The Guardian view on the assisted dying debate:
a first hurdle cleared – many more lie ahead
MPs advanced the proposed bill. With ethical dilemmas and practical safeguards under scrutiny, challenges still remain unresolved
Fri 29 Nov 2024 18.30 GMT
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The Guardian view on the assisted dying debate: a first hurdle cleared – many more lie ahead
《卫报》对协助死亡争论的看法：第一个障碍已经清除——未来还有更多障碍
MPs advanced the proposed bill. With ethical dilemmas and practical safeguards under scrutiny, challenges still remain unresolved
议员们推进了拟议法案。由于道德困境和实际保障措施受到审查，挑战仍未解决
Fri 29 Nov 2024 18.30 GMT
2024 年 11 月 29 日星期五 18.30 GMT
On Friday, MPs voted to advance legislation on assisted dying in England and Wales, reflecting polling that shows widespread public support. However, a slim majority, of less than one-tenth of the House, should temper the confidence of its proponents. This is a profound, historic decision that demands careful consideration. Parliament was at its best in putting through the proposals to the next stage of deliberation. The debate was marked by sobriety and the welcome absence of partisan bickering. MPs approached the issue with humility, showing respect for every contribution, regardless of stance.
周五，议员投票通过了英格兰和威尔士协助死亡法案，民意调查显示公众对此表示广泛支持。然而，该法案仅以不到十分之一的微弱多数通过，这应该会削弱支持者的信心。这是一个意义深远的历史性决定，需要仔细考虑。议会尽最大努力将提案提交下一阶段审议。辩论以严肃和令人欣慰的无党派之争为标志。议员们以谦逊的态度处理这个问题，尊重每一份贡献，无论立场如何。
The central tension between individual autonomy and societal responsibility was clearly highlighted by the discussion. MPs were right to allow for further detailed scrutiny, debate and potential amendments to ensure the terminally ill adults (end of life) bill addresses both ethical concerns and practical safeguards effectively. The desire to alleviate suffering is deeply compelling. The legislation proposes allowing mentally competent adults with a terminal diagnosis and less than six months to live to seek medical assistance to end their lives. Safeguards include independent assessments by two doctors, high court approval and a 14-day reflection period. Once the criteria have been met, a doctor may prescribe a self-administered life-ending medication.
讨论中明确强调了个人自主权与社会责任之间的核心矛盾。议员们允许进一步详细审查、辩论和可能的修订，以确保《绝症成人（生命终结）法案》有效解决道德问题和实际保障措施，这是正确的。减轻痛苦的愿望是迫切的。该立法提议允许被诊断为绝症且生命不足六个月的精神健全的成年人寻求医疗援助以结束生命。保障措施包括两名医生的独立评估、高等法院的批准和 14 天的反思期。一旦满足标准，医生就可以开出自行服用的终止生命的药物。
Despite these measures, opponents highlight unresolved concerns. It is important, if these proposals do become law, to ensure that vulnerable people are protected, public trust in healthcare is maintained and societal values are upheld. This will only be helped by allowing MPs in parliament’s committee stage to take oral and written evidence, as in the case of government legislation. Many sceptical of the change rested their arguments on variable and inequitable NHS-funded care for those nearing death. Every year, more than half a million people die in the UK, making the quality of end-of-life care crucial for many and, eventually, for all of us. Those against the proposed change argue, with good reason, about the wisdom of having a conversation around dying that focuses on a small group – about 600 annually – who might opt for assisted dying if it were legal.
尽管采取了这些措施，反对者仍强调尚未解决的问题。如果这些提议成为法律，那么重要的是要确保弱势群体得到保护，维护公众对医疗保健的信任，维护社会价值观。只有允许议员在议会委员会阶段收集口头和书面证据，就像政府立法的情况一样，才能有助于实现这一点。许多对这一变化持怀疑态度的人将他们的论点建立在NHS 资助的濒死患者护理不稳定且不公平的基础上。每年，英国有超过 50 万人死亡，因此临终关怀的质量对许多人乃至我们所有人都至关重要。那些反对拟议变革的人有充分的理由认为，围绕死亡进行讨论是否明智，重点关注一小部分人——每年约 600 人——如果安乐死合法化，他们可能会选择安乐死。
Critics raise a good question: why does the debate focus disproportionately on the relatively few who might choose assisted dying, while neglecting the far greater number who suffer unnecessarily due to inadequate end-of-life care? It can only be answered substantially by ensuring that assisted dying proceeds in lockstep with universal coverage of palliative and end-of-life services, including hospice care at home.
批评者提出了一个很好的问题：为什么这场辩论过多地关注那些可能选择协助死亡的相对少数人，而忽视了更多因临终关怀不足而遭受不必要痛苦的人？只有确保协助死亡与姑息治疗和临终服务的全民覆盖同步进行，包括在家中提供临终关怀，才能从根本上回答这个问题。
Opposition to the bill also focused on the risk of coercion, particularly by relatives – pressure that can be difficult to detect. Currently, the Crown Prosecution Service weighs whether decisions in “mercy killings” are made independently and free from duress. Critics worry that legalising assisted dying might inadvertently enable such abuses.
反对该法案的人士还关注胁迫风险，尤其是来自亲属的压力——这种压力可能很难被发现。目前，皇家检察署正在衡量“安乐死”的决定是否是独立做出的，是否没有胁迫。批评者担心，安乐死合法化可能会无意中助长此类滥用行为。
Supporters of the proposed legislation are correct that it would be a necessary step forward. But the bill’s detractors are also right that its provisions are insufficient. This is not a procedural point about an act being passed via a private member’s bill brought forward by the Labour MP Kim Leadbeater. Many of the UK’s most important social reforms in recent years – abortion, the death penalty and divorce – took a similar route.
拟议立法的支持者认为这将是向前迈出的必要一步，这是正确的。但该法案的反对者也认为其条款不足。这不是关于一项法案通过由工党议员金·莱德比特 (Kim Leadbeater)提出的私人议员法案的程序问题。英国近年来许多最重要的社会改革——堕胎、死刑和离婚——都采取了类似的路线。
Impassioned speeches in the House revealed strong feelings on the issue. Some cited religious objections tied to the sanctity of life, while others warned of health inequalities, particularly for disabled people, that could have lethal consequences without stronger safeguards. The first assisted deaths are years away. Many other nations have wrestled with the moral dilemmas raised. The debate underscored the need for unity and effort to ensure any legislation is ethical, fair and protects society’s most vulnerable.
众议院的演讲激情洋溢，表达了对这一问题的强烈感受。一些人以生命神圣性为由反对宗教，而另一些人则警告称，如果没有更强有力的保障措施，健康不平等（尤其是对残疾人而言）可能会带来致命后果。首例协助死亡还需要数年时间。许多其他国家也一直在努力解决提出的道德困境。辩论强调，需要团结一致，共同努力，确保任何立法都合乎道德、公平，并保护社会最弱势群体。
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