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1、Unit 4 Active and Passive EuthanasiaU8Additional lnformation for the Teachers Reference Text Active and Passive EuthanasiaWarm-up ActivitiesFurther ReadingWriting SkillsAdditional WorkUnit 4 Active and Passive EuthanasiaWarm-up Activities1. Try to give a definition of euthanasia.2. Brainstorm about

2、the pros and cons of euthanasia.3. Collect references to this issue and take down notes. 4. Order information and work out your own opinion. Warm-upUnit 4 Active and Passive Euthanasia James Rachels was an American professor of moral philosophy and medical ethics who was particularly concerned with

3、ethical issues. Born in Columbus, Georgia, he earned degrees at Mercer University and the University of California before joining the University of Alabama, Birmingham Department of Philosophy faculty in 1977. The popularity of his groundbreaking textbook anthology Moral Problems (1971), which sold

4、100,000 copies, influenced American universities to move away from more traditional philosophically oriented undergraduate moral philosophy courses toward more practical undergraduate courses in ethics. Additional lnformation for the Teachers Reference1. James Rachels (1941 - 2003)Unit 4 Active and

5、Passive Euthanasia2. EuthanasiaEuthanasia is a practice of mercifully ending a persons life in order to release the person from an incurable disease, intolerable suffering, or undignified death. The word euthanasia derives from the Greek for “good death and originally referred to intentional mercy k

6、illing. Proponents of euthanasia believe that unnecessarily prolonging life in terminally ill patients causes suffering to the patients and their family members. Many societies now permit passive euthanasia, which allows physicians to withhold or withdraw life-sustaining treatment when directed to d

7、o so by the patient or an authorized representative.Unit 4 Active and Passive Euthanasia Euthanasia differs from assisted suicide, in which a patient voluntarily brings about his or her own death with the assistance of another person, typically a physician. In this case, the act is a suicide (intent

8、ional self-inflicted death), because the patient actually causes his or her own death.A. Related Laws As laws have evolved from their traditional religious underpinnings, certain forms of euthanasia have been legally accepted. In general, laws attempt to draw a line between passive euthanasia (gener

9、ally associated with allowing a person to die) and active euthanasia (generally associated with killing a person). While laws commonly permit passive euthanasia, active euthanasia is typically prohibited.Unit 4 Active and Passive Euthanasia Laws in the United States and Canada maintain the distincti

10、on between passive and active euthanasia. While active euthanasia is prohibited, courts in both countries have ruled that physicians should not be legally punished if they withhold or withdraw a life-sustaining treatment at the request of a patient or the patients authorized representative. These de

11、cisions are based on increasing acceptance of the doctrine that patients possess a right to refuse treatment. Until the late 1970s, whether or not patients possessed a legal right of refusal was highly disputed. One factor that may have contributed to growing acceptance of this right is the ability

12、to keep individuals alive for long periods of time even when they are permanently unconscious or severely brain-damaged. Proponents jets Unit 4 Active and Passive Euthanasiaof legalized euthanasia believe that prolonging life through the use of modern technological advances, such as respirators and

13、kidney machines, may cause unwarranted suffering to the patient and the family. As technology has advanced, the legal rights of the patient to forgo such technological intervention have expanded. Every U.S. state has adopted laws that authorize legally competent individuals to make advanced directiv

14、es, often referred to as living wills. Such documents allow individuals to control some features of the time and manner of their deaths. In particular, these directives empower and instruct doctors to withhold life-support systems if the individuals become terminally ill. Furthermore, the federal Pa

15、tient Self-Determination Act, which became effective in 1991, requires federally certified health-care betUnit 4 Active and Passive Euthanasiafacilities to notify competent adult patients of their right to accept or refuse medical treatment. The facilities must also inform such patients of their rig

16、hts under the applicable state law to formulate an advanced directive. Patients in Canada have similar rights to refuse life-sustaining treatments and formulate advanced directives. As of mid-1999, only one U.S. state, Oregon, had enacted a law allowing physicians to actively assist patients who wis

17、h to end their lives. However, Oregons law concerns assisted suicide rather than active euthanasia. It authorizes physicians to prescribe lethal amounts of medication that patients then administer themselves. In response to modern medical technology, physicians and lawmakers are slowly developing ne

18、w professional and legal definitions of death. Additionally, experts are formulating rules to batUnit 4 Active and Passive Euthanasiaimplement these definitions in clinical situations, for example, when procuring organs for transplantation. The majority of states have accepted a definition of brain

19、death the point when certain parts of the brain cease to function as the time when it is legal to turn off a patients life-support system, with permission from the family. In 1995 the Northern Territory of Australia became the first jurisdiction to explicitly legalize voluntary active euthanasia. Ho

20、wever, the federal parliament of Australia overturned the law in 1997. In 2001 The Netherlands became the first country to legalize active euthanasia and assisted suicide, formalizing medical practices that the government had tolerated for years. Under the Dutch law, euthanasia is justified (not leg

21、ally punishable) if the mustUnit 4 Active and Passive Euthanasiaphysician follows strict guidelines. Justified euthanasia occurs if (1) the patient makes a voluntary, informed, and stable request; (2) the patient is suffering unbearably with no prospect of improvement; (3) the physician consults wit

22、h another physician, who in turn concurs with the decision to help the patient die; and (4) the physician performing the euthanasia procedure carefully reviews the patients condition. Officials estimate that about 2 percent of all deaths in The Netherlands each year occur as a result of euthanasia.B

23、. Prevalence Although establishing the actual prevalence of active euthanasia is difficult, studies suggest that the practice is not common in the United States. In a study published in 1998 in the New England Journal of Medicine, only about 6 percent of basketballUnit 4 Active and Passive Euthanasi

24、aphysicians surveyed reported that they had helped a patient hasten his or her own death by administering a lethal injection or prescribing a fatal dose of medication. (Eighteen percent of the responding physicians indicated that they had received requests for such assistance.) However, one-fifth of

25、 the physicians surveyed indicated that they would be willing to assist patients if it were legal to do so. No comparable data are available for Canada. However, in 1998 the Canadian Medical Association (CMA) proposed that a study of euthanasia and physician-assisted suicide be undertaken due to poo

26、r information on the subject.C. Ethical Concerns The issue of euthanasia raises ethical questions for physicians and other health-care providers. The ethical code of physicians in theUnit 4 Active and Passive EuthanasiaUnited States has long been based in part on the Hippocratic Oath, which requires

27、 physicians to do no harm. However, medical ethics are refined over time as definitions of harm change. Prior to the 1970s, the right of patients to refuse life-sustaining treatment (passive euthanasia) was controversial. As a result of various court cases, this right is nearly universally acknowled

28、ged today, even among conservative bioethicists (see Medical Ethics). The controversy over active euthanasia remains intense, in part because of opposition from religious groups and many members of the legal and medical professions. Opponents of voluntary active euthanasia emphasize that health-care

29、 providers have professional obligations that prohibit killing. These opponents maintain that active euthanasia is inconsistent with the roles of nursing, basketballUnit 4 Active and Passive Euthanasiacaregiving, and healing. Opponents also argue that permitting physicians to engage in active euthan

30、asia creates intolerable risks of abuse and misuse of the power over life and death. They acknowledge that particular instances of active euthanasia may sometimes be morally justified. However, opponents argue that sanctioning the practice of killing would, on balance, cause more harm than benefit.

31、Supporters of voluntary active euthanasia maintain that, in certain cases, relief from suffering (rather than preserving life) should be the primary objective of health-care providers. They argue that society is obligated to acknowledge the rights of patients and to respect the decisions of those wh

32、o elect euthanasia. Supporters of active euthanasia contend that since society has mutualUnit 4 Active and Passive Euthanasiaacknowledged a patients right to passive euthanasia (for example, by legally recognizing refusal of life-sustaining treatment), active euthanasia should similarly be permitted

33、. When arguing on behalf of legalizing active euthanasia, proponents emphasize circumstances in which a condition has become overwhelmingly burdensome for a patient, pain management for the patient is inadequate, and only a physician seems capable of bringing relief. They also point out that almost

34、any individual freedom involves some risk of abuse and argue that such risks can be kept to a minimum by using proper legal safeguards.Unit 4 Active and Passive Euthanasia3. American Medical Association The American Medical Association (AMA), founded in 1847 and incorporated 1897, is the largest ass

35、ociation of physicians and medical students in the United States. It is a nonprofit professional association of physicians, including all medical specialties. The AMAs purpose is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physician

36、s and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, to raise money for medical education and to serve as an advocate for the advancement of the profession. The Association also publishes the Journal of the American Medical Association (JAMA)

37、, which has the largest circulation of any weekly medical journal in the world. The AMA also publishes a list of Physician Specialty Codes which are a standard method in the U.S. for identifying physician and practice specialties.Unit 4 Active and Passive EuthanasiaText Active and Passive Euthanasia

38、NotesIntroduction to the Author and the ArticlePhrases and ExpressionsExercisesMain Idea of the Text Unit 4 Active and Passive EuthanasiaMain Idea of the Text 1Main Idea of the Text Rachelsessay “Active and Passive Euthanasia first appeared in the New England Journal of Medicine in 1975. In it, Rach

39、els argues that killing is not morally worse than letting a person die of natural causes, when done for humanitarian reasons. Therefore, active euthanasia is not any worse than passive euthanasia, and in cases where a patient is spared needless pain, arguably better.Unit 4 Active and Passive Euthana

40、sia James Rachels (1941 2003) was an American professor of moral philosophy and medical ethics who was particularly concerned with ethical issues. Born in Columbus, Georgia, he earned degrees at Mercer University and the University of California before joining the University of Alabama, Birmingham D

41、epartment of Philosophy faculty in 1977. The popularity of his groundbreaking textbook anthology Moral Problems (1971), which sold 100,000 copies, influenced American universities to move away from more traditional philosophically oriented undergraduate moral philosophy courses toward more practical

42、 undergraduate courses in ethics. Introduction to the Author and the articleIntroduction to the Author and the ArticleUnit 4 Active and Passive EuthanasiaRachelsessay “Active and Passive Euthanasia first appeared in the New England Journal of Medicine in 1975. In it, Rachels argues that killing is n

43、ot morally worse than letting a person die of natural causes, when done for humanitarian reasons. Therefore, active euthanasia is not any worse than passive euthanasia, and in cases where a patient is spared needless pain, arguably better.Introduction to the Author and the articleUnit 4 Active and P

44、assive EuthanasiaPart2_T1 The distinction between active and passive euthanasia is thought to be crucial for medical ethics. The idea is that it is permissible, at least in some cases, to withhold treatment and allow a patient to die, but it is never permissible to take any direct action designed to

45、 kill the patient. This doctrine seems to be accepted by most doctors, and it is endorsed in a statement adopted by the American Medical Association on December 4, 1973:James RachelsActive and Passive EuthanasiaTextUnit 4 Active and Passive Euthanasia The intentional termination of the life of one h

46、uman being by another mercy killing is contrary to that for which the medical profession stands and is contrary to the policy of the American Medical Association. The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological

47、 death is imminent is the decision of the patient and/or his immediate family. The advice and judgment of the physician should be freely available to the patient and/or his immediate family.Part2_T2Unit 4 Active and Passive Euthanasia However, a strong case can be made against this doctrine. In what

48、 follows I will set out some of the relevant arguments, and urge doctors to reconsider their views on this matter. To begin with a familiar type of situation, a patient who is dying of incurable cancer of the throat is in terrible pain, which can no longer be satisfactorily alleviated. He is certain

49、 to die within a few days, even if present treatment is continued, but he does not want to go on living for those days since the pain is unbearable. So he asks the doctor for an end to it, and his family joins in the request. Part2_T3Unit 4 Active and Passive Euthanasia Suppose the doctor agrees to

50、withhold treatment, as the conventional doctrine says he may. The justification for his doing so is that the patient is in terrible agony, and since he is going to die anyway, it would be wrong to prolong his suffering needlessly. But now notice this. If one simply withholds treatment, it may take t

51、he patient longer to die, and so he may suffer more than he would if more direct action were taken and a lethal injection given. This fact provides a strong reason for thinking that, once the initial decision not to prolong his agony has been made, active euthanasia is actually preferable to passive

52、 euthanasia, rather than the reverse. To say otherwise is to endorse the option that leads to more suffering rather than less, and is contrary to the humanitarian impulse that prompts the decision not to prolong his life in the first place.Part2_T4Unit 4 Active and Passive Euthanasia Part of my poin

53、t is that the process of being “allowed to die can be relatively slow and painful, whereas being given a lethal injection is relatively quick and painless. Let me give a different sort of example. In the United States about one in 600 babies is born with Downs syndrome.1 Most of these babies are oth

54、erwise healthy that is, with only the usual pediatric care, they will proceed to an otherwise normal infancy. Some, however, are born with congenital defects such as intestinal obstruction that require operations if they are to live. Sometimes, the parents and the doctor will decide not to operate,

55、and let the infant die. Anthony Shaw describes what happens then:Part2_T5Unit 4 Active and Passive EuthanasiaPart2_T6 . When surgery is denied the doctor must try to keep the infant from suffering while natural forces sap the babys life away. As a surgeon whose natural inclination is to use the scal

56、pel to fight off death, standing by and watching a salvageable baby die is the most emotionally exhausting experience I know. It is easy at a conference, in a theoretical discussion, to decide that such infants should be allowed to die. It is altogether different to stand by in the nursery and watch

57、 as dehydration and infection wither a tiny being over hours and days. This is a terrible ordeal for me and the hospital staff much worse so than for the parents who never set foot in the nursery.Unit 4 Active and Passive EuthanasiaPart2_T7I can understand why some people are opposed to all euthanas

58、ia and insist that such infants must be allowed to live. I think I can also understand why other people favor destroying these babies quickly and painlessly. But why should anyone favor letting “dehydration and infection wither a tiny being over hours and days? The doctrine that says that a baby may

59、 be allowed to dehydrate and wither, but may not be given an injection that would end its life without suffering, seems so patently cruel as to require no further refutation. The strong language is not intended to offend, but only to put the point in the clearest possible way. My second argument is

60、that the conventional doctrine leads to decisions concerning life and death made on irrelevant grounds.Unit 4 Active and Passive EuthanasiaPart2_T8 Consider again the case of the infants with Downs syndrome who need operations for congenital defects unrelated to the syndrome to live. Sometimes, ther

61、e is no operation, and the baby dies, but when there is no such defect, the baby lives on. Now, an operation such as that to remove an intestinal obstruction is not prohibitively difficult. The reason why such operations are not performed in these cases is, clearly, that the child has Downs syndrome

62、 and the parents and doctor judge that because of the fact it is better for the child to die.Unit 4 Active and Passive Euthanasia But notice that this situation is absurd, no matter what view one takes of the lives and potentials of such babies. If the life of such an infant is worth preserving, wha

63、t does it matter if it needs a simple operation? Or, if one thinks it better that such a baby should not live on, what difference does it make that it happens to have an unobstructed intestinal tract? In either case, the matter of life and death is being decided on irrelevant grounds. It is the Down

64、s syndrome, and not the intestines, that is the issue. The matter should be decided, if at all, on that basis, and not be allowed to depend on the essentially irrelevant question of whether the intestinal tract is blocked.Part2_T9Unit 4 Active and Passive EuthanasiaWhat makes this situation possible

