. Врач не должен утаивать от больного правду о его
состоянии, даже в случае обнаружения рака.
3. Ученые работают над созданием препарата, обладающего
уникальными свойствами в борьбе с летальными исходами после
операций на сердце.
4. Он чувствовал, что смер
ть неотвратима.
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5. Пациент не осознавал того, что с ним происходило.
6. Законодательство этой страны запрещает эвтаназию, так
что смертельно больные люди не могут умереть с посторонней
помощью.
7. Он испытывал муки совести после недостаточно
тщательного досмотра багажа подозрительного пассажира.
8. Не дай Бог, случится еще одна авария!
9. Он принял решение выйти из па
выборах.
10. Я воздержался от упоминания имени свидетеля по
этическим причинам.
ртии после неудачи на
III. Explain in English the meaning of the following words and
phrases from the text:
terminally ill
to wrestle with an ethical dilemma
physician-assisted suicide
withhold treatment
withdraw treatment
to be held accountable
mercy killing
without the patient’s explicit consent
clinical depression
ethically sound
mentally competent
counseling
IV. Consult the dictionaries and encyclopedias and explain the
meaning of the following phrases with the word aid:
aid worker
AIDS
Band Aid
Christian Aid
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computer-aided design
financial aid
first aid
first aid kit
hearing aid
Kool-Aid (trademark)
Marshall aid
legal aid
visual aid
DISCUSSION QUESTIONS
1. When do you think doctors first started to help patients commit
suicide?
2. What is euthanasia? Is it a legal or an ethical dilemma?
3. What is the attitude of legal scholars and medical ethicists to
euthanasia?
4. What kind of patients usually come to doctors asking to help
them die?
5. What are the results of the survey carried out by the New
England Journal of medicine about the percentage of doctors who
have helped terminal patients die? What do you think the real numbers
are? Would they be different from the ones mentioned in the text?
6. Comment on the bumper sticker “Good Life, Good Death.”
7. Is euthanasia legal in the U.S.A.? In Russia?
ASSIGNMENT: EUTHANASIA: PROS AND CONS.
Make a table listing the reasons in favor of euthanasia and
possible objections to it. Continue filling it in as you go on reading
the texts below.
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TEXT 3
FIRST AND LAST, DO NO HARM
I will give no deadly medicine
to anyone if asked.
The Hippocratic Oath
“Did you ask for your hemlock?” Thanks to appeals court judges in
New York and California, this question, if you live in the U.S., will
now be in your future.
You will be old, infirm and, inevitably at some point, near death.
You may or may not be in physical distress, but in an age of crushing
health-care costs, you will be a burden to your loved ones, to say
nothing of society. And thanks to courts that back in 1996 legalized
doctor-assisted suicide for the first time in American history, all
around you thousands of your aging contemporaries will be taking
their life.
You may want to live those last few remaining weeks or months.
You may have no intention of shortening your life. But now the
question that before 1996 rarely arose — and when it did arise, only in
the most hushed and guilty tones — will be raised routinely: others are
letting go; others are giving way; should not you too?
Of course, the judges who plumbed the depths of the U.S.
Constitution to find the “right” to physician-assisted suicide — a right
unfindable for 200 years — deny the possibility of such a nightmare
scenario. Psychological pressure on the elderly and infirm to take
drugs to hasten death? Why, “there should be none,” breezily decrees
the Second Circuit Court of Appeals.
King Canute had a better grip on reality. This nightmare scenario is
not a hypothesis; it has been tested in Holland and proved a fact.
Holland is the only jurisdiction in the Western world that heretofore
permitted physician-assisted suicide. The practice is now widespread
(perhaps 2,000 to 3,000 cases a year; the U.S. equivalent would be
40,000 to 60,000) and abused. Indeed, legalization has resulted in so
much abuse — not just psychological pressure but a shocking number
of cases of out-and-out involuntary euthanasia, inconvenient and
by Charles Krauthammer
239
defenseless patients simply put to death without their consent — that
last year the Dutch government was forced to change its euthanasia
laws.
Judge Roger Miner, writing for the Second Circuit, un-
comprehendingly admits the reality of the nightmare: “It seems clear
that some physicians [in the Netherlands] practice nonvoluntary
euthanasia, although it is not legal to do so.” Well, why would such
things occur in the Netherlands? Are the people there morally inferior
to Americans? Are the doctors somehow crueler and more uncaring?
Of course not. The obvious reason is that doctors there were
relieved of the constraint of the law. The absolute ethical norm
established since the time of Hippocrates — that doctors must not
kill— was removed in the name of compassion, and the inevitable
happened. Good, ordinary doctors, in their zeal to be ever more
compassionate in terminating useless and suffering life, began killing
people who did not even ask for it. Once given power heretofore
reserved to God, some exceeded their narrow mandate and acted like
God. Surprise. In America the great moral barrier protecting us from
such monstrous God-doctoring is the one separating passive from
active euthanasia. Pulling the plug for the dying is permitted.
Prescribing death-dealing drugs to those who are quite self-sustaining
is not. It is this distinction that the judges are intent on destroying.
“Physicians do not fulfill the role of Toller by prescribing drugs to
hasten death any more than they do by disconnecting life-support
systems,” writes Judge Miner. This is pernicious nonsense. There is a
great difference between, say, not resuscitating a stopped heart —
allowing nature to take its course—and actively killing someone. In
the first case the person is dead. In the second he only wishes to be
dead. And in the case of life sustained by artificial hydration or
ventilation, pulling the plug simply prevents an artificial prolongation
of the dying process. Prescribing hemlock initiates it.
The distinction is not just practical. It is also psychological. Killing
is hard to do. The whole purpose of this case is to make it easier.
How? By giving doctors who actively assist in suicide the blessing of
the law and society.
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