简·特纳 在辅助死亡辩论期间，大多数政客在一点上达成共识——姑息治疗改革刻不容缓。患者以及我们这些照护他们的人正在等待简·特纳是姑息治疗支持慈善机构Sue Ryder的首席护士 英国政府正在工党大会上讨论该国面临的最大挑战。但在演讲、宣布和头条新闻之中，不应忘记两周前从议会传出的最明确信息之一——我们的姑息治疗系统对太多人来说已不再适用。
Jane Turner During the assisted dying debate, most politicians agreed on one thing – palliative care reform is urgent. Patients and those of us who care for them are waiting Jane Turner is chief nurse at the palliative support charity Sue Ryder he UK government is discussing the country’s biggest challenges at the Labour party conference. But amid the speeches, announcements and headlines, it should not forget one of the clearest messages to emerge from parliament just two weeks ago– our palliative care system is not working for far too many people.
在整个辅助死亡辩论过程中，尽管议员们在核心问题上分歧深重，但往往在一点上达成一致——我们的姑息治疗系统急需修复。一些议员结合个人经历发言，讲述了亲属被迫在疼痛中等待数小时，或因缺乏适当支持而不得不去医院而无法留在自己家中的情况。
Throughout the assisted dying debate, MPs who disagreed deeply on the core issue, often agreed on one thing – our palliative care system urgently needs fixing. Some spoke from personal experience where they had seen relatives forced to wait hours in pain, or those who had to go to hospital instead of staying in their own homes because the right support wasn’t available.
他们提出担忧，指出来自较贫困背景的人更难以获得高质量的姑息治疗，并将该系统描述为“邮编彩票”——有些地区提供居家24小时专科支持，而在隔壁城镇，急诊科（A&E）却是唯一的选择。
They raised concerns that those from poorer backgrounds were more likely to struggle to access good quality palliative care and described the system as a “postcode lottery”, with some areas offering 24-hour specialist support in people’s homes, while in the next town over, A&E is the only option.
随着关注点转向会议季和下一组政治优先事项——包括一个使用时免费的新成人社会护理体系——这些担忧有被遗忘的危险。这绝不能发生。议员们在辅助死亡辩论中指出姑息治疗需要紧急改革是正确的；现在投票结束了，这种紧迫感不能就此消失。
As attention turns to conference season and the next set of political priorities – including a new system of adult social care free at the point of delivery – there is a danger these concerns are forgotten. That must not happen. MPs were right to say palliative care needs urgent reform during the assisted dying debate; that urgency can’t disappear now the vote is over.
Sue Ryder 我们在辅助死亡问题上持中立立场。但我们明确认为，每个人在需要时都应享有获得良好姑息治疗的权利。辩论往往被框架为在难以忍受的痛苦与辅助死亡这两个极端之间的非此即彼的选择。现实很少如此简单。
Sue Ryder we have a neutral stance on assisted dying. But we are clear that everyone deserves access to good palliative care when they need it. Too often, the debate is framed as a stark choice between unbearable suffering on one side and an assisted death on the other. The reality is rarely that simple.
当然，死亡并非易事。有些人会经历疼痛、呼吸困难、烦躁不安或其他令人痛苦的症状。当这种情况发生时，我们的责任是做出回应——运用我们所有的技能、专业知识和同情心，尽最大努力减轻痛苦。但关于辅助死亡的辩论中有一个令人担忧的现象：最困难的死亡往往被呈现为常态。
Of course, dying is not easy. Some people experience pain, breathlessness, restlessness or other distressing symptoms. When that happens, our responsibility is to respond – bringing all the skill, expertise and compassion we have to relieve suffering as best we can. But one troubling thing about the debate around assisted dying is that the most difficult deaths are often presented as if they are the norm.
当良好的照护可得时，死亡可以是一种更平静、更安详的体验：家人围坐在床边，握手、分享故事、在泪水中欢笑，充分利用剩余的时间。我们看到人们变得越来越疲惫。他们睡得更多、吃得更少，随着身体开始自然的死亡过程，逐渐对周围世界的感知减弱。我们有时会看到恐惧，但这并不总是对疼痛的恐惧。更多时候，是对留下亲人的恐惧。我们看到人们需要关于未来的诚实对话。需要尊严、同情、专业照护，以及有人会一直陪伴支持他们和他们所爱之人的信心。
When good care is available, dying can be a calmer, more peaceful experience: families gathering around bedsides, holding hands, sharing stories, laughing through tears and making the most of whatever time remains. We see people becoming increasingly tired. They sleep more and eat less, gradually becoming less aware of the world around them as their bodies begin the natural process of dying. We sometimes see fear, but it is not always fear of pain. More often, it is the fear of leaving loved ones behind. We see people who need honest conversations about what lies ahead. People who need dignity, compassion, expert care and the confidence that someone will be there to support them and those they love.