65、, of course, is the idea that when there is an intestinal blockage, one can “let the baby die, but when there is no such defect there is nothing that can be done, for one must not “kill it. The fact that this idea leads to such results as deciding life or death on irrelevant grounds is another good

66、reason why the doctrine should be rejected.One reason why so many people think that there is an important moral difference between active and passive euthanasia is that they think killing someone is morally worse than letting someone die. But is it? Is killing, in itself, worse than letting die? To

67、investigate this issue, two cases may be considered that are exactly alike except that one involves killing whereas the otherPart2_T10Unit 4 Active and Passive EuthanasiaPart2_T11involves letting someone die. Then, it can be asked whether this difference makes any difference to the moral assessments

68、. It is important that the cases be exactly alike, except for this one difference, since otherwise one cannot be confident that it is this difference and not some other that accounts for any variation in the assessments of the two cases. So, let us consider this pair of cases: In the first, Smith st

69、ands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.Unit 4 Active and Passive EuthanasiaPart2_T12 In

70、the second, Jones also stands to gain if anything should happen to his six-year-old cousin. Like Smith, Jones sneaks in planning to drown the child in his bath. However, just as he enters the bathroom Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he

71、 stands by, ready to push the childs head back under if it is necessary, but it is not necessary. With only a little thrashing about, the child drowns all by himself, “accidentally, as Jones watches and does nothing. Now Smith killed the child, whereas Jones “merely let the child die. That is the on

72、ly difference between them. Did either man behave better, from a moral point of view? If the difference between killing and letting die were in itself a morally importantUnit 4 Active and Passive EuthanasiaPart2_T13matter, one should say that Joness behavior was less reprehensible than Smiths. But d

73、oes one really want to say that? I think not. In the first place, both men acted from the same motive, personal gain, and both had exactly the same end in view when they acted. It may be inferred from Smiths conduct that he is a bad man, although that judgment may be withdrawn or modified if certain

74、 further facts are learned about him for example, that he is mentally deranged. But would not the very same thing be inferred about Jones from his conduct? And would not the same further considerations also be relevant to any modification of this judgment? Moreover, suppose Jones pleaded, in his own

75、 defense, Unit 4 Active and Passive Euthanasia“After all, I didnt do anything except just stand there and watch the child drown. I didnt kill him; I only let him die. Again, if letting die were in itself less bad than killing, this defense should have at least some weight. But it does not. Such a “d

76、efense can only be regarded as a grotesque perversion of moral reasoning. Morally speaking, it is no defense at all. Now, it may be pointed out, quite properly, that the cases of euthanasia with which doctors are concerned are not like this at all. They do not involve personal gain or the destructio

77、n of normal healthy children. Doctors are concerned only with cases in which the patients life is of no further use to him, or in which the patients life has become or will soon become a terrible burden. Part2_T14Unit 4 Active and Passive EuthanasiaPart2_T15However, the point is the same in these ca

78、ses: the bare difference between killing and letting die does not, in itself, make a moral difference. If a doctor lets a patient die, for humane reasons, he is in the same moral position as if he had given the patient a lethal injection for humane reasons. If his decision was wrong if, for example,

79、 the patients illness was in fact curable the decision would be equally regrettable no matter which method was used to carry it out. And if the doctors decision is the right one, the method used is not in itself important. The AMA policy statement isolates the crucial issue very well; the crucial is

80、sue is “the intentional termination of the life of one human being by another. But after identifying this issue, and Unit 4 Active and Passive EuthanasiaPart2_T16forbidding “mercy killing, the statement goes on to deny that the cessation of treatment is the intentional termination of a life. This is

81、 where the mistake comes in, for what is the cessation of treatment, in these circumstances, if it is not “the intentional termination of the life of one human being by another? Of course it is exactly that, and if it were not, there would be no point to it. Many people will find this judgment hard

82、to accept. One reason, I think, is that it is very easy to conflate the question of whether killing is, in itself, worse than letting die, with the very different question of whether most actual cases of killing are more reprehensible than most actual cases of letting die. Most actual cases of killi

83、ng are clearly terrible (think, for example, of all theUnit 4 Active and Passive EuthanasiaPart2_T17murders reported in the newspapers), and one hears of such cases every day. On the other hand, one hardly ever hears of a case of letting die, except for the actions of doctors who are motivated by hu

84、manitarian reasons. So one learns to think of killing in a much worse light than of letting die. But this does not mean that there is something about killing that makes it in itself worse than letting die, for it is not the bare difference between killing and letting die that makes the difference in

85、 these cases. Rather, the other factors the murderers motive of personal gain, for example, contrasted with the doctors humanitarian motivation account for different reactions to the different cases. Unit 4 Active and Passive EuthanasiaPart2_T18I have argued that killing is not in itself any worse t

86、han letting die; if my contention is right, it follows that active euthanasia is not any worse than passive euthanasia. What arguments can be given on the other side? The most common, I believe, is the following:“The important difference between active and passive euthanasia is that: in passive euth

87、anasia, the doctor does not do anything to bring about the patients death. The doctor does nothing, and the patient dies of whatever ills already afflict him. In active euthanasia, however, the doctor does something to bring about the patients death: he kills him. The doctor who gives the patient wi

88、th cancer a lethal injection has himself caused his patients death; whereas if he merely ceases treatment, the cancer is the cause of the death.Unit 4 Active and Passive EuthanasiaPart2_T19 A number of points need to be made here. The first is that it is not exactly correct to say that in passive eu

89、thanasia the doctor does nothing, for he does do one thing that is very important: he lets the patient die. “Letting someone die is certainly different, in some respects, from other types of action mainly in that it is a kind of action that one may perform by way of not performing certain other acti

90、ons. For example, one may let a patient die by way of not giving medication, just as one may insult someone by way of not shaking his hand. But for any purpose of moral assessment, it is a type of action nonetheless. The decision to let a patient die is subject to moral appraisal in the same way tha

91、t a decision to kill him would be subject to moral appraisal: it may be assessed as wise or unwise, Unit 4 Active and Passive EuthanasiaPart2_T20compassionate or sadistic, right or wrong. If a doctor deliberately let a patient die who was suffering from a routinely curable illness, the doctor would

92、certainly be to blame for what he had done, just as he would be to blame if he had needlessly killed the patient. Charges against him would then be appropriate. If so, it would be no defense at all for him to insist that he didnt “do anything. He would have done something very serious indeed, for he

93、 let his patient die. Fixing the cause of death may be very important from a legal point of view, for it may determine whether criminal charges are brought against the doctor. But I do not think that this notion can be used to show a moral difference between active and passive euthanasia. The reason

94、 why it is considered bad to be the cause ofUnit 4 Active and Passive EuthanasiaPart2_T21someones death is that death is regarded as a great evil and so it is. However, if it has been decided that euthanasia even passive euthanasia is desirable in a given case, it has also been decided that in this

95、instance death is no greater an evil than the patients continued existence. And if this is true, the usual reason for not wanting to be the cause of someones death simply does not apply. Finally, doctors may think that all of this is only of academic interest the sort of thing that philosophers may

96、worry about but that has no practical bearing on their own work. After all, doctors must be concerned about the legal consequences of what they do, and active euthanasia is clearly forbidden by the law. Unit 4 Active and Passive EuthanasiaPart2_T22But even so, doctors should also be concerned with t

97、he fact that the law is forcing upon them a moral doctrine that may well be indefensible, and has a considerable effect on their practices. Of course, most doctors are not now in the position of being coerced in this matter, for they do not regard themselves as merely going along with what the law r

98、equires. Rather, in statements such as the AMA policy statement that I quoted, they are endorsing this doctrine as a central point of medical ethics. In that statement, active euthanasia is condemned not merely as illegal but as “contrary to that for which the medical profession stands, whereas pass

99、ive euthanasia is approved. However, the preceding considerations suggest thatUnit 4 Active and Passive EuthanasiaPart2_T23there is really no moral difference between the two, considered in themselves (there may be important moral differences in some cases in their consequences, but, as I pointed ou

100、t, these differences may make active euthanasia, and not passive euthanasia, the morally preferable operation). So, whereas doctors may have to discriminate between active and passive euthanasia to satisfy the law, they should not do any more than that. In particular, they should not give the distin

101、ction any added authority and weight by writing it into official statements of medical ethics.Unit 4 Active and Passive EuthanasiaNotesPart2_TA_Notes1Downs syndrome: congenital mental and physical retardation caused by an extra chromosome. The condition, also called Mongolism, is characterized by a

102、flat face and epicanthic folds.Anthony Shaw (1929 - ): a certified American physician. After graduation from New York University School of Medicine, he taught in medical school while practicing his secondary specialty, pediatric surgery.AMA: American Medical AssociationUnit 4 Active and Passive Euth

103、anasiamake a case against: argue that sth. is wrongset out: give the details of sth. or explain it in a clear, organized way, esp. in writingset foot in: go to (a place)account for: explain the reason for or cause of sth.in a . light: in the way specifiedbe subject to: be under the control ofhave a

104、bearing on: have an influence on (sth.) or a relationship to (sth.) go along with: support; agree with discriminate between: be able to see the difference between two things or peoplePhrases and ExpressionsPart2_TA_ Phrases and ExpressionsUnit 4 Active and Passive Euthanasia积极安乐死与消极安乐死积极安乐死与消极安乐死Par

105、t2_TA_t1一一般般认认为为，积积极极安安乐乐死死与与消消极极安安乐乐死死之之间间的的区区别别对对于于医医学学伦伦理理而而言言是是至至关关重重要要的的。有有一一种种想想法法认认为为：至至少少在在某某些些病病例例中中，可可以以允允许许停停止止治治疗疗，并并让让病病人人就就此此死死去去。但但是是，从从来来不不会会允允许许有有人人采采取取任任何何预预先先方方案案杀杀死死病病人人的的直直接接行行为为。这这一一规规定定似似乎乎已已经经被被大大多多数数医医生生接接受受了了，并并且且也也被被美国医学学会美国医学学会1973年年12月月4日的宣言所认可。日的宣言所认可。一一个个人人的的生生命命被被另另一一

106、个个人人用用无无痛痛苦苦致致死死方方式式而而成成心心终终止止是是与与专专业业医医学精神背道而驰的，并且不符合美国医学学会的政策。学精神背道而驰的，并且不符合美国医学学会的政策。当当发发现现有有毋毋庸庸置置疑疑的的迹迹象象说说明明病病人人的的生生物物性性死死亡亡正正在在步步步步逼逼近近时时，是是否否停停止止使使用用特特别别方方式式来来延延长长躯躯体体的的生生命命是是由由病病人人和和/或或他他的的直直系系亲亲属属来决定的。医师的建议和判断应免费提供给病人和来决定的。医师的建议和判断应免费提供给病人和/或他的直系亲属。或他的直系亲属。Translation of Text詹姆斯詹姆斯雷切雷切尔尔Un

107、it 4 Active and Passive EuthanasiaPart2_TA_t2然然而而，有有另另外外一一种种观观点点可可以以强强有有力力地地反反驳驳这这一一规规定定。以以下下我我会会提提出出一一些相关论点，并强烈建议医生们重新考虑他们对这件事情的看法。些相关论点，并强烈建议医生们重新考虑他们对这件事情的看法。首首先先，一一种种常常见见的的情情形形，即即一一位位患患有有喉喉癌癌的的病病人人，病病情情严严重重无无法法医医治治，本本人人备备受受病病痛痛折折磨磨，而而且且病病痛痛已已无无法法减减轻轻。即即使使继继续续实实施施目目前前的的治治疗疗，他他也也肯肯定定在在几几天天之之内内就就会会

108、死死去去，但但是是由由于于病病痛痛异异常常难难熬熬，所所以以他他不不想想为为了了延延长长仅仅仅仅几几天天的的生生命命而而继继续续忍忍受受这这种种痛痛苦苦。所所以以他他请请医医生生为为他他结结束束这这种种煎煎熬熬，而他的家庭也希望可以满足他的要求。而他的家庭也希望可以满足他的要求。假假设设医医生生容容许许停停止止治治疗疗，而而习习惯惯上上的的那那种种规规定定也也允允许许他他这这么么做做。认认为为这这种种做做法法有有理理的的原原因因就就是是病病人人面面对对着着极极大大的的痛痛苦苦，既既然然他他无无论论如如何何总总是是快快要要死死了了，那那么么没没有有必必要要再再让让他他继继续续遭遭受受无无谓谓的的

109、折折磨磨。但但现现在在请请注注意意：如如果果医医生生仅仅仅仅只只是是停停止止了了治治疗疗，那那么么很很可可能能病病人人需需要要更更长长的的时时间间才才会会死死去去，并并且且较较之之采采取取直直接接的的措措施施、注注射射安安乐乐死死药药剂剂而而言言，他他可可能能会会因因此此遭遭受受更更多多痛痛苦苦。这这一一事事实实使使我我们们有有理理由由相相信信一一旦旦决决定定不不再再让让他他遭遭受受痛痛苦苦时时，积积极极安安乐乐死死比比消消极极安安乐乐死死更更可可取取，而而不不是是相相反反。否否那那么么，就就变变成成了了认认可可那那些些会会导导致致更更多多痛痛苦苦的的做做法法，而而不不是是赞赞成成减减轻轻痛痛

110、苦苦，这这就就与与起起先先促促使使他他们们作作出出不不要要延延长病人生命这一决定的人道主义推动力有所矛盾了。长病人生命这一决定的人道主义推动力有所矛盾了。Unit 4 Active and Passive EuthanasiaPart2_TA_t3我我的的一一局局部部观观点点是是：“允允许许死死亡亡的的过过程程是是相相对对漫漫长长而而痛痛苦苦的的，而而注注射射安安乐乐死死药药剂剂那那么么比比较较快快，痛痛苦苦也也比比较较少少。让让我我举举一一个个不不同同类类型型的的例例子子。在在美美国国，大大概概每每600600个个孩孩子子中中有有一一个个在在出出生生时时就就患患有有唐唐氏氏综综合合征征。而而

111、这这些些孩孩子子中中的的大大多多数数在在其其他他方方面面都都是是健健康康的的，也也就就是是说说，只只要要有有普普通通的的儿儿科科护护理理，他他们们就就能能进进入入根根本本正正常常的的婴婴儿儿期期了了。然然而而其其中中有有一一些些孩孩子子会会有有先先天天的的缺缺陷陷，比比方方肠肠梗梗阻阻，如如果果他他们们要要活活下下去去，就就必必须须要要进进行行手手术术治疗。安东尼治疗。安东尼肖描述了随之产生的情况：肖描述了随之产生的情况： 如如果果不不做做手手术术，那那么么医医生生就就必必须须在在自自然然力力带带走走婴婴儿儿的的生生命命时时努努力力使使其其少少受受些些痛痛苦苦。作作为为一一个个医医生生，他他的

