School of Interdisciplinary Studies, College of Social Sciences, University of Glasgow, Glasgow, UK
School of Interdisciplinary Studies, College of Social Sciences, University of Glasgow, Glasgow, UK.
Med Humanit. 2021 Mar;47(1):61-67. doi: 10.1136/medhum-2018-011621. Epub 2019 Jul 26.
Assisted dying is now a lawful and integral component of many societies 'death system', orienting individual and collective encounters with death and dying. While only a very small number of people living with terminal illness in these societies will opt for an assisted death, the choice, nevertheless, exists for those who satisfy the legal criteria. Theoretically, in these jurisdictions, this turns dying into an optional part of the human life cycle; a final phase of life that, until now, seemed a universal feature of life except in instances of sudden death. As anthropologists specialising in death and dying, we pose the question of how the various cultural scripts that have sought to give meaning to dying in post-industrial Western societies since the mid-20th century might be affected by the advent of assisted dying. We begin by building on both medical and social science literature to construct a working definition of 'dying'. We then identify four dominant cultural scripts: psychological growth, preparation for death, the suffering experience and the caring experience. After outlining each script, we discuss how it may (or may not) be affected by the increase in assisted dying legislation. We propose that it is the 'caring' script; the notion of affective, intergenerational bonds created through the experience of caring for people specifically in the last few months or weeks of their life, which are likely to be most affected. However, we find that access to these cultural scripts is already limited because of the widespread reluctance to recognise and name 'dying', and the challenges of doing so. Consequently, the various cultural scripts we identify are negated not by the increase in assisted dying, but rather by a combination of medical advances and institutional orthodoxies which limit opportunity for people to experience themselves, or others, as 'dying'.
协助自杀现在是许多社会“死亡体系”中的合法且不可或缺的组成部分，引导着个人和集体面对死亡。虽然这些社会中只有极少数患有绝症的人会选择协助自杀，但对于那些符合法律标准的人来说，这种选择是存在的。从理论上讲，在这些司法管辖区，死亡变成了人类生命周期中的一个可选部分；这是生命的最后一个阶段，直到现在，除了突然死亡之外，死亡似乎是生命的普遍特征。作为专门研究死亡的人类学家，我们提出了一个问题，即在 20 世纪中叶以来，试图为后工业西方社会赋予死亡意义的各种文化脚本会如何受到协助自杀的影响。我们首先借鉴医学和社会科学文献，构建了一个关于“死亡”的工作定义。然后，我们确定了四个主要的文化脚本：心理成长、死亡准备、痛苦体验和关怀体验。在概述每个脚本之后，我们讨论了它可能（或可能不会）受到协助自杀立法增加的影响。我们提出，最有可能受到影响的是“关怀”脚本；即通过在生命的最后几个月或几周照顾他人的经历而产生的情感、代际纽带的概念。然而，我们发现，由于普遍不愿意承认和命名“死亡”，以及承认和命名“死亡”所带来的挑战，这些文化脚本的获得已经受到限制。因此，我们所确定的各种文化脚本并没有被协助自杀的增加所否定，而是被医疗进步和机构正统观念所否定，这些观念限制了人们体验自己或他人“死亡”的机会。
