一位著名医生提出了一个“最令人不寒而栗”的建议：如果痴呆症或退行性疾病患者没有自理能力，医生有权结束他们的生命 [英国媒体]

Doctors could be allowed to end the lives of patients with dementia or other degenerative diseases if they can't feed themselves, as one brands medics' proposals 'the most chilling thing she's ever heard’

一位着名医生提出了一个“最令人不寒而栗”的建议：如果痴呆症或退行性疾病患者没有自理能力，医生有权结束他们的生命。

The proposals mean patients who could otherwise survive years would die

这个建议意味着一个还能活很多年的病人会死亡

Removal of tubes mean an incapacitated patient will die of thirst and starvation

拔了管子意味着一个瘫痪病人会被渴死饿死。

● Sian Vasey who has spinal muscular atrophy now worries about going to hospital

Sian Vasey是一位脊髓肌肉萎缩症患者，她现在不敢去医院。
【日期】2018年8月13日

Doctors will be able to decide to end the lives of patients with severe dementia or other degenerative diseases if proposals from their own leaders are adopted.

如果主治医生的建议被采纳，医生将有权决定是否结束严重痴呆或其他退化性疾病患者的生命。

The guidelines say consultants or GPs should be allowed to remove tubes giving food and water to those who cannot feed themselves – even if they could otherwise live for years.

主要意思是，如果没有自理的能力，不管能活多少年，医疗顾问和社区医生有权撤掉鼻饲管和氧气管。

The British Medical Association proposals mean patients who could otherwise have survived for years may have their lives ended by the withdrawal of nutrition and hydration tubes.

英国医学协会的提议意味着，就算病人还能多活几年，也有可能因撤掉鼻饲管饿死渴死。

However, the British Medical Association proposal to withdraw nutrition and hydration tubes was condemned as 'euthanasia by stealth' yesterday.

然而昨天，英国医学协会提出的撤掉提供食物和水管的提议被谴责，认为这是“暗中实行安乐死”。

BMA officials produced the proposals in response to legal test cases in which judges ruled that NHS staff and officials no longer need a court's permission to withdraw artificial nutrition and hydration from a patient who is incapacitated and unable to speak or feed themselves.

对于不能说话和自理的病人，法院规定英国医疗服务工作人员不需要法院许可，就可以撤掉其辅助食物和水。英国医学协会提出了这些建议作为该项条目的回应



Doctors could end the lives of patients with severe dementia and other degenerative diseases (stock)
Last month, Supreme Court justices endorsed the right of doctors to remove 'clinically-assisted artificial nutrition and hydration' on their own authority with the agreement of a patient's family.

上个月，最高法院批准医生有权在患者家属的同意的前提下，取消临床人工营养及水分设备的提供。

Removal of the tubes means that an incapacitated patient will die of thirst and starvation after a short period.

撤下管子意味着无自理能力的病人短时间内有可能饿死或渴死。



It added: 'Due to the degenerative nature of their condition, these patients are on an expected downward trajectory and will inevitably die, usually as a result of their underlying condition, although perhaps not imminently and could, potentially, go on living for many years.’

它还补充道：“由于其退行性性质的病症特点，这些病人的病是慢性的、潜在的、也许还能活上几年。但是身体状况每况愈下，直达到最恶劣的情况，最终结果是死亡。”

Stroke patients and those with 'rapidly progressing brain injury' could also be included.

也包括中风患者和“快速进展性脑损伤”患者。



Guidelines say consultants or GPs should be allowed to remove tubes giving food and water to those who cannot feed themselves (stock)
Decisions on removing nutrition and hydration tubes should be taken by consultants for hospital patients, or GPs for those in nursing or residential homes or living in their own homes.

撤掉鼻饲管的决定权在于住院病人的健康顾问，或者是福利院和提供在家治疗的社区医生。

However, families or friends should be consulted, usually through 'best interests meetings' set up to decide whether it would be better for a patient to live or die.

但也要征询家人和朋友的建议，通常是通过“最优会议”来决定病人是生还是死。

But doctors and campaigners opposed to euthanasia and the deliberate termination of life by medical staff criticised the suggestion last night.

昨晚，反对安乐死和故意终止医疗的医生和社会活动者们反对该项建议。



'It facilitates the extension of end-of-life pathways to people with neurological diseases who are not dying, which is a very negative thing because there are a lot of disabled neurological patients.

该项建议延长了还未死亡的神经系统疾病患者的死亡过程。因为神经性瘫痪病人的数量很多，这件事带的影响非常消极。

'It perpetuates the myth of 'best interests', which has been shown to be erroneous and reflective of members' views and not of the real best interests of the patients.’

这是不对的，所谓的“最优利益”是其他人的想法，而不是病人本身的意愿，这条建议只是延续了“最优利益”的神话，

The BMA paper says that in cases where patients die after the withdrawal of nutritition and hydration tubes, this should not be mentioned on death certificates. Instead only the underlying original condition should be given.

根据英国医疗协会文件内容，死亡证明不会提及病人其实是死于食物和水的短缺，相反，只会给出最初的病因。

Professor Pullicino said this 'directs doctors to falsify death certificates. It tells doctors to put down the pre-existing condition and not that they died of dehydration. It will totally conceal the statistics of patients who are being dehydrated to death.’