112、的天天性性本本是是通通过过手手术术刀刀来来打打败败死死神神，而而站站在在一一边边眼眼看看着着一一个个本本来来可可以以挽挽救救的的小小生生命命死死去去是是我我认认为为在在感感情情上上最最难难以以忍忍受受的的经经历历。在在会会议议上上、在在理理论论讨讨论论中中决决定定应应该该让让这这些些孩孩子子死死去去是是一一件件很很容容易易的的事事。但但是是当当你你站站在在儿儿童童病病房房，看看着着脱脱水水和和感感染染使使一一个个小小小小的的生生命命在在几几小小时时或或几几天天之之内内凋凋零零，那那就就是是完完全全不不同同的的了了。这这对对我我和和其其他他医医护护人人员员是是一一场场可可怕怕的的折折磨磨，其其程

113、程度度远远大大于于从从未未踏踏足足儿儿科科病病房房的父母们所经历的。的父母们所经历的。Unit 4 Active and Passive EuthanasiaPart2_TA_t4我我可可以以理理解解为为什什么么有有一一些些人人会会反反对对任任何何形形式式的的安安乐乐死死，并并坚坚持持必必须须让让这这些些婴婴儿儿活活下下去去。我我想想我我也也可可以以理理解解为为什什么么另另一一些些人人赞赞成成快快速速而而毫毫无无痛痛苦苦地地终终结结这这些些孩孩子子的的生生命命。但但为为什什么么会会有有人人同同意意让让“脱脱水水和和感感染染使使一一个个小小小小的的生生命命在在几几小小时时或或几几天天之之内内凋凋

114、零零？那那条条规规定定说说可可以以让让一一个个孩孩子子遭遭受受脱脱水水而而逐逐渐渐走走向向死死亡亡，却却不不能能给给予予注注射射而而毫毫无无痛痛苦苦地地结结束束生生命命，看看来来实实在在太太过过残残忍忍，以以致致无无须须进进一一步步辩辩驳驳。这这话话说说得得很很严严重重，但但并并非非试试图图冒犯任何人，而只是想要尽可能清楚地摆出观点。冒犯任何人，而只是想要尽可能清楚地摆出观点。我我的的第第二二条条意意见见是是：习习惯惯上上的的那那条条规规定定导导致致在在无无关关的的理理由由根根底底上上做做出有关生死的决定。出有关生死的决定。请请再再想想一一想想那那些些患患唐唐氏氏综综合合症症、需需要要通通过过

115、手手术术来来治治疗疗那那些些与与综综合合征征无无关关的的先先天天缺缺陷陷才才能能存存活活的的婴婴儿儿。有有些些时时候候，没没有有实实行行手手术术，婴婴儿儿死死去去了了，但但如如果果没没有有这这些些缺缺陷陷，孩孩子子就就会会活活下下去去。现现在在，像像这这样样一一项项移移除除肠肠梗梗阻阻的的手手术术也也并并不不太太过过困困难难。在在这这些些情情况况下下没没有有实实施施手手术术的的原原因因，很很明明显显，就就是是因因为为这这些些孩孩子子患患有有唐唐氏氏综综合合征征，而而他他们们的的父父母母和和医医生生由由于于这这样样一个事实便认为让他们这样死去更好。一个事实便认为让他们这样死去更好。Unit 4

116、Active and Passive EuthanasiaPart2_TA_t5但但是是请请注注意意，无无论论看看待待生生命命以以及及这这些些婴婴儿儿潜潜力力的的态态度度如如何何，这这种种情情况况都都是是荒荒唐唐的的。如如果果这这样样一一个个婴婴儿儿的的生生命命值值得得保保存存，那那么么做做一一个个简简单单的的手手术术又又有有什什么么关关系系呢呢？或或者者，如如果果有有人人认认为为这这样样的的孩孩子子最最好好还还是是不不要要活活下下去去，那那么么要要是是碰碰巧巧孩孩子子没没有有肠肠梗梗阻阻，情情况况会会有有什什么么不不同同呢呢？无无论论哪哪一一种种情情形形，生生存存与与死死亡亡的的问问题题都都

117、是是建建筑筑于于无无关关的的理理由由之之上上的的。是是唐唐氏氏综综合合征征而而不不是是肠肠梗梗阻阻成成了了事事情情的的关关键键。假假设设必必须须要要做做这这样样的的决决定定，那那也也必必须须建建立立在在其其根根底底之上，而不可以依赖于是否肠道有阻塞这样的无关问题。之上，而不可以依赖于是否肠道有阻塞这样的无关问题。当当然然，使使这这一一情情况况成成为为可可能能的的，是是这这样样的的一一个个想想法法：在在有有肠肠梗梗阻阻时时，人人们们可可以以“让让婴婴儿儿死死去去，而而当当没没有有这这些些缺缺陷陷存存在在时时，就就不不能能够够这这样样做做了了，因因为为人人们们不不能能够够“杀杀死死他他。这这一一想

118、想法法导导致致根根据据无无关关的的理理由由来来决决定定生生死死的的事实，是应该否认这一规定的另一重要理由。事实，是应该否认这一规定的另一重要理由。之之所所以以有有那那么么多多人人认认为为在在积积极极安安乐乐死死和和消消极极安安乐乐死死之之间间存存在在重重要要的的道道德德差差异异，其其中中一一个个原原因因就就是是他他们们认认为为，从从道道德德角角度度而而言言，杀杀死死某某个个人人比比让让某某个个人人死死更更坏坏。但但是是确确实实如如此此吗吗？杀杀死死某某人人这这一一行行为为本本身身比比让让某某人人死死亡亡更更坏吗？为了研究这一问题，应该考虑以下这样两个案例，它们其他方面完坏吗？为了研究这一问题，

119、应该考虑以下这样两个案例，它们其他方面完Unit 4 Active and Passive EuthanasiaPart2_TA_t6全一样，除了一个涉及杀死某个人而另一个涉及让某人死亡。然后，我就全一样，除了一个涉及杀死某个人而另一个涉及让某人死亡。然后，我就可可以以问问，是是否否这这一一差差异异就就会会造造成成不不同同的的道道德德评评价价。重重要要的的一一点点是是：除除了了这这一一差差异异之之外外，两两个个案案例例完完全全一一样样，否否那那么么我我们们就就不不能能坚坚信信是是这这一一差差异异而而不不是是其其他他对对这这两两个个案案例例在在评评估估上上的的任任何何变变化化负负有有责责任任了了

120、。所所以以，让让我我们们参参考考以下的这一组案例：以下的这一组案例： 第第一一，如如果果史史密密斯斯6岁岁的的表表亲亲出出了了意意外外，他他就就可可以以获获得得一一大大笔笔遗遗产产。一一天天晚晚上上，当当那那个个孩孩子子在在洗洗澡澡时时，史史密密斯斯偷偷偷偷摸摸摸摸地地潜潜入入浴浴室室，溺溺死死了了这这个孩子，并且把现场布置妥当，以使其看起来像是一起意外。个孩子，并且把现场布置妥当，以使其看起来像是一起意外。 第第二二，琼琼斯斯也也可可以以在在他他六六岁岁的的表表亲亲出出意意外外的的情情况况下下获获得得一一笔笔遗遗产产。像像史史密密斯斯一一样样，琼琼斯斯也也偷偷偷偷摸摸摸摸地地潜潜入入打打算算

121、在在孩孩子子洗洗澡澡时时溺溺死死他他。然然而而，正正当当琼琼斯斯进进入入浴浴室室时时，他他恰恰巧巧看看到到孩孩子子滑滑倒倒了了，并并撞撞到到了了头头，然然后后脸脸朝朝下下倒倒在在了了水水中中。琼琼斯斯欣欣喜喜假假设设狂狂；他他站站在在一一边边，准准备备如如果果有有需需要要就就把把孩孩子子的的头头按按下下去去，但但并并没没有有必必要要了了。在在仅仅仅仅几几次次挣挣扎扎之之后后，孩孩子子就就“意意外外地地完完全全自己溺死了，而琼斯看着，什么也没做。自己溺死了，而琼斯看着，什么也没做。Unit 4 Active and Passive EuthanasiaPart2_TA_t7 现现在在，史史密密斯

122、斯杀杀死死了了孩孩子子，而而琼琼斯斯那那么么“只只不不过过让让孩孩子子死死去去。这这是是他他们们之之间间唯唯一一的的差差异异。那那么么从从道道德德的的观观点点而而言言，他他们们两两人人中中有有任任何何一一个个比比另另一一个个做做得得好好些些吗吗？如如果果“杀杀死死和和“让让他他死死去去之之间间的的差差异异本本身身是是个个重重要要的的道道德德问问题题，那那么么我我们们就就应应该该说说琼琼斯斯的的行行为为不不像像史史密密斯斯那那样样更更值值得得谴谴责责。但但是是有有人人真真的的想想要要这这么么说说吗吗？我我想想不不是是的的。首首先先，两两个个人人都都是是出出于于同同样样的的动动机机，即即获获得得个

123、个人人财财富富利利益益，两两个个人人行行动动的的过过程程中中目目标标也也完完全全一一样样。从从史史密密斯斯的的行行为为可可以以推推断断他他是是个个坏坏人人，虽虽然然如如果果进进一一步步了了解解他他的的某某些些事事实实，这这一一判判断断可可能能会会被被推推翻翻或或修修改改，比比方方他他患患有有精精神神错错乱乱。但但是是从从琼琼斯斯的的行行为为中中就就不不能能推推出出同同样样的的判判断断吗吗？而而同同样样进进一一步步的的考考虑虑也也不不会会与与这这一一判判断断的的任任何何更更改改有有关关吗吗？另另外外，假假设设琼琼斯斯在在辩辩护护中中称称：“毕毕竟竟，我我除除了了站站在在那那里里看看着着孩孩子子溺

124、溺水水以以外外，没没有有做做任任何何事事情情。我我没没有有杀杀死死他他；我我只只是是让让他他死死去去而而已已。所所以以再再一一次次出出现现了了这这个个问问题题：如如果果“让让他他死死去去这这一一行行为为本本质质上上稍稍好好于于“杀杀死死他他，那那么么这这一一辩辩护护应应该该至至少少是是有有些些分分量量的的。但但它它没没有有分分量量。这这样样的的“辩辩护护只只能能被被认认为为是是对对道道德德论论证证的的奇奇怪怪误误用用。从从道道德德上上说说，这这等等于于是是没有辩护。没有辩护。 Unit 4 Active and Passive Euthanasia 现现在在可可以以十十分分适适当当地地指指出出

125、，医医生生所所关关心心的的安安乐乐死死问问题题是是与与此此完完全全不不同同的的。它它们们并并不不涉涉及及个个人人利利益益或或对对正正常常孩孩子子进进行行杀杀害害。医医生生只只关关心心那那些些生生命命对对病病人人本本身身已已毫毫无无用用处处的的情情况况，或或者者病病人人的的生生命命已已经经成成为为或或很很快快会会变变成成可可怕怕负负担担的的情情况况。然然而而，这这些些情情况况的的关关键键点点是是相相同同的的：杀杀死死某某人人和和让让某某人人死死之之间间的的差差异异本本身身并并没没有有道道德德上上的的差差异异。如如果果一一个个医医生生出出于于人人道道的的原原因因让让他他的的病病人人死死亡亡，和和出

126、出于于人人道道原原因因给给这这个个病病人人注注射射了了安安乐乐死死药药剂剂在在道道德德上上的的地地位位是是相相同同的的。如如果果他他的的决决定定是是错错误误的的，比比方方如如果果病病人人的的疾疾病病事事实实上上是是可可以以治治愈愈的的，那那么么无无论论这这个个决决定定是是通通过过什什么么方方式式实实施施的的，都都同同样样令令人人懊懊悔悔。如如果医生的决定是正确的，那么使用何种方法本身就不重要了。果医生的决定是正确的，那么使用何种方法本身就不重要了。 AMAAMA政政策策宣宣言言已已把把这这至至关关重重要要的的问问题题分分析析得得非非常常透透彻彻了了；问问题题的的关关键键在在于于“一一个个人人成

127、成心心终终止止另另一一个个人人的的生生命命。但但是是在在辨辨明明了了这这一一问问题题、并并禁禁止止“无无痛痛苦苦致致死死术术之之后后，此此宣宣言言接接着着否否认认了了停停止止治治疗疗也也属属于于成成心心终终止止生生命命的的行行为为。这这就就是是错错误误出出现现的的来来源源，因因为为在在这这些些情情况况里里，如如果果终终止止治治疗疗不不算算是是“一一个个人人成成心心终终止止另另一一个个人人的的生生命命，那那么么它它又又算算是是什什么么呢呢？它它当当然然确实就是，如果不是的话，它就毫无意义了。确实就是，如果不是的话，它就毫无意义了。 Part2_TA_t8Unit 4 Active and Pas

128、sive EuthanasiaPart2_TA_t9 许许多多人人觉觉得得很很难难接接受受这这一一看看法法。我我认认为为，其其中中一一个个原原因因在在于于，很很容容易易将将是是否否杀杀害害本本身身是是否否比比让让某某人人死死亡亡更更糟糟的的问问题题，与与是是否否大大多多数数杀杀害害的的实实际际案案例例比比让让人人死死亡亡的的案案例例更更应应该该谴谴责责这这一一完完全全不不同同的的问问题题混混为为一一谈谈。大大多多数数涉涉及及杀杀害害的的实实际际案案例例无无疑疑是是很很可可怕怕的的比比方方想想一一想想所所有有报报纸纸上上报报道道的的谋谋杀杀，我我们们每每天天都都会会听听说说这这些些事事情情。另另

129、一一方方面面，我我们们几几乎乎很很少少听听说说让让人人死死亡亡的的情情况况，除除了了医医生生被被人人道道主主义义原原因因促促使使而而做做出出的的行行动动。所所以以我我们们学学会会了了将将杀杀害害这这一一行行为为想想得得比比让让人人死死亡亡要要坏坏许许多多。但但是是这这并并不不意意味味着着杀杀害害这这一一行行为为本本身身有有某某些些东东西西使使它它比比让让人人死死亡亡更更坏坏，因因为为并并不不是是“杀杀害害和和“让让人人死死亡亡之之间间赤赤裸裸裸裸的的区区别别会会造造成成这这个个差差异异。相相反反，是是其其他他的的因因素素比比方方出出于于个个人人利利益益的的谋谋杀杀动动机机，相相对对于于医医生生

130、的的人人道道主主义义动动机机对对不不同同情情况况下下的的不不同反响负责。同反响负责。 我我已已经经指指出出，杀杀害害某某人人本本身身并并不不比比让让某某人人死死亡亡更更恶恶劣劣；如如果果我我的的观观点点是是正正确确的的，那那么么接接下下来来就就可可以以说说，积积极极安安乐乐死死就就不不是是比比消消极极安安乐乐死死更更坏坏的的行行为为。那那么么有有什什么么观观点点可可以以支支持持相相反反的的论论点点吗吗？我我相相信信，最最常常见见的的就就是是以以下的说法：下的说法： Unit 4 Active and Passive EuthanasiaPart2_TA_t10 “积积极极安安乐乐死死与与消消极

131、极安安乐乐死死之之间间最最大大的的不不同同在在于于：在在消消极极安安乐乐死死中中，医医生生并并没没有有作作出出任任何何行行为为导导致致病病人人的的死死亡亡。医医生生什什么么也也没没做做，而而病病人人死死于于某某种种他他已已经经患患上上的的疾疾病病。然然而而，在在积积极极安安乐乐死死中中，医医生生在在导导致致病病人人的的死死亡亡上上确确实实是是有有所所为为的的：他他杀杀死死了了病病人人。医医生生给给患患有有癌癌症症的的病病人人注注射射安安乐乐死死药药剂剂，直直接接引引发发了了他他的的死死亡亡；而而如如果果他他仅仅仅仅只只是是停停止止治治疗疗，那那么么就就是是癌癌症症，而不是医生的行为，导致了病人

