英文自修83：病危知情权与教牧陪伴
本系列内容英文原文取自BBC Thought for the Day节目网站，朋友们也可以下载节目录音收听。
译者：默谦
审读：武太白
------------------------
Thought for the Day - 20140519 - Clifford Longley
It was Benjamin Franklin who said nothing is more certain in life than death and taxes. But talking about death remains a major taboo. That is one likely explanation of the revelation, in a new report from the Royal College of Physicians, that fewer than half the patients in NHS hospitals who were known to be dying, were told the truth.
本杰明•富兰克林说，死亡和税收是人生无法避免的两件大事。但是谈论死亡仍然是一个大禁忌。这也许就能解释皇家医学院的一份新报告所指出的事实：在英国国家医疗服务系统的医院里，少于半数病危的病人知道真相。
Surveys also tell us that the great majority of people say they would rather know than not know. But it's very personal, and requires doctors to overcome the emotional distance that they normally like to keep between themselves and their patients. Many of them haven't been trained to handle it. So understandably they shy away from it.
调查也告诉我们，很大一部分人说他们宁愿知道真相。但这是非常个人的事情，而且需要医生克服正常情况下与病人之间保持的情感距离。许多人没有受过处理这种情况的训练，因此他们对此的回避可以理解。
But in that case why are we neglecting one major resource that could help hospital staff cope with this? Under pressure to save money, many hospital trusts have been cutting back on chaplains. The Royal College report does call for "adequately staffed and accessible pastoral care, to ensure that the spiritual needs of dying patients and those close to them are met". But that's the only place in their report where this issue breaks through. In any case the phrase "spiritual needs" sounds very narrow. What chaplains do is much broader than that.
但这种情况下我们为什么忽视了一个能帮助医护人员应付这种情况的好办法呢？处在节省资金的压力之下，许多医院信托在削减牧师的数量。皇家医学院的报告确实在呼吁“配备足够的工作人员，有途径提供教牧关怀，以此保证临终病人和守在他们身边的人的精神需要得到满足”。但在他们的报告中只有一个地方提了这一事项。不管怎样“精神需要”这个词听起来太狭小，牧师能够做的远甚于此。
Above all they can improve communications with patients and relatives. The report says that across the healthcare system, communication with dying patients is generally poor. Communication is not just about "telling" but also about "listening", and chaplains are skilled listeners. In doing so they can soak up some of the stress and suffering that dying patients and their relatives are going through, take it away from the bedside and dump it elsewhere.
首先他们能改善病人和亲属之间的沟通。报告指出在医疗保健体系里，和临终病人的交流普遍不理想。交流并非只是“讲述”，更是“倾听”，而且牧师都是娴熟的倾听者。这样做他们迅速地了解临终病人和他们的亲人所承受的压力和痛苦，把它从枕畔带走，然后倾倒在别处。
Dump it on God, you could say. Chaplains work across denominations and chaplaincy teams nowadays are mixed, but they can provide moral, emotional and spiritual support for each other so the job doesn't get on top of them. And they have their own religious life, through study, worship and prayer, to help them keep a balance. It's that quality of spiritual toughness and their desire to show God's compassion which is where their religious affiliation is relevant to their work, not in trying to make deathbed converts.
你可以说，把它倾倒给上帝。牧师在不同的教派间穿梭，而且如今的牧师队伍也是形形色色，但他们能为彼此提供道德、情感和精神上的支持，因此这份工作并不会令他们受损伤。他们拥有自己的宗教生活，通过学习、礼拜和祈祷来帮助他们保持平衡。精神韧性和他们想展示上帝慈悲的愿望是他们宗教的紧密联系所在，他们的工作正是与这一点相关，并非努力使临终病人皈依到自己的教派。
Most of their work, they tell us, is with people of other faiths than their own, or none at all, and no part of their work involves evangelising or proselytising. A survey in Sweden showed that less than ten per cent of the conversations that hospital chaplains have, are about religion. They are mainly with people reaching the end, who are trying to make sense of their lives and of what is now happening to them. But if they've not been told what that is, they are being denied that opportunity. They surely have a right to it.
他们告诉我们，他们大部分的工作是和其他信仰的人打交道，数量多于同教派的人，或者根本不接触同教派的人。而且他们的工作没有一点是和传教或者是使别人改变宗教信仰相关的。瑞典的一个调查显示，医院牧师进行的和宗教相关的谈话不到百分之十。交谈主要和走到生命终点的人相关，这些人努力想要明白生命的意义，想要了解正发生在自己身上的事。但如果他们从不知道死亡将至，那么他们就失去了这个机会。无疑，他们有这样的权利。