Books & arts
文艺板块
Book review
书评
The right to die
死亡的权力
Going gently
安乐死
The Inevitable. By Katie Engelhart.
《不可避免》。作者：凯蒂·恩格哈特

If it is humane to put down a dog in unbearable and incurable pain, why not extend the same right to humans if they want it? That question echoes through “ The Inevitable” as it follows four people in search of a good death—and in fear of a bad one.
如果杀死一只沉浸在难以忍受且无法治愈的痛苦之中的狗狗是人道的，那为什么想要得到解脱的人类却无法拥有同样的权力？《不可避免》对这一问题给出了答案，书中讲述了畏惧痛苦死亡而寻求安乐死的4个人。
Katie Engelhart’s deeply researched and beautifully reported book raises familiar quandaries. Do people have a right to die on their own terms? Should doctors help? Do motivations matter? And might a right become a duty for everyone who grows old, dependent or demented? It also considers less publicised problems, such as: how do people actually die? Advances in medicine and technology that have made pills and appliances safer have made it harder to achieve an “ easy” or “peaceful” death for those who seek one.
凯蒂·恩格哈特的这本研究深入、内容精妙的书引发了人们熟悉的困惑。人们有权按照自己的方式死去吗？医生应该帮忙吗？动机重要吗？安乐死的这项权利是否会成为每一个老人、被赡养人或痴呆病人的义务？书中还考虑了一些不太公开的问题，例如：人们实际上是如何死亡的？药物和技术上的进步使药片和医疗器械更加安全可靠，也使得寻求安乐死的人更难轻松平和地死亡。
As policymakers and ethicists ponder these moral conundrums, around the world people are taking matters into their own hands, a trend that gives Ms Engelhart’s book its urgency. Faced with intolerable suffering, her subjects have largely given up on laws and doctors and instead turn to strangers on the internet for help. For instance, Avril Henry, a British octogenarian, spent her nights “marinating in her pain” and considered eating lethal fungi from her garden to end it. But “death by mushroom could be slow, messy, painful. The Nembutal would work better.” The “Peaceful Pill Handbook” suggested buying that drug from either a vet-supply store in Mexico or the Chinese black market. Doubtful about Chinese merchandise, Henry settled on Mexico.
当政策制定者和伦理学家思考其中的道德难题时，世界各地的人们选择用自己的方式解决，这一趋势使恩格哈特的书充斥着紧迫感。面对无法忍受的痛苦折磨，她的研究对象大多放弃了法律，对医生也不再抱有希望，他们转而求助互联网上的陌生人。例如，英国八旬老人艾薇儿·亨利夜间常疼痛难耐，她考虑吃下花园里的致命真菌来结束痛苦。但是“蘑菇引发的死亡可能缓慢、混乱、痛苦。戊巴比妥钠的效果更好。”《和平药丸手册》建议从墨西哥的宠物用品店或中国黑市购买这种药。但亨利对中国黑市的药品存疑，最后选定从墨西哥购买。
Over several years, Ms Engelhart’s main characters meticulously plan their escapes from old age, dementia and chronic or mental illness. She also follows two doctors, one of whom lost his licence for teaching people how to “exit” via “DIY death seminars”.
恩格哈特书中的主人公用多年时间精心策划了他们从老年、痴呆和慢性病或精神疾病中解脱出来的过程。她还描绘了两位医生的经历，其中一名医生因通过“DIY死亡研讨会”教人们如何“解脱”而失去了执照。

The similarity between the “euthanasia underground” that it describes and underground abortion networks is striking. The president of Compassion & Choices, a lobby group for doctor-assisted dying, once referred to plastic-bag hoods as “the end-of-life equivalent of the coat hanger”. Among those to have taken charge of their deaths were some early AIDs patients, their suffering immense, their fates fixed. Just having the right drugs, or knowing they could get them, seemed to make many of these young men feel better, recalls the more likeable of the two doctors.
书中所描述的“地下安乐死”与地下堕胎网络之间有惊人的相似之处。“慈悲与选择”是一个提供医生协助死亡的的游说团体，该组织的主席曾提到，用头套塑料袋结束生命就“相当于用衣架堕胎”。那些对自己的死亡负责的人中有一些是早期艾滋病患者，这些人经历着巨大的痛苦，他们的命运已经注定。两位医生中比较讨人喜欢的一位回忆说，仅仅是有了合适的药物，或者知道自己可以得到药物，似乎让许多患病的年轻人更好受一些。
Henry planned to kill herself with the Mexican drugs in her bathtub, but fretted that she would soil herself and that her house would smell. Dignity—in life and death—seems to preoccupy her and others above all. Even more than a bad death they fear a bad end to life, in which they are no longer themselves. A desire for autonomy runs through their stories like the thin veins of some of the characters.
亨利打算服用从墨西哥买的戊巴比妥钠，在浴缸里了结生命，但她担心这样会弄脏自己，还会让家里有臭味。生死存亡之际，尊严似乎是她与其他想要安乐死的人最关心的问题。其分量甚至重于他们害怕的恶终（糟糕的结束生命会让他们失去自我）。对自主的渴望就像人的静脉一样贯穿于他们的故事。
Yet this is not a right-to-die manifesto. The author’s own ethical doubts are among the book’s strengths. She writes compassionately of her subjects’ struggles, but is more reserved about the motives of some of their helpers. She remains torn about what is perhaps the hardest question of all: euthanasia for victims of dementia. Rather than passing judgment, she presents facts. About half of Americans think patients do not have enough control over end-of-life decisions. Existing laws often have arbitrary effects.
然而，这并不是死亡权利宣言。这本书的长处之一在于作者本人基于道德的怀疑。她富有同情心地描写了主人公的挣扎，但对一些帮助者的动机却有所保留。她仍然纠结于可能是所有问题中最难的问题，即痴呆症患者的安乐死。她没有作出判断，只是陈述事实。有大约一半的美国人认为痴呆症患者对临终决策没有足够的控制权。现行法律往往具有任意效力。
After the drugs arrived from Mexico, Henry’s house was raided by police. She had discovered the concept of the “Completed Life”. “That’s when you feel that your life is shaped and finished. And the direction thereafter is down. I did have a complete life. It was a great life ,” she told a friend. Soon after the raid she was found in her bathtub, having drunk the poison the police had missed. The note she left had a postscript: “If I have fouled the bath in death, please please be kind to wash it down.” She provided the disinfectant.
戊巴比妥钠从墨西哥运来后，亨利的家就遭到了警察的突袭。她发现了“完满人生”的概念。她对一个朋友说：“就是当你觉得你的生活被塑造和完成的时候。你此后的生活会走向下坡。我确实拥有了完满的人生。我之前的生活很美好。”警察突袭后不久，人们发现了因喝下警察遗漏的毒药而死在浴缸里的亨利。她留下的纸条上有一个附言：“如果死去的我弄脏了浴缸，请把它清洗干净。”她还提供了消毒剂。

来源：经济学人