132、死亡。而不是医生的行为，导致了病人死亡。 这这里里需需要要弄弄清清楚楚许许多多问问题题。首首先先，说说医医生生在在消消极极安安乐乐死死中中什什么么也也没没做做并并非非完完全全正正确确，因因为为他他确确实实做做了了一一件件非非常常重重要要的的事事：他他让让病病人人死死去去。在在某某些些方方面面，“让让某某人人死死去去当当然然是是不不一一样样的的主主要要因因为为这这类类行行为为是是一一个个人人通通过过不不执执行行其其他他行行为为的的方方式式来来实实现现此此行行为为。比比方方，一一个个人人可可以以通通过过不不给给予予病病人人药药物物治治疗疗的的方方式式而而让让病病人人死死去去，就就像像一一个个人人可

133、可以以通通过过不不与与别别人人握握手手的的方式来侮辱对方。但是就任何道德评估的目的而言，这也仍然是一种行为。方式来侮辱对方。但是就任何道德评估的目的而言，这也仍然是一种行为。Unit 4 Active and Passive EuthanasiaPart2_TA_t10对对决决定定让让一一个个病病人人死死去去的的道道德德评评定定，可可以以参参照照评评价价杀杀死死病病人人所所用用的的同同样样的的道道德德评评定定：无无论论评评价价它它明明智智或或不不明明智智，有有同同情情心心或或有有虐虐待待性性，正正确确或或错错误误。如如果果一一名名医医生生成成心心让让一一位位通通常常来来说说可可以以治治愈愈的的

134、病病人人死死去去，那那么么这这名名医医生生自自然然会会因因为为他他的的行行为为而而受受到到谴谴责责，正正如如他他在在没没有有必必要要的的情情况况下下杀杀死死一一个个病病人人会会被被谴谴责责一一样样。对对于于他他的的控控诉诉也也就就是是完完全全应应当当的的。如如果果这这样样的的话话，那那坚坚持持说说自自己己“什什么么也也没没做做根根本本算算不不上上是是辩辩护护。事事实实上上他他做做了了很很严严重重的的事事情情，因为他让他的病人死去了。因为他让他的病人死去了。 从从法法律律的的角角度度来来说说，确确定定死死因因是是非非常常重重要要的的，因因为为这这会会决决定定是是否否需需要要对对医医生生进进行行有

135、有罪罪控控诉诉。但但我我并并不不认认为为可可以以用用这这一一观观点点说说明明积积极极安安乐乐死死与与消消极极安安乐乐死死之之间间的的区区别别。为为什什么么成成为为致致死死某某人人的的原原因因被被看看作作是是不不好好的的，其其原原因就在于死亡被认为是很坏一件事，因就在于死亡被认为是很坏一件事， 它确实是。它确实是。 然而，如果认定安乐死然而，如果认定安乐死即即使使是是消消极极安安乐乐死死在在给给定定情情境境中中是是值值得得实实行行的的，那那么么也也就就决决定定了了在在这这一一情情况况下下死死亡亡相相对对于于病病人人继继续续存存活活而而言言，并并不不能能算算作作更更坏坏。如如果果这这一一说法成立，

136、那么通常不想成为某人死亡原因的理由也就不能简单适用了。说法成立，那么通常不想成为某人死亡原因的理由也就不能简单适用了。Unit 4 Active and Passive Euthanasia 最最后后，医医生生也也许许会会认认为为所所有有这这些些都都只只是是有有些些学学术术上上的的兴兴趣趣是是那那种种哲哲学学家家们们会会担担忧忧的的事事情情，而而与与他他们们自自己己的的实实际际工工作作没没有有任任何何实实际际影影响响。毕毕竟竟，医医生生必必须须考考虑虑到到他他们们所所作作所所为为的的法法律律后后果果，而而积积极极安安乐乐死死很很明明显显是是法法律律所所禁禁止止的的。但但即即使使这这样样，也也应

137、应该该关关心心到到这这样样一一个个事事实实，即即法法律律强强迫迫医医生生接接受受一一种种站站不不住住脚脚的的道道德德规规定定，并并且且这这种种规规定定对对他他们们的的实实际际工工作作有有相相当当大大的的影影响响。当当然然，大大多多数数医医生生如如今今在在这这个个问问题题中中并并非非处处于于被被强强制制的的立立场场，因因为为他他们们并并不不认认为为他他们们自自己己仅仅仅仅是是附附和和法法律律的的要要求求。或或者者说说，在在我我所所引引用用的的AMAAMA政政策策宣宣言言这这样样的的声声明明中中，他他们们认认可可了了这这一一规规定定作作为为医医学学伦伦理理的的中中心心。在在那那份份宣宣言言中中，积

138、积极极安安乐乐死死不不但但被被判判定定是是非非法法的的，并并且且是是“违违背背医医学学职职业业立立场场，而而消消极极安安乐乐死死那那么么得得到到了了认认可可。然然而而，前前述述的的意意见见说说明明，两两者者本本身身并并无无真真正正的的道道德德差差异异可可能能在在某某些些情情况况的的某某些些结结果果下下是是有有重重要要的的道道德德差差异异，但但是是，就就如如我我指指出出的的，这这些些差差异异可可以以使使积积极极安乐死，而非消极安乐死，安乐死，而非消极安乐死， 成为在道德成为在道德Part2_TA_t11Unit 4 Active and Passive EuthanasiaPart2_TA_t1

139、2更更可可取取的的行行为为。所所以以，尽尽管管医医生生们们为为了了满满足足法法律律的的要要求求可可能能必必须须明明确确区区别别积积极极安安乐乐死死与与消消极极安安乐乐死死，但但他他们们除除此此以以外外不不应应该该再再多多做做什什么么了了。特特别别是是，他他们们不不应应该该通通过过将将这这一一区区别别写写入入关关于于医医德德的的官官方方声声明明而而给给其其再再增增加加任任何附加的权威或分量。何附加的权威或分量。Unit 4 Active and Passive EuthanasiaPart2_TA1_ How, a strong case However, a strong case can b

140、e made against this doctrine.However, it can be strongly argued that this doctrine is wrong. Unit 4 Active and Passive EuthanasiaPart2_TA2_ it is very easy . it is very easy to conflate the question of whether killing is, in itself, worse than letting die, with the very different question of whether

141、 most actual cases of killing are more reprehensible than most actual cases of letting die. it is very easy to think that the question of whether killing is, in itself, worse than letting die, is exactly the same as the very different question of whether most actual cases of killing are more reprehe

142、nsible than most actual cases of letting dieUnit 4 Active and Passive EuthanasiaPart2_TA2_ So one learns So one learns to think of killing in a much worse light than of letting die. So one learns to think killing is much worse than letting die. Unit 4 Active and Passive EuthanasiaPart2_TA2_ . That h

143、as no practical . that has no practical bearing on their own work. that has practically nothing to do with their own workUnit 4 Active and Passive EuthanasiaPart2_TA7_cessationExamples:cessation n. fml ceasing, or stopping, either forever or for some timeThe money saved from the cessation of the roa

144、d project will be invested in public transport.He would not agree to a cessation of hostilities.Unit 4 Active and Passive EuthanasiaPart2_TA8_humanitarianExamples:humanitarian adj. having, expressing devotion to humanity; philanthropicThe United Nations is sending humanitarian aid to the areas worst

145、 affected by the earthquake.It is high time the Government displayed a more humanitarian approach towards victims of the recession.Unit 4 Active and Passive EuthanasiaPart2_TA8_syndromeExamples:syndrome n. a number of symptoms occurring together and characterizing a specific disease or conditionSick

146、 building syndrome is a disease of our time. Irritable bowel syndrome seems to affect more women than men.Unit 4 Active and Passive EuthanasiaPart2_TA1_dongenitalExamples:congenital adj. (of disease or deformities) existing at or from birthBirth marks are congenital.He was a congenital liar and usua

147、lly in debt.Unit 4 Active and Passive EuthanasiaPart2_TA4_obstructionExamples:obstruction n. anything that obstructs; hindrance; obstacleTheres some sort of obstruction on the railway tracks.John was irritated by drivers parking near his house and causing an obstruction.Unit 4 Active and Passive Eut

148、hanasiaPart2_TA7_patentlyExamples:patently adv. obviously; plainly; evidentlyIts patently obvious that he doesnt care. The thing is so patently absurd that we need waste no more words on it.Unit 4 Active and Passive EuthanasiaPart2_TA8_prohibitivelyExamples:prohibitively adv. in a prohibitive way; t

149、o a prohibitive degree; exorbitantly; excessively; extremelyProperty in the area tends to be prohibitively expensive (= so expensive that you can not buy it).It would be complicated but not prohibitively difficult to blend one or the other of these effects into the sandwich burner model.Unit 4 Activ

150、e and Passive EuthanasiaPart2_TA8_thrashExamples:thrash vi. move or toss about violently, flinging the arms, legs, etc. about wildly or vigorouslyHe was screaming and thrashing around on the floor.The gale made the branches of the trees thrash against the windows.Unit 4 Active and Passive Euthanasia

151、Part2_TA1_grotesqueExamples:grotesque adj. very odd or strange-looking or extremely ugly or unpleasantGothic churches are full of devils and grotesque figures.Bosch was a master of the grotesque in painting.Unit 4 Active and Passive EuthanasiaPart2_TA4_perversionExamples:perversion n. act of changin

152、g something from what is normal or right; state of being pervertedHis craving for publicity has become almost a perversion.The past of China has been scarred by countless mistrials and perversions of justice.Unit 4 Active and Passive EuthanasiaPart2_TA7_conflateExamples:conflate vt. fuse or bring to

153、gether; join or weld togetherShe succeeded in conflating the three plays to produce a fresh new work.To a degree remarkable even for a politician, he conflated words and actions.Unit 4 Active and Passive EuthanasiaPart2_TA8_appraisalExamples:appraisal n. evaluation; an estimate of the value, amount

154、or qualityWe should give a totally new appraisal of pottery and porcelain produced in Qin Dynasty.Brett waited through a few moments of silence, then went on with his appraisal.Unit 4 Active and Passive EuthanasiaPart2_TA8_make a case againstExamples:make a case against argue that something or someb

155、ody is wrongTheyll need your testimony to make a case against him in the court tomorrow.I was wrong to say that there was no way to make a case against your husband.Unit 4 Active and Passive EuthanasiaPart2_TA1_set outExamples:set out give the details of sth. or explain it in a clear, organized way,

156、 especially in writingset out the reasons for her resignation in a long letter.He set out his objections to the scheme. Unit 4 Active and Passive EuthanasiaPart2_TA4_set foot inExamples:set foot in go to a placeMelanie and John got divorced and told him never to set foot in her house again.Barely ha

157、d I set foot in the downtown in New York when I realized I was lost.Unit 4 Active and Passive EuthanasiaPart2_TA7_account forExamples:account for explain the reason for or cause of sth.The manager was unable to account for the deficit in the firms bank balance.Such beautiful tunes help to account fo

158、r the popularity of this new age music.Unit 4 Active and Passive EuthanasiaPart2_TA8_in a lightExamples:in a . light in the way specifiedShe worshiped him, but then shed only seen him in a good light. Gina hates me so much that shed even tell lies about her own brother to make me appear in a bad lig

159、ht.Unit 4 Active and Passive EuthanasiaPart2_TA8_be subject toExamples:be subject to be under the control ofThe trip to the Great Wall may be subject to last minute cancellation, so we should get prepared for the possibility. A U.S. citizen can be subject to both federal and state law on environment

160、al issues.Unit 4 Active and Passive EuthanasiaPart2_TA1_have bearing onExamples:have bearing on have an influence on sth. or a relationship to sth.What youve done has a significant bearing on the fulfillment of our program. Experts generally agree that diet has an important bearing on your general h

161、ealth. Unit 4 Active and Passive EuthanasiaPart2_TA4_go along withExamples:go along with support an idea, or agree with someones opinionAs long as what you do is right, I will go along with you.I usually got prepared to go along with what the majority decided.Unit 4 Active and Passive EuthanasiaPart

162、2_TA1_discriminate betweenExamples:discriminate between be able to see the difference between two things or peopleWisdom consists in the ability to discriminate between the probable and improbable, and in being reconciled to the inevitable.Each child should be taught to discriminate between right an

163、d wrong. Unit 4 Active and Passive EuthanasiaExercisesI. Comprehension Questions1. 2. 3. 4.5.How does the writer define the difference between active and passive euthanasia?What is the attitude of American health professionals toward active and passive euthanasia?Which does the writer consider prefe

164、rable, active or passive euthanasia? What is his justification?According to the writer, how could doctors decisions concerning life and death be affected by the conventional doctrine?Why do many people think that there is an important moral difference between active and passive euthanasia?Unit 4 Act

165、ive and Passive Euthanasia6. 7.8.9.10. What is the purpose of the hypothetical cases involving Smith and Jones?How does the writer challenge the American Medical Associations policy statement?How does the writer refute the argument that in passive euthanasia the doctor does nothing?Does the writer t

166、hink that the notion of death as a great evil is applicable to euthanasia? What is his explanation?What is the writers purpose in writing this essay? Who is his intended audience?Unit 4 Active and Passive EuthanasiaDo you think the writer has made a strong case? In what way has the article changed o

167、r contributed to the development of your own views of euthanasia?How would you define the difference between active and passive euthanasia?II. Topics for Discussion1.2.Unit 4 Active and Passive EuthanasiaIs there any reason to believe that the distinction between active and passive euthanasia, that

168、is, between killing and letting die, is meaningful once it is obvious that a patient does not wish to continue to live? To discover your own views on whether killing a patient can ever be morally justifiable, consider the following scenario: someone quite close to you is in great pain, paralyzed, an

169、d, according to the doctors, will die within a month. This person wants to die and beseeches you to give him or her a lethal drug. What would you do? You may consider the scenario first with the condition that no one will ever discover what you have done and again with the constraint that someone wi

170、ll discover your role.3.Unit 4 Active and Passive EuthanasiaII. Topics for Discussion4. If you are incurably ill, slowly dying, and suffering great pain that is only intermittently alleviated by drugs, would you prefer that extraordinary measures be taken to keep you alive? If you are too sick to ma

171、ke your wishes known, who would you want to speak for you, your doctor or your family members? Discuss your decision and the reasons behind it. Some considerations to weigh in the balance include: (a) possible medical costs, (b) the feelings of family and friends, (c) the desire not to be dependent

172、on others, (d) the fear of becoming totally helpless and losing control over your intellectual and physical faculties, (e) the possibility, however slight, of a cure being discovered in a short time.Unit 4 Active and Passive Euthanasiasneakingderanged2. ( ) 1. ( ) The wolf was moving quietly and sec

173、retly in the woods toward the sheep, watching for an opportunity to attack it. On April 4, 1968, on the balcony of his motel, King was shot to death by a mentally ill man, James Earl Ray, who may or may not have been a hired killer.III. VocabularyA. Replace the italicized parts in the following sent

