UDorothy Guellec
Ngoba
Ngaba imigaqo ekudala ikho yenkqubo yethu yokhathalelo lwempilo isongelwa ngequbuliso?
Mhlawumbi yonke into imalunga nemali, okanye ngaba kunjalo? I-HMO sele ikhuthaza oogqirha ukuba bayigcine
iindleko eziphantsi, usebenzisa indibaniselwano yemivuzo yemali okanye izohlwayo, ezidala
ngokoluvo lwam ungquzulwano olucacileyo lomdla phakathi koogqirha nabanye
izigulane. Emva kwesigqibo seNkundla ePhakamileyo ngo-1997 amazwe athatha
ngokwabo ukutshintsha umhlaba re: ngokusemthethweni ukuzibulala ugqirha-uncedo. Ngaba
kuyenzeka nje ukuba urhulumente wokuqala avume inkqubo ecacileyo
unikezelo lwezempilo lukwangumbuso wokuqala ukuvuma ukuncediswa ngugqirha
ukuzibulala? Mhlawumbi kunesibindi kwaye kungekhona ngengozi, kodwa kwangaxeshanye, kunjalo
umdla ukufumana umthetho wokuqala wanceda ukuzibulala ngokucacileyo
ichasene “nenkqubo yokuqala evunyiweyo elubala yokhathalelo lwempilo
umlinganiselo.” Bendithetha ngeOregon. Ugqirha uncedise ekuvoteni ukuzibulala
inyathelo eMaine alivunywanga.
A
uphononongo luza kupapashwa kungekudala kwi-JAMA (Ijenali ye-American Medical Association)
ibonisa ukuba umdla euthanasia kunye PAS (ugqirha wanceda ukuzibulala) phakathi
Izigulana eziswelekayo zihlala zinxulumene noxinzelelo lwengqondo kunomzimba
iimpawu. Olu phononongo lwenziwe ngenkxaso-mali yabucala evela kwiNgxowa-mali yeCommonwealth
kunye neNathan Cummings Foundation. Ngokophononongo malunga nesinye kwishumi
izigulana ezigulela ukufa zathi zicingisise nzulu ukusebenzisa uncedo lukagqirha
ukuzibulala okanye ukubulawa kwabantu ukuze babulale ubomi babo, kwaye “inxalenye nje yezi
bazama ukwenza ngokweengcamango zabo.” Iziphumo zibonisa ukuba nangona kunjalo
ingxoxo yoluntu ehlawuliswa kakhulu ejikeleze i-PAS kunye ne-euthanasia, uninzi lwe
izigulane eziswelekayo aziyi kucingela olu khetho ngokwazo. Njengoko ndabonisa
kwiNgxelo yangaphambili abantu abaninzi batshintsha iingqondo zabo kwaye oku kwaqinisekiswa
kuphononongo lweCommonwealth/Cummings. Uphando luvavanyo lokuqala olukhulu
Izimo zengqondo zabaguli abagulela ukufa malunga noncedo lokuzibulala kunye ne-euthanasia.
Ababhali besi sifundo balumkisa oogqirha abafumana izicelo ze-euthanasia
okanye i-PAS ukucinga kuqala malunga nokudakumba kunye "nolunye uxinzelelo lwengqondo."
Nini
Ndaqalisa ukuphanda unyaka wokuqala kaOregon kunye nebango elithi “akukho kuxhatshazwa
zazixeliwe” impendulo yam ezenzekelayo yathi “Wow! Akukho kudlala?" Angeke
Ingqondo eqhelekileyo iyalela ukhathalelo olukhulu ngabacebisi ukuba babeke unyawo lwabo olungcono
phambili, ukukhetha njengabagqatswa be-PAS abo banokuphumelela ngokulula esidlangalaleni
ukuhlola? Ngaba nawuphi na ugqirha uya kuba sisidenge ngokwaneleyo ukuba aqhubele phambili aze avume
ukwaphula umthetho? Kuba akukho mfuneko yomthetho ukuba ukuxhatshazwa makubekho
kuxelwe ngoogqirha okanye abantu abaqhelekileyo, okanye inkuthazo eyomeleleyo yokwenza oko, kutheni sifanele
ulindele ukuva ngabo?
