Wolf Ruth
Med Law. 2014 Oct;33(3):49-59.
The medical approach as summarized by Leibowitz--"We must treat the person, not just the disease"--highlights the importance of treating the sick person and not only the illness' pathology. This approach calls for healing not only the physical side, but also--and mainly--the mental aspect of the patient. One of the goals of this article is to turn physicians' attention towards the compassion necessary in treating a person with a severe or chronic illness, or a person who is dying--precisely because sometimes there is no medical cure for the physical state of such a patient. Therefore, physicians' attention does need to be directed to providing emotional assistance to such a patient. Sometimes, the emotional strength the patient draws from the medical team that is treating him can change his view of, and approach to, the illness, and can enable his body to muster the emotional strength necessary to deal with his situation. Buddhism's approach enables the sick patient to experience his illness in a different way, by making peace with one's situation and, sometimes, even viewing the situation differently--viewing the illness as a type of renewal. Buddhism, therefore, enables a sick person to choose a different point of view when his energy is exhausted and he loses hope, providing quality of life to patients. In such a situation, a sick person finds emotional strength in the knowledge that the end of his life is actually a renewal somewhere else. The limited life expectancy of the terminally ill patient demands that he be able to spend his time with minimal concerns and worries, and does not leave much time for treating the emotional side--the patient's fear. In light of this fact, the patient's ability to look ahead and grasp at hope is the most important issue. As much as possible, this is accomplished in an atmosphere of acceptance and with the absence, or reduction, of fear. The freedom to decide for oneself how to behave, according to one's own approach, is what makes it possible for the sick individual to feel empowered, and is liable to encourage the patient to adopt a different point of view. The Buddhist approach recommends replacing the helplessness that usually accompanies the predicament of terminally ill patients with acceptance of responsibility for their behavior in any given situation; this is Buddhism's main contribution to both physicians and patients alike.
莱博维茨总结的医学方法——“我们必须治疗病人,而不仅仅是治疗疾病”——突出了治疗病人而非仅仅治疗疾病病理的重要性。这种方法要求不仅治愈病人身体方面的疾病,而且主要是治愈病人的精神层面。本文的目标之一是将医生的注意力转向治疗重症或慢性病患者或垂危患者时所需的同情心——恰恰是因为有时对于此类患者的身体状况没有医学上的治愈方法。因此,确实需要引导医生关注为这类患者提供情感支持。有时,患者从治疗他的医疗团队中汲取的情感力量可以改变他对疾病的看法和应对方式,并能使他的身体积聚应对自身状况所需的情感力量。佛教的方法能让患病的患者以不同的方式体验疾病,通过与自身状况和解,有时甚至以不同的视角看待这种状况——将疾病视为一种重生。因此,佛教能让病人在精力耗尽且失去希望时选择不同的观点,从而提高患者的生活质量。在这种情况下,病人从这样的认知中找到情感力量,即他生命的终结实际上是在别处的重生。晚期绝症患者有限的预期寿命要求他能够以最少的担忧度过时光,没有多少时间用于处理情感方面——患者的恐惧。鉴于这一事实,患者展望未来并抓住希望的能力是最重要的问题。尽可能在接纳的氛围中且没有恐惧或恐惧减少的情况下做到这一点。根据自己的方式自主决定如何行动的自由,能让患病个体感到有力量,并可能鼓励患者采取不同的观点。佛教方法建议用对自身在任何特定情况下行为的责任感取代通常伴随晚期绝症患者困境的无助感;这是佛教对医生和患者的主要贡献。