174、ences with words or phrases from the text that best keep the original meanings. Unit 4 Active and Passive Euthanasiacoercean appraisalpatently3. ( ) 4. ( ) 5. ( ) The trade union decided to launch a 3-day labour stoppage in the coming week to force the government into accepting its demand for a pay

175、raise.It was not until after his death that the literary critics made a high assessment of this obscure writer.Bitterly disappointed, she nevertheless appreciated the folly of compelling her daughter to persist in an occupation manifestly unsuitable to her.Unit 4 Active and Passive Euthanasiahas a b

176、earing on8. ( ) thrashingimminent6. ( ) 7. ( ) Bill strode up and down the side of the pool yelling at the man who was moving violently about in the water.The weatherman said that a rainstorm was likely to happen very soon and warned people on the small island to stay home for safety.You had better

177、go and have a private talk with the janitor he may have some information that is relevant to the burglary case.Unit 4 Active and Passive Euthanasiacessationendorsed9. ( ) 10. ( ) The money saved from the discontinuation of the road project will be invested in public transport.They had clashed many t

178、imes on matters of national security and on the question of the hydrogen bomb, which Oppenheimer had never fully supported.Unit 4 Active and Passive Euthanasiahumane2. ( ) salvageable1. ( ) B. Find the words from the text that are most nearly opposite in meaning to the words in bold type in the foll

179、owing sentences.Half a year ago, the doctor diagnosed Toms disease as incurable, but miraculously Tom pulled through and was found healthy in a recent medical checkup.The terrorist who had killed hundreds of innocent citizens was caught by the police last week and is to be sentenced to death for his

180、 brutal acts.Unit 4 Active and Passive Euthanasiadefectalleviatedprolonglethal3. ( ) 4. ( ) 5. ( ) 6. ( ) In his quest for physical perfection, Jack spends hours in the gym every day.The lack of rain this year has aggravated the already serious shortage of food in this poor country.Mary had to curta

181、il her lunch hour due to the emergency staff meeting.While adventuring in the jungle, John Smith was bitten by a snake. Fortunately, the snake was a harmless species.Unit 4 Active and Passive Euthanasiaaccidental10. ( ) compassionatelytheoretical forbid7. ( ) 8. ( ) 9. ( ) The foreman callously forc

182、ed the workers to continue the dangerous project in the snowstorm, totally disregarding their health and safety.They have agreed to store the furniture, but we still have to resolve the practical problem of how to transport it over there.The rules of the club do not permit smoking. If you break them

183、 you will forfeit your membership.The car crash wasnt an accident; it was a deliberate attempt to kill him.Unit 4 Active and Passive EuthanasiaBC. Choose the word or phrase that best completes each of the following sentences.1. Unfortunately these drugs are quite toxic and hinder the bodys ability t

184、o infection.A. set offC. take offB. fight offD. see off2. Those who torture others in mind or body in order to gain ego satisfaction are consideredA. sadisticC. shoddyB. secularD. sheepishA_.Unit 4 Active and Passive Euthanasia3. Justice in any constitutional sense is still not anything hoped for by

185、 these residents, although some say that things have changed and that the younger generation wont put up with the things older peopleA. kept up withC. went along with B. went through withD. come up withThat mans actions are entirely by his desire for happiness, a doctrine which has been called “theo

186、logical utilitarianism.A. motivatedC. mutteredB. muffledD. mediated4. C_.A_Unit 4 Active and Passive Euthanasia5. During the two-month drought, all the sunflowers on both sides of the road into brown, rattling, burry stalks.A. rooted C. bloomedB. sproutedD. withered6. The lighthearted exchanges, whi

187、ch they knew were being recorded, sound nothing like the words of men who fear they have done something or even something out of the ordinary.A. reprehensibleC. indispensableB. comprehensibleD. insatiableD_A_,Unit 4 Active and Passive Euthanasia7. Since boyhood he had been determined to become extre

188、mely successful that is, extremely wealthy, for he saw money as the only proof of success.A. irreconcilableC. irreversibleB. irreducibleD. irrefutable8. Blanche Blank points out that a university should be a resource centre for those who want to develop their intellectual powers, and that selling it

189、 to the youth as a take-off pad for the material good life is really a of its true spirit.A. germinationC. perversionB. saturationD. retaliationD_C_Unit 4 Active and Passive Euthanasia9. The most story was told by an oil worker who saw a small boy of five or six shot.A. exquisiteC. intrinsicB. grote

190、squeD. lenient10. Before the rainy season came, the workers were busy rebuilding the dam because it was too weak to the pressure of the rising water.A. withholdC. adjustB. exertD. inflictA_B_Unit 4 Active and Passive Euthanasia The controversy regarding the practice of euthanasia is essentially a co

191、ntroversy about ethics. The debate about euthanasia is a value debate (1) people who weigh values differently, who see the nature of the world and the place of humans in that world differently. The differences between those on (2) sides in this debate can best be seen through an examination of value

192、 hierarchies. A value hierarchy is the manner in (3) a person orders his or her value system by ranking different values in orderwhich_amongopposite_IV. ClozeThere are 20 blanks in the following passage. Fill in each blank with an appropriate word. Make sure to use it in the right form.Unit 4 Active

193、 and Passive Euthanasiaof importance. Perhaps Abraham Maslow developed the most famous value hierarchy. His hierarchy of needs attempts to explain various facets of human behavior by showing (4) people can move up or down the hierarchy depending on which needs are (5) All types of values can be orga

194、nized (6) hierarchies. Proponents of euthanasia have a different value hierarchy than (7) the opponents. Dr. Doerflinger clearly argues (8) a particular value hierarchy when he contends that life is the supreme good and that all other goods must come only (9) life is secured. His logic states that (

195、10) life, no other value or good can exist, and therefore it is a prerequisite for all other values. Proponents of euthanasia also believe in the value of life, (11) they dont place it as highly on their hierarchy. (12) awithoutInsteadbut_after_do_in_met_.how_for_,Unit 4 Active and Passive Euthanasi

196、aendthreatenedchallenges proponent of euthanasia might argue that individual rights are the supreme value, or that quality of life is more important than the (13) of life itself. The logic here is that although life is clearly an important value, there may be times (14) life itself is not worth livi

197、ng. If a person has no individual rights, or if a person has a (15) quality of life, they may make the decision to (16) their life because it is no longer worth living, no longer a good life. One of the main reasons that the debate about euthanasia has been so hotly contested is because it (17) the

198、value systems of people. The people who believe in individual rights and quality of life (18) the supreme value see their value hierarchy threatened by the power of the state. If the status quo (19) to change to eliminate this threat, people who see life itself as the supreme value would find their

199、value hierarchy (20) were_as_whenlow_value_.Unit 4 Active and Passive Euthanasia Now, it may be pointed out quite properly that the cases of euthanasia with which doctors are concerned are not like this at all. They do not involve personal gain or the destruction of normal healthy children. Doctors

200、are concerned only with cases in which the patients life is not of further use to him, or in which the patients life has become or will soon become a terrible burden. However, the point is the same in these cases:V. TranslationA. Translate the following paragraphs from the text into Chinese.Unit 4 A

201、ctive and Passive Euthanasiathe bare difference between killing and letting die does not, in itself, make a moral difference. If a doctor lets a patient die for humane reasons, he is in the same moral position as if he had given the patient a lethal injection for humane reasons. If his decision was

202、wrong if, for example, the patients illness was in fact curable the decision would be equally regrettable no matter which method was used to carry it out. And if the doctors decision is the right one, the method used is not in itself important. The AMA policy statement isolates the crucial issue ver

203、y well; the crucial issue is “the intentional termination of the life of one human being by another. But after identifying this issue, and forbidding “mercy killing, the statement goes on to deny that theUnit 4 Active and Passive Euthanasiacessation of treatment is the intentional termination of a l

204、ife. This is where the mistake comes in, for what is the cessation of treatment, in these circumstances, if it is not “the intentional termination of the life of one human being by another? Of course it is exactly that, and if it were not, there would be no point to it.Unit 4 Active and Passive Euth

205、anasiaB. Translate the following paragraphs into English.近近年年来来，由由于于医医疗疗技技术术的的进进步步，人人即即使使在在受受到到严严重重损损伤伤的的情情况况下下依依然然有有可可能能无无限限期期地地活活下下去去，这这使使得得围围绕绕安安乐乐死死是是否否道道德德的的争争论论进进一一步步加加剧剧了了。随随着着人人的的寿寿命命的的延延长长，高高龄龄的的人人将将日日益益增增多多，这这时时疾疾病病以以及及生生活活能力的丧失为安乐死的施行提供了可能。能力的丧失为安乐死的施行提供了可能。如如果果一一个个病病人人的的病病情情恶恶化化，使使他他无无法法

206、作作出出合合理理的的选选择择，那那么么就就必必须须由由其其家家属属、医医生生和和法法庭庭来来决决定定是是否否延延长长或或终终止止其其生生命命。但但令令人人遗遗憾憾的的是是，有有关关“生生命命的的定定义义目目前前仍仍存存在在着着分分歧歧。一一个个人人可可能能被被宣宣布布为为“脑脑死死亡亡，然然而而他他的的主主要要器器官官仍仍在在工工作作着着。有有些些人人认认为为安安乐乐死死所所涉涉及及的的问问题题主主要要是是宗宗教教问问题题。他他们们认认为为无无论论一一个个病病人人受受到到的的损损伤伤严严重重到到何何种种程程度度，生生命命都都是是神神圣圣不不可可侵侵犯犯的的，任任何何人人都都无无权权决决定定病病

207、人人的的生生死死。另另一一些些人人那那么么坚坚持持认认为为，对对于于一一个个严严重重受受到到损损伤伤的的生生命命来来说说，死死亡亡也也许许是是一一种种更更好好的的选择，因而安乐死就成了一种善举。选择，因而安乐死就成了一种善举。Unit 4 Active and Passive EuthanasiaVI. WritingThroughout North America, committing suicide or attempting to commit suicide is no longer a criminal offense. However, helping another perso

208、n commit suicide is a criminal act. One exception is the state of Oregon which allows people who are terminally ill and in intractable pain to get a lethal prescription from their physician. This is called “Physician Assisted Suicide or PAS. Do you think that a person has the right to commit suicide

209、? Do you think that a person has the right to help another person commit suicide? Write an essay to state your views on these two questions. The suggested title is “When Can We Play God?Unit 4 Active and Passive Euthanasia现现在在可可以以十十分分适适当当地地指指出出，医医生生所所关关心心的的安安乐乐死死问问题题是是与与此此完完全全不不同同的的。它它们们并并不不涉涉及及个个人人

210、利利益益或或对对正正常常孩孩子子进进行行杀杀害害。医医生生只只关关心心那那些些生生命命对对病病人人本本身身已已毫毫无无用用处处的的情情况况，或或者者病病人人的的生生命命已已经经成成为为或或很很快快会会变变成成可可怕怕负负担担的的情情况况。然然而而，这这些些情情况况的的关关键键点点是是相相同同的的：杀杀死死某某人人和和让让某某人人死死之之间间的的差差异异本本身身并并没没有有道道德德上上的的差差异异。如如果果一一个个医医生生出出于于人人道道的的原原因因让让他他的的病病人人死死亡亡，和和出出于于人人道道原原因因给给这这个个病病人人注注射射了了安安乐乐死死药药剂剂在在道道德德上上的的地地位位是是相相同

211、同的的。如如果果他他的的决决定定是是错错误误的的，比比方方如如果果病病人人的的疾疾病病事事实实上上是是可可以以治治愈愈的的，那那么么无无论论这这个个决决定定是是通通过过什什么么方方式式实实施施的的，都都同同样样令令人人懊懊悔悔。如如果果医医生生的的决决定定是是正正确确的的，那那么么使使用用何何种种方方法法本本身身就就不不重要了。重要了。AMA政政策策宣宣言言已已把把这这至至关关重重要要的的问问题题分分析析得得非非常常透透彻彻了了；问问题题的的关关键键在在于于“一一个个人人成成心心终终止止另另一一个个人人的的生生命命。但但是是在在辨辨明明了了这这一一问问题题、并并禁禁止止“无无痛痛苦苦致致死死术

212、术之之后后，此此宣宣言言接接着着否否认认了了停停止止治治疗疗也也属属于于成成心心终终止止生生命命的的行行为为。这这就就是是错错误误出出现现的的来来源源，因因为为在在这这些些情情况况里里，如如果果终终止止治治疗疗不不算算是是“一一个个人人成成心心终终止止另另一一个个人人的的生生命命，那那么么它它又又算算是是什什么么呢？它当然确实就是，如果不是的话，它就毫无意义了。呢？它当然确实就是，如果不是的话，它就毫无意义了。A.Unit 4 Active and Passive EuthanasiaControversy surrounding the morality of euthanasia has

213、been heightened in recent years because of advances in medical technology that makes it possible for human beings to be kept alive almost indefinitely, even when severely impaired. As a mans life span lengthens, more and more people will reach a high age when illness and disability create the possib

214、ility for euthanasia.If a patients conditions are deteriorating, making him unable to make a rational choice, decisions to prolong or terminate life must be left to his family, doctors, and courts. But unfortunately the definition of “life is still at issue. A person may be declared “brain dead whil

215、e his vital organs still function. B.Unit 4 Active and Passive EuthanasiaSome people regard the problems posed by euthanasia as essentially religious. They think that life is sacred, no matter how severely disabled the patient may be, nobody can make a decision whether he or she should stay alive or

216、 not. Some others insist that death may be preferable to a severely impaired life. Euthanasia thus becomes an act of charity.Unit 4 Active and Passive EuthanasiaFurther ReadingFurther Reading In Crisis, She Rejected Plea to Expedite DyingIdiom StudiesMain Idea of Further ReadingExercisesUnit 4 Activ

217、e and Passive EuthanasiaIn the early summer of 1967, Elisabeth and Manny Ross moved for the fifth time. They now felt comfortably settled in Chicago and, assuming they would be living and working there for the foreseeable future, they bought a home a few blocks away from the house they had been rent

218、ing. Elisabeth and Manny had decided to postpone their annual summer vacation and instead take a holiday at Christmas in order, Text b1Further ReadingIn Crisis, She Rejected Plea to Expedite DyingDerek GillUnit 4 Active and Passive EuthanasiaText b2as they had just explained to their 7-year-old son,

219、 Kenneth, to give him and his little sister, Barbara, “a real Swiss Christmas with sleigh bells and festivals. Suddenly, and apparently without stimulus or prompting, Elisabeth felt a deep and inexplicable concern about her mothers well-being. She turned to Manny and told him she had to fly to Switz

220、erland immediately tomorrow, if they could get plane reservations. She admitted that her impulsive decision sounded crazy, but there was some very important reason a purpose she did not yet understand why she should be with her mother as quickly as possible. A week later, she and the two children ar

221、rived in Zurich. There they boarded the train for Zermatt, where Mrs. Kubler and other members of Elisabeths family were staying.Unit 4 Active and Passive Euthanasia Zermatt was the ideal place for a restful vacation and for what Elisabeth called “a time for old-fashioned happiness. Mrs. Kubler look