The
ingxoxo malunga nezikhokelo iyaqhubeka ngaphandle kwesisombululo. ENetherlands apho
euthanasia kunye nogqirha wanceda ukuzibulala izikhokelo decriminalized zaba
kusekwe kodwa kuncinci kakhulu kunokufundwa kumava amaDatshi. Amandla
nokuba semthethweni kwezikhokelo zabo kuyathandabuzeka. Oogqirha abaninzi abalandeli
Izikhokelo kunye nezinga eliphezulu lokungathotyelwa zixeliwe. Oku kuya kuba
ezahlukeneyo Ndiqinisekile ukuba umkhuba esemthethweni ngokupheleleyo. Mhlawumbi awona ngqwabalala
izityholo iinzame zokwakha izikhokelo livela Callahan kunye White ngubani
gxotha zonke iinzame zokwakha izikhokelo njenge “façade yolawulo entsonkothileyo
ukufihla intlupheko yokubanakho ukunyanzeliswa kokwenyani. " Esona sizathu siphambili
ucinga ukuba ithambeka elijikeleze ukuzibulala ngenxa yoncedo lukagqirha linokuba mtyibilizi kakhulu
nangenxa yezikhokelo ezenziwe ngononophelo, kukuba ukucingelwa ngasemva
izikhokelo ngokwemvelo zimtyibilizi ngeendlela ezingenamlinganiselo wolawulo
ukuchaneka kunokulungisa. Ubudlelwane besigulane sikaGqirha bubucala kwaye bungcwele kwaye
ayinakubekwa esweni, kwaye into engenako ukumodareyithwa ayinakulawulwa. Callahan
kunye noMhlophe banzima kakhulu kumaphepha abo amade (83) e-Univ. yoMthetho waseRichmond
inqaku elithi “Ukugunyaziswa ngokusemthethweni koGqirha baNcedisa ukuzibulala: Ukudala iRegulatory
Ilali yasePotemkin.” Isihloko sithetha ukuba i-façade iya kumiswa nge
imimiselo kunye nezikhokelo, kodwa emva kwe-façade okanye inkohliso yommiselo
bekungayi kubakho nto kwaphela.
Mhlawumbi
I-PAS (ugqirha wancedisa ukuzibulala) akunjalo, njengoko abaninzi bathanda ukuyibeka, ngokulula a
ulwandiso olunengqiqo lomsebenzi kagqirha wokuphelisa iintlungu nokubandezeleka, i
Isibophelelo esidala kwisambatho esitsha. Mhlawumbi i-PAS ibhenela kwabo kufuneka bangene
ulawulo. Kunokuthi kuvele ukuba ukutya kwesi sinyanzeliso solawulo kumela
ukuxhatshazwa okukhulu kunokusilela ukuthobela umthetho. Isifundo kwiNtsha
England Journal of Medicine (Februwari 24, 2000) malunga namava oogqirha
kunye ne-Oregon Death with Dignity Act yabonisa ukuba i-46% "yabaguli
ekwenzelwe bona ungenelelo olumandla, batshintsha iingqondo zabo malunga nokuncediswa
ukuzibulala.” Isiphelo kunye neenkcukacha zibonisa ukuba e-Oregon oogqirha banika
malunga ne-1 kwizicelo ze-6 zomyalelo weyeza elibulalayo kunye nokuba i-1 phakathi
I-10 iphelela ekuzibulaleni. Ungenelelo loncedo olumandla (iintlungu
relieving) ikhokelele abanye - kodwa hayi bonke - abaguli ukuba batshintshe iingqondo zabo.
