大渐弥留的混沌之态:评《生死有时》一书

The Chaotic Uncertainties of Death and Dying:A Review of And a Time to Die

在人类命运共同体遭受一场前所未有的大疫威胁之际,上海教育出版社及时地推出了《生死有时》一书。尽管其副标题发问的要点是“美国医院如何型塑死亡”,但这个问题的尖锐性指向几乎是所有的重症医学实践。大疫将人之死的个体性纳入到一个疾病全球化的视野,《生死有时》并没有讨论重大公共卫生危机导致的世界性灾难,然而也能让我们联想到一个存在主义意义的危机问题。那就是大渐弥留的混沌之态。在此书中,涉及生命末端期的混沌问题包括:尊严死何以可能?旨在尊重患者主体性的生前预嘱是否可行?针对重症患者的医疗措施应该何时从常规治疗过渡到临终关怀?

At a time when the community of human destiny is threatened by an unprecedented pandemic,the Shanghai Education Publishing House has launched the book And a Time to Die in a timely manner.Although the main point of its subtitle is"How American Hospitals Mold Death",the sharpness of the question points to almost all critical care medical practices.The pandemic brings the individuality of human death into a global vision of disease.This book does not discuss the worldwide catastrophe caused by major public health crises,but it does remind us of an existential crisis problem.That is the state of chaos in dying.In this book,the chaotic wonders that deal with the end of life include:How is death with dignity possible?Are living wills designed to respect the subjectivity of the patient feasible?When should medical treatments for critically-ill patients shift from routine treatment to hospice care?