我理解痛苦故事为何有如此强大的冲击力。它们本该如此。没有人愿意看到另一个人类身处疼痛或痛苦之中。即使有最优质的照护，有些死亡依然可能很艰难。但事实上，我们见证的最大痛苦往往不是身体上的。是不确定性。可能是孤独。是因为回家所需的支持未能及时安排，而不得不在拥挤的病房度过宝贵的最后时光。是家人因在复杂的体系中奔波而精疲力竭，而他们本应专注于共度时光。
I understand why stories of suffering have such a powerful impact. They should. Nobody wants to see another human being in pain or distress. And even with the best quality care, some deaths can be difficult. But in truth, some of the greatest suffering we witness is not physical. It is uncertainty. It can be loneliness. It is spending precious final days in a crowded hospital ward because the support needed to get someone home has not been arranged in time. It is families exhausted from navigating a complex system when they should be focused on time together.
这就是为什么关于安乐死的讨论现在必须伴随着一场同样紧迫的讨论，即人们在生命最后几周和几个月如何生活。善终很少由最后一个行动来定义，而取决于某人是否感到安全、舒适和被倾听。这关乎在正确的地点（通常是家中）获得正确的照护，并确保没有人在面对生命终点时感到恐惧、无助或孤单。
That is why the conversation about assisted dying must now be matched by an equally urgent conversation about how people live in their final weeks and months. A good death is rarely defined by one final act, but by whether someone feels safe, comfortable and listened to. It is about having the right care, in the right place, which is often at home, and ensuring nobody faces the end of life feeling frightened, unsupported or alone. Whatever your view on assisted dying, decent palliative care should be non-negotiable.
无论你对安乐死持何种观点，体面的姑息照护都不应成为妥协的筹码。
My perspective comes from standing at the bedsides of dying people for years and supporting the families who love them. Working with our partners within healthcare, we want to build a palliative and end-of-life care system that can keep pace with growing demand and give everyone access the care they deserve.
我的观点源于多年守护在垂死者床边、支持他们亲人的经历。通过与医疗体系内的合作伙伴共同努力，我们希望建立一个能跟上不断增长需求、让每个人都能获得应得照护的姑息与临终关怀体系。跳过一连串的时事通讯推广我们需要在人们最需要的地方投资姑息和临终关怀。这意味着医院需要提供更好的姑息照护。
My perspective comes from standing at the bedsides of dying people for years and supporting the families who love them. Working with our partners within healthcare, we want to build a palliative and end-of-life care system that can keep pace with growing demand and give everyone access the care they deserve. skip past newsletter promotion after newsletter promotion We need to invest in palliative and end-of-life care where people need it most. That means better palliative care in hospitals.
我们还需要社区具备正确的专业知识，以避免不必要且令人痛苦的住院治疗。这意味着要通过增加居家临终关怀服务来扩大社区照护，让更多人能在亲人环绕下在自己的家中接受照护。这也意味着要确保人们在需要时能获得专业支持，而不是由他们的邮政编码或生病的时间决定。
We also need the right expertise in the community to avoid unnecessary and distressing hospital admissions. And that means expanding care in the community with increased hospice-at-home services so more people can be cared for in their own homes, surrounded by the people they love. And it means making sure specialist support is available when people need it, not determined by their postcode or the time of day they become unwell.
这些不是生命终点的可选附加项。它们是医疗保健的基本组成部分，应该人人可及。
These are not optional extras at the end of life. They are essential components of healthcare, and they should be available to everyone.
工党议员齐聚大会，部长们有机会表明改善姑息照护不仅仅是一场激烈辩论中提出的谈资。解决辩论凸显出的不平等问题的责任才刚刚开始。安乐死投票可能已尘埃落定，但姑息照护危机远未结束。
Labour MPs gather at conference, ministers have an opportunity to show that improving palliative care is more than a talking point raised during a contentious debate. The responsibility to tackle the inequalities the debate brought into sharp focus has only just begun. The assisted dying vote may be over. The palliative care crisis is not.