Unit-5-TO-LIE-OR-NOT-TOLIE课文翻译大学英语四

Unit5TOLIEORNOTTOLIE—THEDOCTOR'SDILEMMASisselaBokIsiteverproperforamedicaldoctortolietohispatient?Shouldhetellapatientheisdying?Thesequestionsseemsimpleenough,butitisnotsosimpletogiveasatisfactoryanswertothem.Nowanewlightisshedonthem.Shoulddoctorseverlietobenefittheirpatients--tospeedrecoveryortoconcealtheapproachofdeath?Inmedicineasinlaw,government,andotherlinesofwork,therequirementsofhonestyoftenseemdwarfedbygreaterneeds:theneedtoshelterfrombrutalnewsortoupholdapromiseofsecrecy;toexposecorruptionortopromotethepublicinterest.Whatshoulddoctorssay,forexample,toa46-year-oldmancominginforaroutinephysicalcheckupjustbeforegoingonvacationwithhisfamilywho,thoughhefeelsinperfecthealth,isfoundtohaveaformofcancerthatwillcausehimtodiewithinsixmonths?Isitbesttotellhimthetruth?Ifheasks,shouldthedoctorsdenythatheisill,orminimizethegravityoftheillness?Shouldtheyatleastconcealthetruthuntilafterthefamilyvacation?Doctorsconfrontsuchchoicesoftenandurgently.Attimes,theyseeimportantreasonstolieforthepatient'sownsake;intheireyes,suchliesdiffersharplyfromself-servingones.Studiesshowthatmostdoctorssincerelybelievethattheseriouslyilldonotwanttoknowthetruthabouttheircondition,andthatinformingthemrisksdestroyingtheirhope,sothattheymayrecovermoreslowly,ordeterioratefaster,perhapsevencommitsuicide.Asonephysicianwrote:Oursisaprofessionwhichtraditionallyhasbeenguidedbyapreceptthattranscendsthevirtueofutteringthetruthfortruth'ssake,andthatis'asfaraspossibledonoharm.'Armedwithsuchaprecept,anumberofdoctorsmayslipintodeceptivepracticesthattheyassumewilldonoharmandmaywellhelptheirpatients.Theymayprescribeinnumerableplacebos,soundmoreencouragingthanthefactswarrant,anddistortgravenews,especiallytotheincurablyillandthedying.Buttheillusorynatureofthebenefitssuchdeceptionismeanttoproduceisnowcomingtobedocumented.Studiesshowthat,contrarytothebeliefofmanyphysicians,anoverwhelmingmajorityofpatientsdowanttobetoldthetruth,evenaboutgraveillness,andfeelbetrayedwhentheylearnthattheyhavebeenmisled.Wearealsolearningthattruthfulinformation,humanelyconveyed,helpspatientscopewithillness:helpsthemtoleratepainbetter,needlessmedicine,andevenrecoverfasteraftersurgery.Notonlydoliesnotprovidethehelphopedforbyadvocatesofbenevolentdeception;theyinvadetheautonomyofpatientsandrenderthemunabletomakeinformedchoicesconcerningtheirownhealth,includingthechoiceofwhethertobepatientinthefirstplace.Wearebecomingincreasinglyawareofallthatcanbefallpatientsinthecourseoftheirillnesswheninformationisdeniedordistorted.Dyingpatientsespecially--whoareeasiestomisleadandmostoftenkeptinthedark--canthennotmakedecisionsabouttheendoflife:aboutwhetherornottheyshouldenterahospital,orhavesurgery;aboutwhereandwithwhomtheyshouldspendtheirremainingtime;abouthowtheyshouldbringtheiraffairstoacloseandtakeleave.Liesalsodoharmtothosewhotellthem:harmtotheirintegrityand,inthelongrun,totheircredibility.Lieshurttheircolleaguesaswell.Thesuspicionofdeceitundercutstheworkofthemanydoctorswhoarescrupulouslyhoneswiththeirpatients;itcontributestothespiraloflawsuitsandofdefensivemedicine,andthusitinjures,inturn,theentiremedicalprofession.Sharpconflictsarenowarising.Patientsarelearningtopressforanswers.Patients'billsofrightsrequirethattheybeinformedabouttheirconditionandaboutalternativesfortreatment.Manydoctorsgotogreatlengthstoprovidesuchinformation.Yeteveninhospitalswiththemosteloquentbillofrights,believersinbenevolentdeceptioncontinuetheirage-oldpractices.Colleaguesmaydisapprovebutrefrainfromobjecting.Nursesmaybitterlyresenthavingtotakepart,dayafterday,indeceivingpatients,butfeelpowerlesstotakeastand.Thereisurgentneedtodebatethisissueopenly.Notonlyinmedicine,butinotherprofessionsaswell,practitionersmayfindthemselvesrepeatedlyindifficultywhereseriousconsequencesseemavoidableonlythroughdeception.Yetthepublichaseveryreasontobewaryofprofessionaldeception,forsuchpracticesarepeculiarlylikelytobecomedeeplyrooted,tospread,andtoerodetrust.Neitherinmedicine,norinlaw,government,orthesocialsciencescantherebecomfortintheoldsaying,Whatyoudon'tknowcan'thurtyou.撒谎还是不撒谎——医生的难题医生可以对病人撒谎吗?医生应该告诉病人他已经病入膏肓了吗?这些问题看起来很简单，但是要给出令人满意的回答却并不那么简单。这里给了他们一线光明。为了对病人有好处——为了加快病人康复或不让病人知道死亡的来临——医生到底该不该撒谎?医疗行业与法律、政府及其他行业一样，往往显得对诚实与否的问题不那么看重，要紧的倒是另外的一些事情，譬如，应设法避免可怕的消息造成的打击，或是应考虑恪守保密的诺言，或是需要揭露腐败行为或促进公众利益等。举例说吧。一个46岁的男子，在与家人外出度假之前进行常规体格检查，虽然他自我感觉良好，但医生发现他患了某种癌症，6个月内就会死去。这时，医生该怎么对他讲呢?是不是最好对他讲实话?要是他问起检查结果，医生该不该否认他得了病?该不该将病情的严重性缩小到最低限度?该不该将真情至少隐瞒到他全家度假之后?医生们常常面临这样的非常紧迫的选择。他们不时认为，为了病人自身的利益，撒谎很有必要，在他们看来，这种谎言与利己的谎言截然不同。研究结果表明，大多数医生深信身患重病的人不想知道他们的真实病情，如果将真情相告，则有可能使他们完全失去希望，结果使他们恢复得更慢或恶化得更快，甚至会自寻短见。正如一位内科医生写道：“我们这个职业，传统上恪守一条信条，那就是：'尽可能不造成伤害'，这一信条胜过为讲真话而讲真话的美德”。有了这样一个指导原则，一些医生可能渐渐习惯于采用他们认为对病人很可能有益而“无害”的骗人做法。他们可能开出无数帖安慰剂，说一些没有事实根据的打气的话，并歪曲严重的病情，对那些患有不治之症和濒临死亡的病人，则尤其如此。然而，现在开始有人提出证据，说明这种欺骗旨在给病人带来好处的说法是虚幻的。研究结果表明，与许多医生的想法相反，绝大多数病人确实想知道真实情况，甚至是严重的病情。当他们了解到医生没有对他们讲真话的时候，他们感到自己被玩弄了。我们还获悉，将真实情况妥当地告诉病人，能帮助他们与病魔作斗争，有助于他们更好地忍受疼痛，减少用药，甚至在手术后更快地康复。谎言不仅不能提供鼓吹“仁慈”欺骗的人们所希望的那种“帮助”，它还侵犯了病人的个人自由，使他们不能对有关自己健康的问题作出明达的选择，包括要不要就医这一首要的选择。我们越来越意识到，病人发病期间，在不知病情或未被如实地告知病情的情况下，他们会遭到什么样的