評論
打印
Clearly, people didn't want us to talk about death,
顯而易見，人們并不希望我們和他們談論死亡，
or, we thought that.
或者，我們自己如此認為。
So with loads of funding from the Federal Government
所以，在聯邦政府和地方衛生部門資金的支持下
and the local Health Service, we introduced a thing
我們在John Hunter醫院引入了
at John Hunter called Respecting Patient Choices.
一個名為“尊重病人的選擇”的項目
We trained hundreds of people to go to the wards
我們培訓了成百上千的工作人員，
and talk to people about the fact that they would die,
派他到病房去告訴別人他們大限將至
and what would they prefer under those circumstances.
然后問他們有什么打算。
They loved it. The families and the patients, they loved it.
此舉受到病人和家屬的歡迎。
Ninety-eight percent of people really thought
98%的人真的認為
this just should have been normal practice,
這應該成為一種常態化的做法，
and that this is how things should work.
同時，這也是順應自然的做法。
And when they expressed wishes,
而當這些病人表達他們的意愿的時候，
all of those wishes came true, as it were.
所有這些意愿都可以實現。
We were able to make that happen for them.
我們可以幫他們實行他們的意愿。
But then, when the funding ran out,
然而，當這筆資金用完之后中，
we went back to look six months later,
六個月后我們再來評估這一項目，
and everybody had stopped again,
這一做法又被停止了。
and nobody was having these conversations anymore.
也沒有人去進行這方面的談話了。
So that was really kind of heartbreaking for us,
這是一種很令我們心酸的結局，
because we thought this was going to really take off.
因為我們一直以為，這會成為一種常態化的東西。
The cultural issue had reasserted itself.
文化問題又一次得到了體現。
So here's the pitch:
這就是問題所在。
I think it's important that we don't just get on this freeway
我認為，在我們決定走上去ICU這條路時，
to ICU without thinking hard about whether or not
我們真的要想
that's where we all want to end up,
我們是否真的想死在ICU里，
particularly as we become older and increasingly frail
這點在我們老態龍鐘和變得脆弱不堪時尤其重要，
and ICU has less and less and less to offer us.
這時，ICU能為我們做的事情是少之又少的。
There has to be a little side road
如果不去ICU,肯定還有其它的選擇的
off there for people who don't want to go on that track.
前提是——你不想死在ICU里。
And I have one small idea,
而對于可能發生的事，我有一個“小”主意
and one big idea about what could happen.
我一個“大”主意
And this is the small idea.
我的小主意是：
The small idea is, let's all of us
讓我們所有人
engage more with this in the way that Jason has illustrated.
更多地象Jason所描述的那樣。
Why can't we have these kinds of conversations
我們為什么就不能和Jason一樣
with our own elders
和我們的長輩
and people who might be approaching this?
或者那些正在慢慢變老的人和Jason一樣談一下這個問題呢？
There are a couple of things you can do.
你可以為此做一些事情。
One of them is, you can,
其中一個是，
just ask this simple question. This question never fails.
你只需問一個簡單的問題。這是一個很有用的問題。
"In the event that you became too sick to speak for yourself,
“萬一你病得不能講話了，
who would you like to speak for you?"
你想讓誰代你表達你的心聲呢？”
That's a really important question to ask people,
這真是一個非常重要的問題，
because giving people the control over who that is
這是因為，給予誰這個權利
produces an amazing outcome.
會給你帶來不同的結局。
The second thing you can say is,
你可以說的第二個事情是，
"Have you spoken to that person
“你和哪個人談過了
about the things that are important to you
你認為對你來說是很重要的事嗎
so that we've got a better idea of what it is we can do?"
那樣我們就比較清楚我們能為你做些什么。
So that's the little idea.
這就是我的“小”主意。
The big idea, I think, is more political.
我的大主意，我認為更實用。
I think we have to get onto this.
我認為，我們必須做好一件事。
I suggested we should have Occupy Death.
我建議搞一個“占領死亡”運動（Occupy Death）
My wife said, "Yeah, right, sit-ins in the mortuary.
我妻子對我說，“對，對，到太平間去靜坐”
Yeah, yeah. Sure."
對，應該的。
So that one didn't really run,
所以，這個行不通，
but I was very struck by this.
但我還是受到一些打擊的。
Now, I'm an aging hippie.
現在，我是一個老嬉皮士。
I don't know, I don't think I look like that anymore, but
我不知道，我并不認為我還象一個嬉皮士，但是
I had, two of my kids were born at home in the '80s
在90年代，我的兩個小孩都是在家里生產的
when home birth was a big thing, and we baby boomers
那時，在家生小孩是件大事，而我們這幫嬰兒潮年代出生的人
are used to taking charge of the situation,
已經習慣了處理這些事，
so if you just replace all these words of birth,
所以，如果你要替換掉這些關于生產的字，
I like "Peace, Love, Natural Death" as an option.
我會選擇“和平、愛和自然死亡”
I do think we have to get political
我真的認為，我們必須得面對現實
and start to reclaim this process from
并且重申這一進程
the medicalized model in which it's going.
從我們現行的醫療化模型中解放出來
Now, listen, that sounds like a pitch for euthanasia.
聽走來，好像我又在鼓吹安樂死。
I want to make it absolutely crystal clear to you all,
我想向各位澄清一下
I hate euthanasia. I think it's a sideshow.
我討厭安樂死。我認為那是一個次要的問題。
I don't think euthanasia matters.
我不認為安樂死會有什么好處
I actually think that,
事實上，我認為，
in places like Oregon,
在象Oregon這類地方，
where you can have physician-assisted suicide,
你可以尋求到一些在醫生的輔助下的自殺方式，
you take a poisonous dose of stuff,
你可以吃點毒藥之類的東西，
only half a percent of people ever do that.
可只有0.5%的人做過這樣的蠢事。
I'm more interested in what happens to the 99.5 percent
其實，我對其它的99.5%的
of people who don't want to do that.
不想通過服毒而死去的人感興趣。
I think most people don't want to be dead,
我想，大多數人都不想死，
but I do think most people want to have some control
但我認為，大多數人都想能夠控制
over how their dying process proceeds.
自己死亡的過程。
So I'm an opponent of euthanasia,
所以，我反對安樂死，
but I do think we have to give people back some control.
但我又認為，我們應該給病重的人一些自己控制權。
It deprives euthanasia of its oxygen supply.
這能夠讓安樂死失去理由。
I think we should be looking at stopping
我認為，我們應該去嘗試了解病人
the want for euthanasia,
想要安樂死背后的原因，
not for making it illegal or legal or worrying about it at all.
而不只是讓它合法代或非法，或者毫不關心。
This is a quote from Dame Cicely Saunders,
這是Dame Cicely Saunders的一句話，
whom I met when I was a medical student.
我還是一個醫學院學生的時候遇過她
She founded the hospice movement.
她創立了護理所運動。
And she said, "You matter because you are,
她說，“你就是你，你是重要的，
and you matter to the last moment of your life."
直到你生命的最后一刻?！?/div>
And I firmly believe that
我堅定地相信
that's the message that we have to carry forward.
這是我們應該繼續前行的旨意
Thank you.
謝謝