222、ed in the pink of health and had, on the day the Ross family arrived, been on an eight-mile hike with Elisabeths older brother, Ernst, and her fraternal triplet, Eva (her identical triplet, Erika, could not be there). On the last evening at the resort where they were all staying, when the sun was se

223、tting over the peaks, Mrs. Kubler sat with Elisabeth on the balcony of her bedroom where Kenneth and Barbara, exhausted after the days outing, were fast asleep. Mother and daughter sat through a long silence and watched shadows move like ragged fingers across the green valleys far below. Then Mrs. K

224、ubler turned to face Elisabeth and said, Text b3Unit 4 Active and Passive Euthanasia“I want your solemn promise that youll do something for me. I want you to promise that, when I become incapable, when I become a human vegetable, youll help me to die. She spoke with an uncharacteristic urgency. Elis

225、abeth was taken aback, both by the appeal and by its timing. She reacted not as an expert on dying, not as a teacher who instructed others to be alert for symbolic language, but as a shocked daughter. She replied too quickly, “What nonsense is this! A woman who is in her 70s and who can hike miles e

226、very day in the mountains is sure to die very suddenly. Mother, youre the last person to become a human vegetable.Text b4Unit 4 Active and Passive EuthanasiaText b5 Mrs. Kubler continued to speak as if she had not heard her. She again asked for a promise that, when she became incapable of caring for

227、 herself, Elisabeth would help her to die. Elisabeth looked at her mother with astonishment and again protested that the question was purely hypothetical. In any case, she said firmly, she was totally opposed to mercy killing, if that was what her mother was talking about. In her opinion, no physici

228、an had the right to give a patient an overdose to relieve suffering. She could not promise her mother or, for that matter, anyone else to expedite dying. In the unlikely event that her mother did in fact become physically incapable, all that she could promise was that she would help her to live unti

229、l she died.Unit 4 Active and Passive EuthanasiaText b6Mrs. Kubler began to cry softly. It was only the second time in her life that Elisabeth had seen her mother shed tears.Mrs. Kubler rose from her chair and went inside. For a while, Elisabeth sat alone and thought about her mothers request, her ow

230、n response to it and her attitude toward euthanasia. It was tempting to avoid the issue. She remembered some lines of Erich Fromm, the psychiatrist-philosopher: “There is no such thing as medical ethics. There are only universal human ethics applied to specific human situations.There were times, she

231、 was obliged to admit, when it was wrong to keep someone alive but such a time would only occur when a patient was clearly beyond medical help, when organs were keptUnit 4 Active and Passive EuthanasiaText b7functioning only with machines. So long as there was a meaningful life, so long as a patient

232、 could express and receive feelings, it had to be wrong to “play God and decide arbitrarily whether a patient should live or die. Surely, though, it was not to answer this hypothetical question that she had changed the familys vacation plans and come to Switzerland. The next day, when Mrs. Kubler ac

233、companied Elisabeth and the children to the train station, both women were tense and uncomfortable. However, when the train came in, Elisabeth turned to her mother, hugged her and said, “All I can promise you is that I will do for you what I do for all my patients. I promise I will do my best to hel

234、p you live until you die.Unit 4 Active and Passive EuthanasiaMrs. Kubler appeared to understand now what Elisabeth was saying. She nodded, wiped her eyes, smiled and said, “Thank you.Those were the last words Elisabeth heard her mother speak. Hardly had the family arrived back in Chicago when a cabl

235、e came from Eva. It read, “Mother has had a massive stroke.Three days later Elisabeth was back in Switzerland.At the hospital Elisabeth found her mother unable to speak, unable to move anything except her eyelids and, very feebly, her left hand. It was obvious, however, from the expression in her ey

236、es, that Mrs. Kubler understood what was said to her.Text b8Unit 4 Active and Passive EuthanasiaThey devised a method of communicating. Her mother would use her eyelids and her slightly mobile left hand to indicate affirmative or negative answers to questions put to her. One blink of the eyelids or

237、one squeeze of the hand would signify an affirmative and two blinks or two squeezes would mean a negative response.Using this form of communication, Mrs. Kubler made it very clear that she did not want to remain in the hospital. Elisabeth confronted her mother with the impossibility of her returning

238、 home, where she would require round-the-clock nursing attention. It was Eva who came up with the solution.Text b8Unit 4 Active and Passive EuthanasiaShe knew of an infirmary, more a rest home than a hospital, in Riehen, a few miles outside of Basel. Set in spacious well-tended grounds, it was run b

239、y a dedicated group of Protestant nuns.Immediately after taking her mother to the infirmary, Elisabeth spent a couple of painful days quite alone at the Klosbachstrasse apartment. She sorted clothes, furniture and objets dart; she took down pictures and curtains and labeled everything for subsequent

240、 distribution according to her mothers expressed wishes.Elisabeth now believes that in closing down the family home in Zurich, she was given a new and important understanding about life and death. Life, she now sees, is aText b8Unit 4 Active and Passive Euthanasiaseries of losses, and every loss is

241、a “little death. In the hour or so before she finally left the home on Klosbachstrasse she had gone through the five identifiable stages of dying: denial, anger, bargaining, depression and acceptance. Each “little death and this was one of hers was a salutary and perhaps essential preparation for de

242、ath itself. But every ending was also a new beginning. Another lesson, long and difficult, now focused on the infirmary at Richen. Mrs. Kubler, paralyzed and unable to speak, held on to life not just for the few weeks that Elisabeth and her sisters had anticipated, not for months, but for four years

243、. She had clearly foreseen the manner of her dying and, recoiling at the prospect, had pleaded with Elisabeth for mercy killing.Text b9Unit 4 Active and Passive EuthanasiaFor Elisabeth, the issue of euthanasia was no longer a hypothetical one, no longer an intellectual debating point, but a question

244、 of the heart and conscience. There were times when she was ready to change her views, moments when she wondered agonizingly whether she should have given her mother the promise she had asked for; but these doubts stalked her only when she was far away from Switzerland.For when she was with her moth

245、er, her conviction remained that neither she nor anyone else had the right to take the life of someone who could still express and receive feelings. Mrs. Kubler was not a human vegetable. She needed no machines to keep her heart beating or her lungs breathing.Text b10Unit 4 Active and Passive Euthan

246、asiaToday, Elisabeth Kubler-Ross sees her prime task as helping people to live a full life without being burdened by their “negativities, helping people to take care of “unfinished business before they die.She claims that the evidence of patients who have had near-death encounters with spiritual gui

247、des and relatives who have predeceased them supports her belief that physical existence with all its pain, stress, struggle and challenge is, in effect, “a learning experience and a growth period for an ongoing journey.She is convinced that the only thing of value that man carries with him through t

248、he “tradition is the record of how much he contributed to the commonweal “how much he cared and how much he loved.Text b11Unit 4 Active and Passive EuthanasiaDerek GillNotes to Further ReadingDerek Gill: biographer. Author of Quest: The Life of Elisabeth Kubler-Ross. This book provides an important

249、backdrop for understanding the teachings and activities of Elisabeth Kubler-Ross, a famous physician and pioneer thanatologist.Unit 4 Active and Passive Euthanasiaa human vegetableNotes to Further Readinga human vegetable: a person who is physically alive but mentally inactive because of injury, ill

250、ness or abnormalityUnit 4 Active and Passive Euthanasiaround-the-clockNotes to Further Readinground-the-clock: done or happening all the time, both day and nightUnit 4 Active and Passive Euthanasiathe five identifiable stages of dyingNotes to Further Readingthe five identifiable stages of dying: In

251、her landmark book On Death and Dying, Dr. Elisabeth Kubler-Ross argued that human grieving is a process that moves through five identifiable stages: Denial: refusing to admit the reality of the loss; Anger: asking “why me?, feeling a sense of unfairness, anger at being cheated; Bargaining: offering

252、to give up something to change what has happened, making a bargain with God; Depression: admitting the reality of the loss, feeling deep sadness and pain; Acceptance: acknowledging that death is a permanent part of normal life and resuming a normal lifeUnit 4 Active and Passive Euthanasiaobjets dart

253、Notes to Further Readingobjets dart: (Fr.) small objects of artistic valueUnit 4 Active and Passive EuthanasianegativitiesNotes to Further Readingnegativities: the disagreeable qualities of one who dissentsUnit 4 Active and Passive EuthanasiatraditionNotes to Further Readingtradition: life experienc

254、e before ones deathUnit 4 Active and Passive EuthanasiaMrs Kubler looked in the pink of health Mrs Kubler looked in the pink of health . Mrs. Kubler seemed to be in perfect healthParaphrase of Difficult SentencesUnit 4 Active and Passive EuthanasiaErnst is her fraternal triplet Paraphrase of Difficu

255、lt SentencesErnst is her fraternal triplet and Eva is her identical triplet. Ernst is male among the triplets, and Elisabeth and Eva are female.Unit 4 Active and Passive Euthanasia you are the last Paraphrase of Difficult Sentences. you are the last person to become a human vegetableit is impossible

256、 for you to become a human vegetableUnit 4 Active and Passive EuthanasiaShe reacted not as an expert Paraphrase of Difficult SentencesShe reacted not as an expert on dying, not as a teacher who instructed others to be alert for symbolic language, but as a shocked daughter. Elisabeth reacted to her m

257、others appeal not professionally as an expert on dying, nor as a teacher who taught the others to be careful to use words with symbolic meanings, but she reacted emotionally as a daughter who was shocked at her mothers request.Unit 4 Active and Passive Euthanasia危急关头，她拒绝安乐死的请求危急关头，她拒绝安乐死的请求T1Transla

258、tion of Further Reading1967年年的的初初夏夏，伊伊丽丽莎莎白白和和曼曼力力罗罗丝丝夫夫妇妇第第五五次次搬搬家家。 他他们们现现在在觉觉得得在在芝芝加加哥哥安安家家很很舒舒服服。 于于是是便便买买了了一一套套房房子子，离离他他们们原原来来租租借借的的房子只相隔几个街区，打算以后长久地在那里工作生活下去了。房子只相隔几个街区，打算以后长久地在那里工作生活下去了。伊伊丽丽莎莎白白和和曼曼力力本本来来每每年年夏夏天天都都有有一一次次度度假假活活动动，可可是是今今年年他他们们打打算算推推迟迟到到圣圣诞诞节节。他他们们对对七七岁岁的的儿儿子子凯凯纳纳斯斯，和和小小女女儿儿芭芭芭芭

259、拉拉说说可可以以带带他们去瑞士过一个有雪橇、铃铛、热热闹闹的真正的圣诞节。他们去瑞士过一个有雪橇、铃铛、热热闹闹的真正的圣诞节。突突然然间间，伊伊丽丽莎莎白白清清楚楚没没有有任任何何的的刺刺激激，却却突突然然无无缘缘无无故故地地为为母母亲亲的的健健康康状状况况感感到到莫莫名名的的深深深深焦焦虑虑。她她对对曼曼力力说说她她必必须须马马上上飞飞往往瑞瑞士士， 如如果果能能订订上上飞飞机机票票的的话话，明明天天就就走走。她她成成认认自自己己心心血血来来潮潮的的决决定定听听起起来来很很荒唐，虽然她自己目前也不知道到底为什么要尽快赶到母亲身边去，荒唐，虽然她自己目前也不知道到底为什么要尽快赶到母亲身边去

260、，德里克德里克吉尔吉尔Unit 4 Active and Passive EuthanasiaT2但但这这样样做做一一定定是是有有道道理理的的。一一周周之之后后，她她和和两两个个孩孩子子赶赶到到了了苏苏黎黎世世，然然后乘火车前往泽而玛特。库伯乐太太和伊丽莎白的其他家人都住在那里。后乘火车前往泽而玛特。库伯乐太太和伊丽莎白的其他家人都住在那里。 泽泽而而玛玛特特是是度度假假休休养养的的胜胜地地，伊伊丽丽莎莎白白称称之之为为“度度过过往往日日幸幸福福时时光光的的胜胜地地。库库伯伯乐乐太太太太看看起起来来身身体体状状况况极极佳佳，她她在在罗罗丝丝一一家家到到的的那那天天，还还和和伊伊丽丽莎莎白白的的

261、哥哥哥哥恩恩斯斯特特，三三胞胞胎胎兄兄弟弟伊伊瓦瓦三三人人一一起起徒徒步步旅旅行行了了八八英英里。伊丽莎白还有一个三胞胎的姐妹，名叫爱丽佳，当时没能一起去。里。伊丽莎白还有一个三胞胎的姐妹，名叫爱丽佳，当时没能一起去。 在在这这儿儿度度假假的的最最后后一一个个晚晚上上，当当太太阳阳落落山山的的时时候候，库库伯伯乐乐太太太太和和伊伊丽丽莎莎白白坐坐在在卧卧室室的的阳阳台台上上，而而凯凯纳纳斯斯和和芭芭芭芭拉拉在在外外面面玩玩了了一一天天，累累了了，很快就睡着了。很快就睡着了。 母母女女俩俩坐坐在在那那里里，久久久久不不语语。如如手手指指般般参参差差不不齐齐的的阴阴影影在在苍苍翠翠的的深深谷谷里里

262、移移动动。库库伯伯乐乐太太太太转转过过身身来来面面向向伊伊丽丽莎莎白白，说说道道：“我我要要你你郑郑重重发发誓誓为为我我做做一一件件事事。我我要要你你容容许许，如如果果我我生生活活不不能能自自理理，或或者者如如果果我我变变成成植物人，你要帮我快点死去。她说话时语气很急迫，和平时很不一样。植物人，你要帮我快点死去。她说话时语气很急迫，和平时很不一样。Unit 4 Active and Passive EuthanasiaT3伊伊丽丽莎莎白白吃吃了了一一惊惊，母母亲亲在在这这个个时时间间，提提出出这这个个请请求求，让让伊伊丽丽莎莎白白做做出出的的反反响响，既既不不像像研研究究死死亡亡的的专专家家，

263、也也不不像像以以教教育育别别人人慎慎用用象象征征性性语语言言的的教教师师，而而是是一一个个倍倍感感震震惊惊的的女女儿儿。她她的的答答复复非非常常迅迅速速，“您您在在胡胡说说什什么么呀呀！一一个个7070多多岁岁每每天天还还能能在在山山里里徒徒步步旅旅行行几几英英里里的的女女人人，哪哪会会那那么么容容易易说说死死就就死了？妈妈，您不可能变成植物人的。死了？妈妈，您不可能变成植物人的。库库伯伯乐乐太太太太好好似似根根本本没没有有听听见见女女儿儿说说的的话话，再再次次恳恳求求女女儿儿能能够够容容许许她她，当她生活不能自理时，一定要帮她快点死去。当她生活不能自理时，一定要帮她快点死去。伊伊丽丽莎莎白白

264、震震惊惊地地望望着着母母亲亲，再再次次断断言言这这个个问问题题纯纯粹粹是是凭凭空空想想出出来来的的。她她肯肯定定地地答答复复，如如果果母母亲亲是是在在说说安安乐乐死死的的话话，无无论论如如何何，她她都都会会反反对对的的。在在她她看看来来，没没有有任任何何一一个个医医生生有有权权利利给给病病人人大大剂剂量量的的药药物物来来免免除除他他的的痛痛苦苦。她她不不能能够够容容许许母母亲亲，也也不不会会容容许许任任何何人人，去去加加速速他他们们的的死死亡亡。如如果果不不可可能能的的事事情情真真的的发发生生了了，母母亲亲真真的的失失去去生生活活能能力力，她她能能够够保保证证的的便便是是她她会会帮帮她她支撑到