Pullicino教授说，这是指导医生伪造死亡证明。这项建议怂恿医生忽视目前存在的病症，说他们不是死于饥饿和脱水。这将完全隐瞒脱水死亡患者的数据。



Doctors are told that to decide whether a patient's best interests lie in living or dying and should consider the chances that a condition could improve
Doctors are told that to decide whether a patient's best interests lie in living or dying they should consider the chances that their condition will improve, what their quality of life is, and what their views on whether they wish to live on in their condition are likely to be.

医生被告知要去决定病人最好的选择，生存还是死亡。他们能应当考虑目前情况能否改善，生活质量能否提高，在当前身体状况下是否愿意继续维持生命。

Friends and family should be consulted, the document said, but should not have the final decision.

文件说，要征求家人朋友的建议，但是不要因此做出最后决定。

The test case decision that first allowed doctors to decide their patients should die was made by the Law Lords in 1993.

在1993年，上议院高级法官首次决定，允许医生决定病人生死。

They said 22-year-old Tony Bland, a Liverpool football supporter who suffered severe brain damage in the crush at Hillsborough football stadium in April 1989, should be allowed to die.

据称，22岁的利物浦足球球迷托尼·布兰德，在1989年4月在希尔斯堡足球场遭受严重脑损伤，应被允许死亡。

The landmark Bland ruling set down that artificial nutrition and hydration by tube are not normal feeding but medical treatment. It also said that it might not be in a patient's best interests to be treated, and if medical treatment is not in the best interests of a patient who cannot speak for themselves, it can be stopped.

布兰德裁定具有里程碑的意义，认为使用软管人工提供营养和水分不是普通喂食，而是医疗措施。他还说，医疗可能不符合病人的最优利益，并且如果医疗措施不符合无法说话的病人的最大利益，那么就能够停止治疗。



A spokesman for the BMA said decisions surrounding the withdrawal of clinically-assisted nutrition and hydration (CANH) presented 'clinical, ethical and legal challenges’.

英国医疗协会发言人称，围绕撤除临床辅助营养水分（CANH）的决定，是对“医院、伦理、法律”的挑战。

He added: 'Following a number of legal developments, the BMA has been working with the Royal College of Physicians and the General Medical Council to produce guidance on best practice for health professionals when facing decisions about CANH.

他补充道：“随着法律的与时俱进，英国医疗协会一直与皇家医师学院和综合医学委员会保持合作，以求面对有关CANH的决定是，为专业医护人员提供最佳指导。”

'CANH is a form of medical treatment. The aim of medical treatment is not simply to prolong life at all costs, and the courts have been clear that in some circumstances it will not be in the best interests of the individual patients to receive it.

CANH是一项治疗措施。医疗的目的并不是不惜一切代价的延长生命，法院已经明确指出，在某些情况下，接受治疗不符合患者的最优利益。

'Those making these decisions must do so in full dialogue with families to determine what is right for the individual patient, and of course, when there is any disagreement the court still has an important role to play.

做这些决定必须与家属充分沟通，来为个别患者做决定。当然，如果有不同意见，可以去法院对峙。

'We shared the draft guidance in confidence with legal and health professionals and organisations and patient support groups to seek their views. The final version will reflect last month's Supreme Court judgment when it is published this year.'

我们征求法律卫生专业人员、机构、病人支持组织的意见，共同秘密起草这项规定。最终版本将反映上个月最高法院今年公布的结果。

It's the most chilling thing I've ever heard

这是我听过最令人不寒而栗的事情了。



Sian Vasey, 62, (pictured) described the British medical councils
plans as the most chilling thing she's ever heard

Sian Vasey, who suffers from spinal muscular atrophy, yesterday described the BMA plans as 'the most chilling thing I have ever heard’.

Sian Vasey患有脊髓肌肉萎缩症，昨天她称英国医疗协会的这项计划是“我听过最令人不寒而栗的建议”。

Miss Vasey said: 'If I reach the point where I can't eat, drink or talk then I am in trouble.

Vasey女士说：“如果我到了不能靠自己吃饭、喝水、说话的地步，那就麻烦了。”

'It is already the case that I can't feed myself.

目前我已经无法自理了。

If the talk goes I would have to rely on somebody to speak for me. It's a nightmare.

如果到了靠别人替我说话的地步，那真是噩梦。

'I worry about what will happen if I have to go into hospital. Often people are admitted to hospital unable to speak or move, but they get better.

我担心如果有一天我不得不去医院，那将会发生什么。通常人们被送往医院都不能说话不能动了，但是他们会缓过来。

'Under these rules many will not have a chance to get better.’

根据这些规定，很多人都没有接受治疗的机会了。



Miss Vasey, who campaigns on behalf of the disability group Not Dead Yet, is among disabled people who would like to be able to write a living will requesting that she continue to be treated should she be admitted to hospital unable to speak for herself.

Vasey女士是“现在还不想死”的残疾人团体代表，现在这些残疾人希望立个生前遗嘱，让她继续去医院接受治疗，尽管该医院不愿意为其发声。

However, the only living wills which have legal force and which doctors must abide by are those which require medical staff to withdraw treatment.

然而，唯一一个拥有法律效力，医生必须遵守的的请愿书，是那些医护人员要求放弃治疗建议。

Under the law, hydration and nutrition provided to incapacitated patients by tube counts not as basic care, but as medical treatment.

在这个法律条款下，提供水和营养并不是无自理能力病人的基本护理，反而成为了医疗措施。