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2024年4月7日发(作者:)
Unite 3 Doctor’s Dilemma: Treat or Let Die?
Abigail Trafford
1. Medical advances in wonder drugs, daring surgical procedures, radiation therapies, and
intensive-care units have brought new life to thousands of people. Yet to many of them,
modern medicine has become a double-edged sword.
2. Doctor’s power to treat with an array of space-age techniques has outstripped the
body’s capacity to heal. More medical problems can be treated, but for many patients, there
is little hope of recovery. Even the fundamental distinction between life and death has been
blurred.
3. Many Americans are caught in medical limbo, as was the South Korean boxer Duk Koo
Kim, who was kept alive by artificial means after he had been knocked unconscious in a fight
and his brain ceased to function. With the permission of his family, doctors in Las Vegas
disconnected the life-support machines and death quickly followed.
4. In the wake of technology’s advances in medicine, a heated debate is taking place in
hospitals and nursing homes across the country --- over whether survival or quality of life is
the paramount goal of medicine.
5. “It gets down to what medicine is all about, ” says Daniel Callahan, director of the
Institute of Society, Ethics, and the Life Sciences in Hastings-on-Hudson, New York. “Is it
really to save a life? Or is the larger goal the welfare of the patient?”
6. Doctors, patients, relatives, and often the courts are being forced to make hard choices
in medicine. Most often it is at the two extremes of life that these difficulty ethical questions
arise --- at the beginning for the very sick newborn and at the end for the dying patient.
7. The dilemma posed by modern medical technology has created the growing new
discipline or bioethics. Many of the country’s 127 medical schools now offer courses in
medical ethics, a field virtually ignored only a decade ago. Many hospitals have chaplains,
philosophers, psychiatrists, and social workers on the staff to help patients make crucial
decisions, and one in twenty institutions has a special ethics committee to resolve difficult
cases.
Death and Dying
8. Of all the patients in intensive-care units who are at risk of dying, some 20 percent
present difficult ethical choices --- whether to keep trying to save the life or to pull back and
let the patient die. In many units, decisions regarding life-sustaining care are made about
three times a week.
9. Even the definition of death has been changed. Now that the heart-lung machine can
take over the functions of breathing and pumping blood, death no longer always comes with
the patient’s “last gasp” or when the heart stops beating. Thirty-one states and the District
of Columbia have passed brain-death statutes that identify death as when the whole brain
ceases to function.
10. More than a dozen states recognize “living wills” in which the patients leave
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