Society
kunye namajelo eendaba agxile ikakhulu kukubaluleka kokuzimela geqe kwi
umxholo "welungelo lokufa", ingqalelo encinci ihlawulwe
iinzame ngaxeshanye zokungahoyi ukuzimela xa umntu ofayo okanye okhubazekileyo efuna
ukukhathalelwa ukuba ii-bioethicists, iintanda-bulumko zokuziphatha, oogqirha, kwaye ngaphezu kwayo yonke inkathalo elawulwayo
abaphathi beinshorensi yezempilo bayibona “njengelize”. I-Futile Care Theory ihamba into
ndiyayithanda lento. Xa umguli efikelela “kwinqanaba elichazwe kwangaphambili lokugula, okanye
ukwenzakala, naluphi na unyango olulolunye ngaphandle kokhathalelo lokuthuthuzela luya kuthathwa
"ilize" kwaye ke ngoko iya kubanjwa, nokuba ithini na iminqweno ye
isigulana okanye usapho.” Imilinganiselo yobuqu kunye nokuziphatha komguli akukho
ixesha elide elifanelekileyo. Isiphelo sebali, kwaye rhoqo, isiphelo sobomi. Oogqirha kufuneka babeke i
imidla yezigulana ngaphezu koqwalaselo lweendleko zabahlawuli beqela lesithathu okanye
inzuzo yabo yemali.
In
incwadi yakhe entsha ethi, “Inkcubeko yokufa: uHlaselo lweNdlela yokuziphatha kwezonyango
America” (inikezelwe kuRalph Nader) UWesley J. Smith unikela amaphepha amaninzi kuyo
I-Futile Care Theory kunye neziphumo zayo .Uthi iimpembelelo ezinzulu
umlinganiselo “kwatyhilwa ngowe-1994 nguRobert M. Vearch, owabhalayo
Ngokucacileyo, 'ixesha lokwahlulwa kwezempilo lifikile kuthi!' Wabongoza
ulwabiwo ngohlahlo-lwabiwo mali lwehlabathi apho umlawuli wesicwangciso sezempilo sikarhulumente,
isibhedlele, isebe elithile lesibhedlele, okanye umbutho wokunyamekela impilo
uya kunikwa imfumba yemali emiselweyo. Isixa-mali besingayi kwanela umntu ngamnye
ugqirha ukwenza yonke into kwisigulane ngasinye. Yayiza kwabiwa njani le mali?
“Nguluntu,” olukhokelwa “zizithethe zonqulo nezentanda-bulumko”
– ngamanye amazwi ngabakwaBioethicists. Ingozi yokuqala iya kuba yiHippocratic
I-Ethic, leyo yena (uRobert M. Veatch) asibongoza ukuba siyilahle kuba “ichaza
owona mgaqo ungundoqo ungundoqo wokuba ugqirha ngamnye ufanele azuze
umguli ngokwamandla nesigqibo sikagqirha.” Ingaba unga
uthembe ugqirha ngobomi bakho? Cinga ngale nto ngononophelo kakhulu kwi
ukukhanya kweFutile Care Theory.
Do
abantu abadala banoxanduva lokufa ngenxa yemali kunye nomthwalo weemvakalelo
ukunyamekela abalupheleyo, abaneziphene nabagula kakhulu? Inkulumbuso igqwetha
"umsebenzi wokufa" ngunjingalwazi wefilosofi yeYunivesithi yase-East Tennessee, uJohn
Hardwig. Hardwig uthatha "ukuchithwa kwesithethe seHippocratic ku
inqanaba elitsha, liqinisekisa ukuba ngamanye amaxesha yinto yokuziphatha kugqirha
ukuncama umdla wezigulane zakhe kwezo ze
abangaguliyo—ngokukodwa kwabo bamanye amalungu entsapho.” Kwi
uluvo lwam oluthobekileyo UJohn Hardwig yicanon ekhululekileyo, umntu oyingozi kakhulu
uyala ukubona ukuba ingxaki imalunga nemali, kwaye asihlali kuyo
ilizwe elingenabuntu.
inye
ugqirha wabhala kwi-lister “Isizathu sokuba ndingabi nancwadi yelifa okanye nayiphi na
Olunye uxwebhu kukuba ndikholelwa ukuba umoya uguqukele kwicala elingelilo. I
kholelwa ukuba maninzi amathuba okuba eli phepha lindivise ubuhlungu (buphelise ubomi bam
phambi kwexesha) ndincede ke. Ewe ndinethamsanqa lokuba nabantu abanothando
ecaleni kwam. Ii-HMO kunye nabanye basebenzisa elo phepha njengebhajethi. Zingaphi
kuthi sinethamsanqa njengala gqirha? Yeyiphi imiba emikhulu yoluntu
ubandakanyeka xa kungqubana imali kunye nolwabiwo lwezempilo?