265、生命的最后一刻。支撑到生命的最后一刻。库库伯伯乐乐太太太太开开始始轻轻声声地地哭哭泣泣。这这是是伊伊丽丽莎莎白白有有生生以以来来第第二二次次见见母母亲亲掉掉眼泪。眼泪。Unit 4 Active and Passive Euthanasia库伯乐太太起身进了房间。伊丽莎白单独坐了一会，反复考虑母亲的请库伯乐太太起身进了房间。伊丽莎白单独坐了一会，反复考虑母亲的请求，自己的答复和自己对于安乐死的态度。她情愿不去面对这个问题。求，自己的答复和自己对于安乐死的态度。她情愿不去面对这个问题。她记得心理分析家、哲学家艾力奇她记得心理分析家、哲学家艾力奇弗莱蒙所说的几句话：弗莱蒙所说的几句话：“没有什么没

266、有什么医学伦理可言。只有特定情况下的普遍的人类伦理。医学伦理可言。只有特定情况下的普遍的人类伦理。有些时候，她也被迫成认非要维持一个人的生命是错误的，但只有当病有些时候，她也被迫成认非要维持一个人的生命是错误的，但只有当病人确实是无药可救，而且身体器官只像机器那样机械运作的时候，坚持人确实是无药可救，而且身体器官只像机器那样机械运作的时候，坚持维持生命才是错误。只要生命还有意义，只要病人还能够表达和接受感维持生命才是错误。只要生命还有意义，只要病人还能够表达和接受感情，医生就不能够扮演上帝的角色，擅自决定病人的生死。当然，她绝情，医生就不能够扮演上帝的角色，擅自决定病人的生死。当然，她绝对不是

267、为了答复这个虚无的问题，才改变了方案举家来瑞士度假的。对不是为了答复这个虚无的问题，才改变了方案举家来瑞士度假的。 第二天，库伯乐太太陪着伊丽莎白和孩子们去火车站，母女俩都感第二天，库伯乐太太陪着伊丽莎白和孩子们去火车站，母女俩都感到紧张，不自在。当火车进站时，伊丽莎白转向母亲，拥抱了她，到紧张，不自在。当火车进站时，伊丽莎白转向母亲，拥抱了她，“我我能向你保证的是我会像对待我所有的病人那样对待你。能向你保证的是我会像对待我所有的病人那样对待你。 我保证我会尽力我保证我会尽力让你活到最后一刻。让你活到最后一刻。T4Unit 4 Active and Passive EuthanasiaT5库库

268、伯伯乐乐太太太太似似乎乎听听懂懂了了伊伊丽丽莎莎白白的的话话，点点点点头头，擦擦干干眼眼睛睛，微微笑笑着着说：说：“谢谢。谢谢。这这是是伊伊丽丽莎莎白白听听母母亲亲说说的的最最后后一一句句话话。他他们们刚刚赶赶回回芝芝加加哥哥就就收收到到伊伊娃的电报：母亲严重中风。娃的电报：母亲严重中风。三天后，伊丽莎白又回到瑞士。三天后，伊丽莎白又回到瑞士。在在医医院院，伊伊丽丽莎莎白白看看到到母母亲亲不不能能说说话话，除除了了眼眼皮皮和和左左手手能能够够微微微微活活动动以以外外，全全身身不不能能移移动动。但但从从眼眼神神来来看看，库库伯伯乐乐太太太太显显然然能能听听懂懂别别人人对对她说的话。她说的话。她她

269、们们设设计计了了一一种种交交流流方方式式。母母亲亲能能够够用用眼眼皮皮和和微微微微移移动动的的左左手手答答复复“是是或或“不不是是。眼眼皮皮眨眨一一下下或或手手握握一一下下代代表表“是是，眼眼皮皮眨眨两两下下或或手握两下表示手握两下表示“不是。不是。通通过过这这种种交交流流方方式式，库库伯伯乐乐太太太太明明白白地地表表示示自自己己不不想想待待在在医医院院。伊伊丽丽莎莎白白却却明明白白地地告告诉诉母母亲亲回回家家是是不不可可能能的的，因因为为那那样样得得需需要要有有人人2424小小时时看护她。还是伊娃提出了一个解决方案：她知道瑞恩有一家护理院，跟看护她。还是伊娃提出了一个解决方案：她知道瑞恩有一

270、家护理院，跟Unit 4 Active and Passive EuthanasiaT6医院很不相同，更像是一个疗养的地方，就在巴塞尔几英里之外，地方医院很不相同，更像是一个疗养的地方，就在巴塞尔几英里之外，地方很大，管理妥当，由一批尽职尽责的新教徒的修女照料着。很大，管理妥当，由一批尽职尽责的新教徒的修女照料着。 把母亲送去养老院后，伊丽莎白在卡洛巴斯特拉斯的公寓里单独度把母亲送去养老院后，伊丽莎白在卡洛巴斯特拉斯的公寓里单独度过了痛苦的几天。整理衣物、家具和一些艺术品，将画取下来，窗帘放过了痛苦的几天。整理衣物、家具和一些艺术品，将画取下来，窗帘放下，将每件东西贴上标签，以便日后按照母亲的

271、意愿分发出去。下，将每件东西贴上标签，以便日后按照母亲的意愿分发出去。 伊丽莎白现在觉得在关闭苏黎世的家的时候，她对生与死重新有了伊丽莎白现在觉得在关闭苏黎世的家的时候，她对生与死重新有了重大的领悟。重大的领悟。 在她看来，生命是一个遗失的过程，每一次遗失就是一次在她看来，生命是一个遗失的过程，每一次遗失就是一次“小小的死亡。小小的死亡。 在她最后离开卡洛巴斯特拉斯公寓前的大约一个小时在她最后离开卡洛巴斯特拉斯公寓前的大约一个小时里，她对死亡的认识经历了五个明显的阶段：否认，愤怒，交涉，沮丧，里，她对死亡的认识经历了五个明显的阶段：否认，愤怒，交涉，沮丧，接受。接受。 对于死亡本身而言，每一次

272、对于死亡本身而言，每一次“小小的死亡都是有益的，或许还是小小的死亡都是有益的，或许还是必要的一次准备。这次是她所经历的。但是，每一个结束又是一个新的必要的一次准备。这次是她所经历的。但是，每一个结束又是一个新的开始。开始。Unit 4 Active and Passive EuthanasiaT7需需要要长长时时间间解解决决的的另另一一个个难难题题现现在在集集中中在在瑞瑞恩恩的的护护理理院院。库库伯伯乐乐太太太太全全身身瘫瘫痪痪，不不能能说说话话，却却还还活活着着。她她不不会会像像伊伊丽丽莎莎白白和和她她的的姐姐妹妹料料想想的的那那样样只只活活上上几几个个星星期期，或或者者几几个个月月，而而是

273、是四四年年。她她已已经经清清楚楚预预见见到到了了自自己己会会如如何何死死去去，对对未未来来的的日日子子充充满满恐恐惧惧，她她请请求求伊伊丽丽莎莎白白能能让她安详地死去。让她安详地死去。对对伊伊丽丽莎莎白白而而言言安安乐乐死死的的问问题题已已经经不不是是一一个个虚虚无无的的问问题题了了，也也不不再再是是一一个个智智力力辩辩论论的的焦焦点点，而而是是一一个个有有关关良良心心的的问问题题。有有时时她她几几乎乎要要改改变变看看法法，她她痛痛苦苦地地考考虑虑着着是是不不是是应应该该履履行行对对母母亲亲的的承承诺诺。但但这这些些疑疑虑随着她来到瑞士便烟消云散了。虑随着她来到瑞士便烟消云散了。当当她她与与母

274、母亲亲在在一一起起时时，她她深深信信不不疑疑无无论论是是她她还还是是任任何何别别人人都都没没有有权权利利结结束束这这个个仍仍能能表表达达情情感感和和接接受受情情感感的的人人的的生生命命。库库伯伯乐乐太太太太不不是是一个植物人。她并不需要机器来维持心脏跳动或肺的呼吸。一个植物人。她并不需要机器来维持心脏跳动或肺的呼吸。今今天天，伊伊丽丽莎莎白白库库伯伯乐乐罗罗丝丝看看到到了了自自己己的的首首要要任任务务就就是是帮帮助助人人们们过过一一种种完完全全意意义义上上的的生生活活，而而不不因因自自己己的的“消消极极态态度度背背上上包包袱袱，她要帮人们在临终前处理她要帮人们在临终前处理“未竟之事。未竟之事。

275、Unit 4 Active and Passive EuthanasiaT7她她认认为为，濒濒死死的的人人能能够够看看到到自自己己灵灵魂魂的的引引路路人人或或过过世世的的亲亲人人，这这一一事事实实坚坚决决了了她她的的信信念念：伴伴随随着着痛痛苦苦、压压力力、抗抗争争和和挑挑战战的的肉肉体体的的存存在在其其实就是一个为永无止境的旅程做准备的实就是一个为永无止境的旅程做准备的“学习的经历与成长的阶段。学习的经历与成长的阶段。她她深深信信人人在在“传传统统中中所所拥拥有有的的唯唯一一有有价价值值的的东东西西就就是是他他为为公公众众事事业做出多大奉献业做出多大奉献他付出过多少的关心，献出多少的爱。他付

276、出过多少的关心，献出多少的爱。Unit 4 Active and Passive EuthanasiaMIOFR1Main idea of Further ReadingIn the text of further reading, Derek Gill depicts the story of her mother and tortures she has gone through in deciding whether her mother should be given a comfortable death with dignity. Finally she reaches a con

277、clusion that life with all its pain, stress, struggle and challenge, is in effect a learning experience and a growth period.Unit 4 Active and Passive Euthanasialdiom Studies 1Idiom Studies1. out of spiritsnot lively or energetic无精打采无精打采2. speak/talk of the devil When you are talking about someone, h

278、e or she just happens to appear.说魔鬼魔鬼到说曹操曹操到。说魔鬼魔鬼到说曹操曹操到。on the side of the angels supporting the good or moral side在道义一方，在善的一方在道义一方，在善的一方 3. Unit 4 Active and Passive Euthanasiafor the hell of it doing it for fun or for no particular reasons, on a whim仅仅为了取乐，玩玩而已仅仅为了取乐，玩玩而已ldiom Studies 24. sell o

279、nes soulgive up something very important such as honesty in exchange for wealth or prestige为名利等出卖灵魂为名利等出卖灵魂 5. bear ones crosslive with pain or trouble; keep on even though you suffer or have trouble背十字架，忍受苦难背十字架，忍受苦难6. 7. give the devil his due be fair (even to someone who is bad and you dislike)即使

280、对坏人也要公平对待；平心而论即使对坏人也要公平对待；平心而论Unit 4 Active and Passive Euthanasialdiom Studies 38. a tin godan often pompous or dictatorial person who demands or receives more respect than is merited 自以为了不起的人；徒有虚名的人自以为了不起的人；徒有虚名的人move heaven and earthmake every effort; do everything possible全力以赴；竭尽全力全力以赴；竭尽全力9. ru

281、sh in where angels fear to treadget oneself into dangerous or difficult situation that wiser people would know to avoid; take a risk foolishly and conceitedly; be reckless鲁莽地干预与己无关的事；愚蠢地冒险；胆大妄为鲁莽地干预与己无关的事；愚蠢地冒险；胆大妄为10.Unit 4 Active and Passive EuthanasiaExercisesI. Comprehension Questions1.2.3.4.Wha

282、t was Elizabeths schedule for their summer vacation? And why did Elisabeth suddenly change her mind?Was there any sign that Elisabeths mother was not well? What made Elisabeth so desperate to be with her mother in Switzerland?What did Elisabeths mother ask her to do? How did Elisabeth respond to her

283、 mothers unexpected request?What happened to her mother soon after Elisabeth arrived back in Chicago? In what condition was her mother when Elisabeth was back in Switzerland again?Unit 4 Active and Passive Euthanasia5. What lessons about life did Elisabeth learn from her mothers suffering?Unit 4 Act

284、ive and Passive EuthanasiaEX2II. Topics for Discussion1.2.3.How do you understand Erich Fromms claim that there is no such thing as medical ethics and that there are only universal human ethics applied to specific human situations? Elisabeth believes that physical existence with all its pain, stress

285、, struggle and challenge is, in effect, “a learning experience and a growth period for an ongoing journey. Could you explain why she has such a belief? Do you share her idea?In the medical field, there are many heated discussions about such issues as abortion and human cloning. What is your stance o

286、n these issues?Unit 4 Active and Passive EuthanasiaA resume is a summary of experience and other qualifications submitted with a job application. When you send a resume to a prospective employer, you have to make sure that you organize it in an easy-to-read format and include a cover letter to intro

287、duce yourself and identify the position for which you are applying.Although no standard form can cover all resume writing, some general principles are commonly followed. For instance, the resume should be brief, no more than one or two typed pages, and the content should be to the point, giving only

288、 the information that is necessary and will interest the employer. A well-written resume may get you a job interview and possibly lead to a brighter future. Generally, a resume will be most effective if it includes the following information in it:Functional Writing: Resumes (Rsums)Unit 4 Active and

289、Passive Euthanasia What follows aims at preparing you for and helping you with writing up your own research paper. In order to achieve this, the assumption we have made here is that you will be using a typical organizational pattern for your paper in other words, the IMRD format (Introduction, Metho

290、ds, Results, and Discussion) or some variant of it. We hope that the IMRD format will enable you to fulfill the task of constructing a research paper, which remains one most important aspect of academic writing. Writers of RPs usually operate in a strategic manner. They are fully aware that they nee

291、d to establish sufficiently interesting questions for their research, demonstrate the answerability of the questions and stand up to the competitionUnit 4 Active and Passive EuthanasiaThe name, address, and telephone number of the applicant, or other relevant personal informationThe title or descrip

292、tion of the specific position that the applicant is applying forDetailed information about the applicants prior work experienceDetailed information about the applicants educational backgroundThe names of several referencesAdditional relevant information1.2.3.4.5.6.Unit 4 Active and Passive Euthanasi

293、aPersonal DataIn the upper-left-hand corner, type your name, address and a telephone number where you can be reached at any time. This information should be single spaced. All words in the address should be spelled out without using abbreviations, and the zip code should be included. Note that views

294、 differ on providing other personal information, which may be included in the resume or not. Some experts recommend that job applicants avoid listing dates of birth, marital status, or specific data that would reveal race, religion or national origin; this is to prevent any discrimination on the job

295、 market. However, such information may be included at your own discretion. For example, resumes sent by young university graduates sometimes include a bit more detailed personal information because they are newly on the job market and have less work experience to rely on to interest the prospective

296、employer. In addition, extracurricular activities and such can appeal to employers in certain fields.Unit 4 Active and Passive EuthanasiaIn the job application, information about the position sought should be given if the applicant has any. Because there may be several job openings in a certain work

297、 division, identification of the position may help the employer better select. However, if the applicant is not sure of a specific position, he/she need not include this reference in the resume.Position SoughtUnit 4 Active and Passive EuthanasiaList the jobs you have previously held so the employer

298、may better evaluate your qualifications. Include the companies names and addresses and identify the positions you held in each, followed by a brief description of your responsibilities. This can be written in fragments that begin with action verbs such as met, conducted, supervised, directed. Each j

299、ob description should be factual, impersonal, and concise. Remember that you should order the positions you have held according to the most recent first.ExperienceUnit 4 Active and Passive EuthanasiaInformation on the applicants educational background is one important aspect of his/her qualification

300、s. List all the schools you have attended after high school. Begin with the most recent and work backward in time. Include the years you attended, the degrees, diplomas, or certificates you received, and your area of study. You may also list any honors or scholarships that you were awarded. If you d

301、id not receive a degree, type the number of credits you accrued. Also, if courses you completed specifically relate to the job you are applying for, you can include any relevant course titles. If you do not want to list them on the resume, as some experts suggest, you can mention them in your cover

302、letter. EducationUnit 4 Active and Passive EuthanasiaIf your school has a placement office, keep all your letters of reference on file there. If it does not have such an office, you have two options: First, you may list three or four persons who have known you for at least one year and who are in a

303、position to recommend you as a dependable, responsible person, such as your former teachers, previous employers or certain reputable and established persons you are very close to. (Your referees should not include your relatives.) Request recommenders permission to list them and then provide their n

304、ames, professional addresses, and phone numbers. You may also, as an alternative, type “References available upon request at the end of the cover letter and then later provide them only if the prospective employer asks for them. For example, applicants who have several years experience in business s

305、ometimes prefer not to list the names of references. ReferencesUnit 4 Active and Passive EuthanasiaYou can include additional information about activities or awards that relate to your career goals. For example, applicants often include information about hobbies and similar interests that they feel

306、are positive factors in influencing potential employers, such as athletic, intellectual or social interests. You may list these under the headings “Activities or “Academic Honors, whichever title is appropriate.You may place the “Education section before the “Experience section if your work experien

307、ce is very limited. This arrangement de-emphasizes the limitations of this aspect of your qualifications. Additional InformationUnit 4 Active and Passive EuthanasiaFinally, when you finish writing the resume, you should always remember to polish your resume so that it is as effective as possible. Yo

308、u should draft, revise and refine your resume as many times as possible before you type it in its final form. Make sure that you have included every useful item and omitted no important information. Double check all factual information, such as titles, names, numbers, etc. Last but not least, ensure

309、 that your resume is typed accurately and arranged neatly, without any typos or poorly duplicated pages. It is commonly known that well-written resumes help applicants positively impress employers at the outset.Look at the following two samples and practice writing your own resume.Sample One:Unit 4

310、Active and Passive Euthanasia555 Owen HallCurrent Address:Sherman SmithPermanent Address:West Lafayette, IN 47906(765) 495 - 5555555 Robinson St.Los Angeles, CA 15555(555) 555 - 5555(after May 5, 2021)OBJECTIVEA summer internship position that would allow me to apply my research, interpersonal, and

311、written communication skills to public policy projects in a legal environmentUnit 4 Active and Passive EuthanasiaPROFESSIONAL EXPERIENCEPurdue UniversityLiberal Arts Honors Council memberWrote business letters to corporations to sponsor council eventsPresented information about preparing vita docume

312、nts to university studentsOrganized and oversaw the councils meal preparation for Lafayette Urban Ministrys homeless shelter8/06-presentGraphic Artists, Inc.Graphic Artist Wrote contracts for mural paintings and large works of art Devised portfolio of art work to market to potential customers Explai

313、ned to customers the details of craft6/07 - 8/07Unit 4 Active and Passive EuthanasiaARC AlleghenyCamp CounselorInteracted with and monitored the activities of people with mental and physical disabilitiesOrganized pertinent information from client files and coordinated tasks with staffAssessed and re

314、ported the well-being of clients at the end of camp sessions6/06 - 8/06EDUCATIONWest Lafayette, INPurdue UniversityGraduation date: 5/09Major: EnglishMinor: SpanishUnit 4 Active and Passive EuthanasiaSIGNIFICANT COURSEWORKPolitical Science: Public PolicyConducted research projects and wrote policy a

315、nalysis papers on affirmative action, health care policy, and welfare policyBusiness WritingDrafted memoranda and professional lettersSpanishWrote compositions on major works of Spanish and Latin American literatureHONORSNational Society of Collegiate ScholarsAlpha Delta Honor SocietyNational Achiev

316、ement ScholarshipCommission on Law: Invited DelegateGolden Key National InternationalHonor SocietyUnit 4 Active and Passive EuthanasiaACTIVITIESReferences available upon requestPurdue Pre Law SocietyPurdue Student GovernmentPresident: Spanish ClubDeans Freshman ScholarSample Two:Ron E. Lye266 South

317、Wales StreetNorthampton Northamptonshire 5F61 287POSITION SOUGHTAssistant Product ManagerUnit 4 Active and Passive EuthanasiaPuck N Shuck Aural Hygiene, StainesSeptember 1987 to present.Marketing Research Assistant (part time after school; full time during summers). Compiled and summarized data gath

318、ered from consumer research studies. Prepared reports on the effects of advertising using shocking images. Assisted in preparing surveys for nationwide attitudes to mouthwash products. Assembled sales information for potential new product development. Proofread statistical reports and questionnaires

319、.EXPERIENCEUnit 4 Active and Passive EuthanasiaSchool of Business, Samson University.September 1987 to June 1991Bachelor of Arts Degree. Major: Marketing. Minor: Study of Religion. Courses included Marketing Research, Manipulation of the Customer, Advertising Theory and Practice, Advertising Campaig

320、ns, and Noncommercial Advertising.Norma Shearer Secondary School for Boys, WesthamptonSeptember 1983 to June 1987Academic Diploma. Captain of Chess Club, Member of Stamp Collecting Club, Synchronized Swimming Team. Also member of basketball and track teams.EDUCATIONReferences available upon requestU

321、nit 4 Active and Passive EuthanasiaAdditional WorkAdditional WorkI. Idiom StudiesIII. Reading AppreciationII. Vocabulary ExpansionIV. Translation of ProverbsUnit 4 Active and Passive EuthanasiaChoose a suitable idiom from the list given below to fill in each blank in the following sentences. Make ch

322、anges when necessary.I. Idiom Studiesout of spiritson the side of the angelsfor the hell of itgive the devil his duemove heaven and earthtalk of the devilsell ones soulbear ones crossa tin godrush in where angels fear to treadIdiom studiesUnit 4 Active and Passive EuthanasiaFor most of the book the

323、woman appears to be a criminal, but in the last chapter she proves to beThe poor girl has to for the big family her parents are too ill to work.I dont have much respect for Robert but he did help me when my car broke down.The clerk I spoke to at the tax office huffed and puffed as if I were wasting

324、his valuable time he was really just a littleThe boy was spoilt by his parents who would always to get him anything he wanted.1.2.3.4.5.on the side of the angels_.bear hers cross_give the devil his due_tin god_.move heaven and earth_Unit 4 Active and Passive EuthanasiaWhen asked why he had stolen th

325、e car, the rich young man said he had done it just Tom tried for one year to earn enough to live as a novelist, but in the end he had to and write copy for an advertising agency.I am just wondering if you ever see John now well, Here he is coming along the road.She was the very first girl who blushe

326、d and smiled at him and there he was running off to the altar John was because he had failed the exam again, so his parents tried every means to cheer him up.rush in where angels_!speak/talk of the devil_!sell his soul_6.7.8.9.10.out of spiritsfor the hell of it_.fear to treadUnit 4 Active and Passi

327、ve EuthanasiaII. Vocabulary ExpansionThere are four choices marked A, B, C and D under each of the following sentences. Choose the one that best completes the meaning of the sentence. A. smackedB. snatchedC. smashedD. crushed1. The report says that heart disease life away from 7.4 million people las

328、t year.B_Unit 4 Active and Passive EuthanasiaA. tranquilizingB. sinkingC. transferringD. slacking2. Exercise has a well-recognized effect, which helps you work in a more relaxed fashion. A_Unit 4 Active and Passive EuthanasiaA. evacuatedB. escortedC. entailedD. eclipsed3. Residents of this island ar

329、e growing rich from the mining of gold deposits, which has now fishing as the states major revenue source.D_Unit 4 Active and Passive EuthanasiaA. pinpointB. permeateC. pierceD. pluck4. The government has founded a $2.5 million program to investigate whether honeybees can be trained to landmines and

330、 other military targets.A_Unit 4 Active and Passive EuthanasiaA. transplantingB. transgressingC. transformingD. transmitting5. Were in an era when computer hackers are stealing credit-card numbers and other technologically adept criminals are national borders.B_Unit 4 Active and Passive EuthanasiaA.

331、 furnishedB. lightedC. ventilatedD. painted6. Both of them are reported to have experienced an episode of carbon-monoxide poisoning caused by the use of burning coals to heat a poorly room.C_Unit 4 Active and Passive EuthanasiaA. disentanglingB. affiliatingC. inflatingD. afflicting7. Physicians do n

332、ot always have a clear understanding of the ailments that are their patients, but they usually suggest options for further treatment.D_Unit 4 Active and Passive EuthanasiaA. outragedB. outlawedC. outshinedD. outdone8. Several countries, including Britain, Denmark and Germany, have all scientific wor

333、k on cloning humans.B_Unit 4 Active and Passive EuthanasiaA. indulgenceB. implicationC. imperativeD. immersion9. In fact, they say that if their companies are to compete at all in the global market place, diversity is anC_.Unit 4 Active and Passive EuthanasiaA. meddleB. enforceC. imperilD. fake10. A

334、lthough some airlines prohibit passengers from using electronic equipment during take-off and landing, most are reluctant to a total ban, given that many passengers want to work during flights.B_Unit 4 Active and Passive EuthanasiaEverybody knows the saying about grass being greener on the other sid

335、e of the fence. People know it means that whatever you havent got is exactly the thing you want.But for most Americans, this is only a saying no more connected with reality than needles in haystacks. Whereas its a plain statement of fact about farm animals. Every cow, horse, sheep and goat I have kn

336、own has spent much of its time trying to eat grass on the other side of fences. They think its tastier over there. This may contain a lesson for human beings.III. Reading AppreciationRead and appreciate the following essay.The Grass Is Always GreenerNoel PerrinUnit 4 Active and Passive EuthanasiaCon

337、sider the lambs on my small Vermont farm. A few years ago I decided to conserve energy my own, plus fuel for the lawn mower by turning part of our lawn into a small pasture for two or three lambs. So I got two rolls of stock fencing, which had a dozen horizontal strands set close together at the bot

338、tom and farther apart at the top. There was a vertical wire every six inches.I didnt know much about raising lambs, but I did know: (1) they were sure to want to creep through the fence, and (2) at a month old they were very small.For a while the lambs quietly nibbled grass in their pasture, and har

339、dly even seemed to see the lawn on the other side. But when they got to be three months old, trouble started. The black lamb, the biggest and boldest, discovered he could ram his headUnit 4 Active and Passive Euthanasiathrough the fence about a foot from the ground. Then, because the hole he had ram

340、med it through was only four and a half inches high and six inches wide, he would not be able to get his head back through. Hed be stuck there, bleating wildly, until someone pulled him back inside. After this had happened about a dozen times, the other two lambs finally caught on: here was a way to

341、 reach that tantalizing grass on the far side. From then on, at least once a day, we would hear a chorus of bleats from the pasture and find all three lambs trapped like three Puritans with their heads in the stocks. Later I discovered why they also make wire with 12-inch spacing. Its for sheet. It

342、has just enough give so that when they get desperate they can wriggle their heads back inside.Unit 4 Active and Passive EuthanasiaThe next year I was late buying lambs, and I didnt want the fenced part of the lawn to get too high before they arrived. (Tall grass gets tough and is hard on a lambs sto

343、mach.) A friend has a big horse and a small pasture, so I invited him to keep his horse at our place until the lambs arrived.From a horses point of view, a three-foot-high sheep fence is not tall at all, so I was not surprised that the horse spent most of the first day reaching over it to graze our

344、lawn. Inside his own pasture, succulent May grass stood at least four inches high. Outside, the grass was much shorter, but it had the charm of being forbidden.By nightfall, a three-foot strip along the edge of the lawn was neatly chewed to the roots. Fine with me. The horse had had his fun, and I w

345、ould save two passes with the lawn mower.Unit 4 Active and Passive EuthanasiaBut, having a quarter-acre of lush growth inside the pasture, all that horse could think about was more lawn outside. When we got up the next morning, the entire fence line was bowed outward at a 30-degree angle where the h

346、orse had leaned powerfully against it, and the strip of cropped lawn was now four and a half feet wide. I rode him home to his owner right after breakfast and spent the next two hours straightening the fence.Sometimes, of course, a smart farmer can put this animal delusion to good use. My neighbour

347、Floyd Dexter does this regularly. Like all Vermont farmers, he gets his hay baled and under cover as fast as possible. Sometimes this means a few bales at the edge of a field arent quite dry enough and develop a musty odor. Cows dont fancy hay with a musty odor. So Floyd keeps one little section of

348、fence that has only three strands of barbed wire instead of four permitting the cows to get their heads through more easily. Then he puts the musty hay outside.Unit 4 Active and Passive EuthanasiaConfronted with tasty grass on the inside, and maybe a couple of bales of good hay in the feeder, the co

349、ws from a long row, heads through the fence, and eagerly chomp musty hay. According to Floyd, the cows reason like this: That hay is out of our reach because he doesnt want us to have it. Therefore it must be exceptionally good. So even at the risk of tearing our necks on this wire, lets spend the r

350、est of the day trying to steal it. And they do.It often strikes me that farm animals and human beings have a lot in common.There was the son of friends, for example, who got accepted at our local college, Dartmouth. Its a pretty good place but rural. Will wanted to be in a city. He spent most of his

351、 freshman year trying to transfer. The next fall he became a sophomore at Tufts University, near Boston, and he was happy for about two months.Unit 4 Active and Passive EuthanasiaJust before Christmas he wrote Dartmouth saying he was ready to come back. He may never know that I encouraged the dean t

352、o make him finish out the year in Boston because I didnt think he had had his head through the wire long enough.There are me and my own two daughters, for that matter. I grew up in a suburb and loved the idea of raising my children where they could keep horses.I made that dream come true. The girls

353、liked our horses, but still felt deprived. As my elder daughter said to me when she was 15, eyes flashing, “Do you realize that there is not one clothing store within ten miles, that the nearest movie theater is thirteen miles, that no famous rock band has ever played within fifty miles?Unit 4 Activ

354、e and Passive EuthanasiaCows do not possess the intelligence of humans, but it seems to me that there are an awful lot of people straining to eat the musty hay of a different job, a new spouse, or a change in geography, when all around them is luscious green grass.Unit 4 Active and Passive EuthanasiaAW_4IV. Translation of Proverbs身教重于言传。身教重于言传。1. Death keeps no calendar.2. One mans breath is anothers death.从小看大，三岁看老。从小看大，三岁看老。小儿不打不成才。小儿不打不成才。 3. Our lives are but our marches to the grave.4. Death makes equal the high and low.有其父必有其子。有其母必有其女。有其父必有其子。有其母必有其女。