安乐死 – 选择的权利

本文获得: Play Club annual essay competition Golden Award

作者：Edward Fanghua Yu

敬爱的州长：

就在上个月，SB128， 一个非常重要的法案没有被加州的立法机构通过。该法案将在州内使得安乐死合法化，但未能通过州议会的健康委员会。我坚信，安乐死有其令人信服的理由，但这个理由被教条式的和过时的反对意见所遮蔽。安乐死在华盛顿州和俄勒冈州的成功实施证明其可行性。我希望能说服您使用州长的权力来呼吁立法机构通过该法案。

反对安乐死合法化常见的理由是允许安乐死会导致负面的影响，像对临终关怀的投资减少和来自家族的压力导致强迫自杀，尤其是对于收入较低的患者。但俄勒冈州通过的类似法案（DWDA）使得临终关怀有了改善。通过该法案之后，俄勒冈州迅速集结了专案组致力于改善临终关怀，还取消了限制使用止痛药的法律，允许医生更自由地对绝症患者使用个体化的治疗。

这被引为俄勒冈州提高临终关怀的实例。事实上，只有四分之一的选择安乐死的患者认为不能足够缓解疼痛是他们做出选择的原因。安乐死法案也不仅仅是影响穷人。只有3％的俄勒冈州的患者因为财务原因选择安乐死。有趣的是，常见的反对安乐死的三个理由，即患者会受财政压力，家庭压力的影响和减少疼痛控制的开支，在选择安乐死的患者中是最少考虑的。这是因为对安乐死的程序有严格的规定，用来防止外来的压力影响了患者的判断。华盛顿州的安乐死法案要求有二位医师核实患者的心理健康和一位没有亲戚关系的成年人签字才能使整个程序合法化。

值得注意的是，安乐死的合法化并不会使其正常化。安乐死的合法化只是给慢性疾病和癌症患者提供一个选择。在华盛顿州，大约每年有一万两千人死于癌症， 但只有少于两百人选择安乐死，相当于不到百分之二。许多道德的忧虑是害怕压倒性的自杀比例会导致伦理的败坏，但从安乐死这么小的比例来看，这些忧虑是误导性的。

安乐死赋予了患者维护自己尊严和自主的权利，因此非常重要。身患绝症的病人仍然可以选择进行正常的治疗。但安乐死的合法化授予了那些不想经受疾病对他们身体造成不可避免的衰弱的患者权利。这些不想在医院病床上慢慢死去的患者可以得到解脱。一个突出的例子是布列塔尼•梅纳德，她是加利福尼亚州的居民，搬到俄勒冈州以行使其选择安乐死的权利。在确诊为一种极其恶性的脑癌，第四期胶质母细胞瘤多形性之后，她知道她将在几个月之内死去。她与多个专家讨论过最后几个月将过怎样的生活，她被吓坏了，她知道自己不愿意以这种方式死去。安乐死允许她有尊严地去世了。我相信如果法案SB-128通过了，她就不必要搬离加州来结束她的痛苦。如果SB-128通过了，您将允许像布列塔尼一样的绝症患者找到结束他们痛苦折磨的方式。你会给这些患者最伟大的礼物。你会给他们选择的权利。

致敬
一个关心的加州居民



附英文原文：

Euthanasia- The Right to Choose

Edward Fanghua Yu

High School Division, Male

12th Grade, Dougherty Valley High School

Dear Mr. Governor,

Just last month, an extremely significant bill was stalled in California’s legislature-SB 128. The bill would have legalized euthanasia within the state, but was unable to pass the Assembly’s Health Committee. I strongly believe that there is a compelling argument for euthanasia that is being clouded out by the dogmatic, outdated responses of the opposition. Its successful implementation in both Washington and Oregon demonstrate its viability. I hope to convince you to use your authority as governor to call a legislative session to pass the bill.

A commonly used argument against legalization is that accepting euthanasia would lead to negative effects such as decreased investment in palliative care and familial coercion to commit suicide, particularly among lower income patients. But the passage of Oregon’s Death with Dignity Act (DWDA) has led to an improvement in palliative care. After the act passed, Oregon quickly assembled a task force to improve their palliative care efforts and removed broad laws that limited the use of pain medication, allowing doctors more freedom to use individualized treatments on terminally ill patients.

This is cited as improving the palliative care services of the state. In fact, only a quarter of the patients of DWDA cited inadequate pain relief as a reason for euthanasia. DWDA does not disproportionately affect the poor either. Only three percent of Oregon’s patients cited financial implications as a reason for euthanasia. Interestingly, the trio of common anti-euthanasia arguments- that patients will be affected by financial pressure, familial pressure, or a decrease in spending on pain control- makes up the smallest three concerns of DWDA recipients. This is because euthanasia programs are coupled with intense provisions preventing pressure from affecting the patient’s judgment. Washington’s DWDA requires two physicians to verify the patient’s mental health and an unrelated adult to sign off on the patient’s request to legitimize the process.

It is important to understand that legalizing euthanasia will not normalize it. Legalization of euthanasia only provides an option to patients who are suffering from chronic illnesses and cancer. In Washington, where there are an estimated twelve thousand deaths due to cancer per year, less than two hundred choose euthanasia, which is equivalent to less than two percent. Many moral arguments stem from a fear of corrupted ethics due to an overpowering trend of suicides, but with such small results, these arguments are misleading.

Euthanasia is important because it allows patients who want to preserve their dignity and autonomy the ability to do so. Terminally ill patients may still choose to undergo normal methods of treatment. But legalization of euthanasia empowers those who want to forgo the degradation that the disease will inevitably cause to their bodies. Those patients who do not want to see themselves slowly waste away in a hospital bed can now relieve their suffering. A prominent activist for euthanasia was Brittany Maynard, a resident of California who had to move to Oregon to exercise her right to choose. Diagnosed with stage IV glioblastoma multiforme, an extremely malignant brain cancer, she knew would die within months. After discussing with many experts what her last days would be like, she was terrified and knew she did not want to die that way. Euthanasia allowed her to die with her dignity. I believe that she should not have had to leave our state to end her suffering. By passing SB-128, you would allow terminally ill patients like Brittany to find an end to their torment. You would give these patients the greatest gift. You would give them a choice.

Sincerely,

A Concerned Citizen.

原稿首发于中华商报