Nairn T A
Catholic Theological Union, Chicago, IL, USA.
Health Prog. 1997 Nov-Dec;78(6):36-9, 42.
The success of science and medical technology has led to medical brinkmanship, pushing aggressive treatment as far as it can go. But medicine lacks the precision necessary for such brinkmanship to succeed, and the resulting cycle of expectation and disappointment in technology has, in part, led to an increasing acceptance of euthanasia and assisted suicide, linked closely with advocacy for patient autonomy. At the opposite extreme lies medical vitalism, which refers to attempts to preserve the patient's life in and of itself without any significant hope for recovery. The Catholic moral tradition offers a middle ground, well expressed in the 1994 Ethical and Religious Directives for Catholic Health Care Services. The tradition does not deny the good of technology or state that some lives are not worth living. Rather, it calls us to accept the fact that medical technology has limits. In reclaiming this tradition, we reclaim the naturalness of death. Reclaiming the tradition has practical consequences for the use of life-prolonging technology at the end of life and for end-of-life decision making. These can be placed in three broad categories: the Christian understanding of care, the ambiguity inherent in end-of-life decision making, and the task of Christian formation.
科学与医疗技术的成功导致了医疗边缘政策，将激进治疗推向极致。但医学缺乏使这种边缘政策成功所需的精准度，而由此产生的对技术的期望与失望的循环，在一定程度上导致了对安乐死和协助自杀的接受度不断上升，这与倡导患者自主权密切相关。与之相反的极端是医学活力论，它指的是试图单纯维持患者的生命，而对康复毫无显著希望。天主教道德传统提供了一个中间立场，这在1994年的《天主教医疗服务伦理与宗教指南》中得到了很好的体现。该传统并不否认技术的益处，也没有宣称有些生命不值得活下去。相反，它呼吁我们接受医学技术存在局限性这一事实。在重拾这一传统的过程中，我们重拾了死亡的自然性。重拾这一传统对于临终时使用延长生命的技术以及临终决策具有实际影响。这些影响可大致分为三类：基督教对护理的理解、临终决策中固有的模糊性以及基督教培育的任务。
